CLOVERFIELDS FOUNDATION: Form 990PF, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CLOVERFIELDS FOUNDATION (EIN 20-1919362)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-11
- IRS object ID
- 201323169349100292
- 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
- Schedule B
- Accounting Fees Schedule
- Expenditure Responsibility Stmt
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-11T10:00:16-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410223337 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DORSEY & WHITNEY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 S 6TH ST STE 1500 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | 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 | 201919362 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLOVERFIELDS FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CLOV | NameControl |
| Phone | 6124926440 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O DEAN BARR 50 SOUTH 6TH STREET | AddressLine1 |
| Address Line2 | NO 1500 | AddressLine2 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554021498 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEPHEN J HEMSLEY | Name |
| Title | PRESIDENT, TREAS & DIR | Title |
| Phone | 6124926440 | Phone |
| Date Signed | 2013-11-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEAN D BARR | Name |
| PTIN | P00005626 | PTIN |
| Phone | 6123402600 | Phone |
| 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 | 18964846 | FMVAssetsEOY |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Received Rev And Expnss | 495000 | ContriReceivedRevAndExpnss |
| Dividends Rev And Expnss | 282701 | DividendsRevAndExpnss |
| Dividends Net Invst Incm | 282701 | DividendsNetInvstIncm |
| Net Gain Sale Assets Rev And Expnss | 2252911 | NetGainSaleAssetsRevAndExpnss |
| Gross Sales Price | 5446067 | GrossSalesPrice |
| Capital Gain Net Incm Net Invst Incm | 2252911 | CapitalGainNetIncmNetInvstIncm |
| Total Revenue And Expenses | 3030612 | TotalRevenueAndExpenses |
| Total Net Investment Income | 2535612 | 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 | 9000 | AccountingFeesRevAndExpnss |
| Accounting Fees Net Invst Incm | 0 | AccountingFeesNetInvstIncm |
| Accounting Fees Dsbrs Chrtbl Prps | 0 | AccountingFeesDsbrsChrtblPrps |
| Other Prof Fees Rev And Expnss | 48725 | OtherProfFeesRevAndExpnss |
| Other Prof Fees Net Invst Incm | 48725 | OtherProfFeesNetInvstIncm |
| Other Prof Fees Dsbrs Chrtbl Prps | 0 | OtherProfFeesDsbrsChrtblPrps |
| Taxes Rev And Expnss | 61400 | TaxesRevAndExpnss |
| Taxes Net Invst Incm | 0 | TaxesNetInvstIncm |
| Taxes Dsbrs Chrtbl Prps | 0 | TaxesDsbrsChrtblPrps |
| Other Expenses Rev And Expnss | 11794 | OtherExpensesRevAndExpnss |
| Other Expenses Net Invst Incm | 0 | OtherExpensesNetInvstIncm |
| Other Expenses Dsbrs Chrtbl Prps | 0 | OtherExpensesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 130919 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 48725 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 0 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 2619806 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 2619806 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 2750725 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 48725 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 2619806 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | 279887 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 2486887 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Savings And Temp Cash Invst BOY | 403423 | SavingsAndTempCashInvstBOY |
| Savings And Temp Cash Invst EOY | 1445915 | SavingsAndTempCashInvstEOY |
| Savings And Temp Cash Invst EOYFMV | 1445915 | SavingsAndTempCashInvstEOYFMV |
| Investments Corp Stock BOY | 13924089 | InvestmentsCorpStockBOY |
| Investments Corp Stock EOY | 12488505 | InvestmentsCorpStockEOY |
| Investments Corp Stock EOYFMV | 17268931 | InvestmentsCorpStockEOYFMV |
| Investments Corp Bonds BOY | 394126 | InvestmentsCorpBondsBOY |
| Investments Corp Bonds EOY | 0 | InvestmentsCorpBondsEOY |
| Investments Corp Bonds EOYFMV | 0 | InvestmentsCorpBondsEOYFMV |
| Investments Other BOY | 250000 | InvestmentsOtherBOY |
| Investments Other EOY | 250000 | InvestmentsOtherEOY |
| Investments Other EOYFMV | 250000 | InvestmentsOtherEOYFMV |
| Total Assets BOY | 14971638 | TotalAssetsBOY |
| Total Assets EOY | 14184420 | TotalAssetsEOY |
| Total Assets EOYFMV | 18964846 | TotalAssetsEOYFMV |
| Loans From Officers BOY | 495000 | LoansFromOfficersBOY |
| Total Liabilities BOY | 495000 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Do Not Follow SFAS117 | X | OrgThatDoNotFollowSFAS117 |
| Capital Stock BOY | 0 | CapitalStockBOY |
| Capital Stock EOY | 0 | CapitalStockEOY |
| Paid In Or Capital Surplus BOY | 0 | PaidInOrCapitalSurplusBOY |
| Paid In Or Capital Surplus EOY | 0 | PaidInOrCapitalSurplusEOY |
| Retained Earnings BOY | 14476638 | RetainedEarningsBOY |
| Retained Earnings EOY | 14184420 | RetainedEarningsEOY |
| Total Net Assets BOY | 14476638 | TotalNetAssetsBOY |
| Total Net Assets EOY | 14184420 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 14971638 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 14184420 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 14476638 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | 279887 | ExcessOfRevenueOverExpenses |
| Other Increases | 0 | OtherIncreases |
| Subtotal | 14756525 | Subtotal |
| Other Decreases | 572105 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 14184420 | TotalNetAssetsFundBalancesEOY |
Capital Gains And Losses CapitalGainsAndLosses
Capital Gains And Losses Info CapitalGainsAndLossesInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Asset | PUBLICLY TRADED SECURITIES | DescriptionOfAsset |
| Gross Sales Price | 5446067 | GrossSalesPrice |
| Cost Or Other Basis | 3193156 | CostOrOtherBasis |
| Gain Or Loss | 2252911 | GainOrLoss |
| Gains Minus Excess Or Losses | 2252911 | GainsMinusExcessOrLosses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | 2252911 | CapitalGainNetIncome |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | 0 | LiableFor4942Tax |
| Qualifying Distributions Year1 | 2596576 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 16445165 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.157893 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 1325000 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 9532657 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.138996 | DistributionRatioYear2 |
| Qualifying Distributions Year3 | 2028643 | QualifyingDistributionsYear3 |
| Noncharitable Assets Year3 | 1717390 | NoncharitableAssetsYear3 |
| Distribution Ratio Year3 | 1.181236 | DistributionRatioYear3 |
| Qualifying Distributions Year4 | 1886678 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 3749209 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.503220 | DistributionRatioYear4 |
| Qualifying Distributions Year5 | 3689692 | QualifyingDistributionsYear5 |
| Noncharitable Assets Year5 | 7017292 | NoncharitableAssetsYear5 |
| Distribution Ratio Year5 | 0.525800 | DistributionRatioYear5 |
| Total Distribution Ratio | 2.507145 | TotalDistributionRatio |
| Average Distribution Ratio | 0.501429 | AverageDistributionRatio |
| Net Noncharitable Assets | 19918409 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 9987668 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 24869 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 10012537 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 2619806 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | 49738 | InvestmentIncomeExciseTax |
| Tax Under Section511 | 0 | TaxUnderSection511 |
| Subtotal | 49738 | Subtotal |
| Subtitle A Tax | 0 | SubtitleATax |
| Tax Based On Investment Income | 49738 | TaxBasedOnInvestmentIncome |
| Est Tax Payments And Overpayment | 49258 | EstTaxPaymentsAndOverpayment |
| Tax Paid With Extension | 26000 | TaxPaidWithExtension |
| Total Credits And Payments | 75258 | TotalCreditsAndPayments |
| Form2220 Attached | X | Form2220Attached |
| Penalty For Underpayment | 232 | PenaltyForUnderpayment |
| Overpayment | 25288 | Overpayment |
| Amount Credited To Next Year | 25288 | 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 | MN | 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 | DEAN D BARR DORSEY WHITNEY LLP | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 6124926440 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH 6TH STREET SUITE 1500 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554021498 | 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 | 1 | GrantsToOrganizations |
| Noncharitable Purpose | 0 | NoncharitablePurpose |
| Tr Fail To Qualify As Exceptions | 0 | TrFailToQualifyAsExceptions |
| Maint Expend Responsibility | 1 | MaintExpendResponsibility |
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|
| STEPHEN J HEMSLEY | ||||||||
| 622 FERNDALE ROAD WEST | WAYZATA | MN | 55391 | DIR, PRESIDENT & TREAS | 1.00 | 0 | 0 | 0 |
| BARBARA K HEMSLEY | ||||||||
| 622 FERNDALE ROAD WEST | WAYZATA | MN | 55391 | DIRECTOR, SECRETARY | 0.50 | 0 | 0 | 0 |
| MATTHEW S HEMSLEY | ||||||||
| 4620 MOORELAND AVENUE | EDINA | MN | 55424 | DIRECTOR | 0.50 | 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 | 18406033 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 1815702 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 20221735 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Acquisition Indebtedness | 0 | AcquisitionIndebtedness |
| Adj Total FMV Of Unused Assets | 20221735 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 303326 | CashDeemedCharitable |
| Net Noncharitable Assets | 19918409 | NetNoncharitableAssets |
| Minimum Investment Return | 995920 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 995920 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 49738 | TaxBasedOnInvestmentIncome |
| Total Tax | 49738 | TotalTax |
| Distributable Amount Before Adj | 946182 | DistributableAmountBeforeAdj |
| Recoveries Qlfy Distributions | 0 | RecoveriesQlfyDistributions |
| Distributable Amount Before Ded | 946182 | DistributableAmountBeforeDed |
| Deduction Fr Distributable | $0 | DeductionFrDistributableAmount |
| Distributable Amount As Adjusted | 946182 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 2619806 | ExpensesAndContributions |
| Program Related Investments Total | 0 | ProgramRelatedInvestmentsTotal |
| Qualifying Distributions | 2619806 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 0 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 2619806 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 946182 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 0 | UndistributedIncomePriorYear |
| Total For Prior Years | 0 | TotalForPriorYears |
| Excess Distri Carryover Year5 | 3350709 | ExcessDistriCarryoverYear5 |
| Excess Distri Carryover Year4 | 1700528 | ExcessDistriCarryoverYear4 |
| Excess Distri Carryover Year3 | 1943133 | ExcessDistriCarryoverYear3 |
| Excess Distri Carryover Year2 | 861290 | ExcessDistriCarryoverYear2 |
| Excess Distri Carryover Year1 | 1799718 | ExcessDistriCarryoverYear1 |
| Total Excess Distri Carryover | 9655378 | TotalExcessDistriCarryover |
| Qualifying Distributions | 2619806 | QualifyingDistributions |
| Applied To Year1 | 0 | AppliedToYear1 |
| Applied To Prior Years | 0 | AppliedToPriorYears |
| Treated As Distri From Corpus | 0 | TreatedAsDistriFromCorpus |
| Applied To Current Year | 946182 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 1673624 | RemainingDistriFromCorpus |
| Excess Distri Cyov App CY Corpus | 0 | ExcessDistriCyovAppCYCorpus |
| Excess Distri Cyov Applied CY | 0 | ExcessDistriCyovAppliedCY |
| Total Corpus | 11329002 | 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 | 3350709 | ExcessDistriCyovFromYear5 |
| Excess Distri Cyov To Next Year | 7978293 | ExcessDistriCyovToNextYear |
| Excess From Year4 | 1700528 | ExcessFromYear4 |
| Excess From Year3 | 1943133 | ExcessFromYear3 |
| Excess From Year2 | 861290 | ExcessFromYear2 |
| Excess From Year1 | 1799718 | ExcessFromYear1 |
| Excess From Current Year | 1673624 | ExcessFromCurrentYear |
Supplementary Information SupplementaryInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | STEPHEN J HEMSLEY | ContributingManager |
| Contributing Manager | BARBARA K HEMSLEY | ContributingManager |
| Only Contributes To Preselected | X | OnlyContributesToPreselected |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (24 entries)
| Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient RelationshipRecipientRelationship | Recipient Foundation StatusRecipientFoundationStatus | Purpose Of Grant Or ContributionPurposeOfGrantOrContribution | AmountAmount |
|---|---|---|---|---|---|---|---|
| AMERICAN HEART ASSOCIATION | |||||||
| 7272 GREENVILLE AVE | DALLAS | TX | 75231 | N/A | PUBLIC CHARITY | FUNDING FOR HEARTWALK EVENT | $500 |
| BASILICA OF ST MARY'S | |||||||
| BOX 50010 | MINNEAPOLIS | MN | 554050010 | N/A | PUBLIC CHARITY | OUTREACH PROGRAM AND THE ASCENSION SCHOOL | $34,000 |
| CATHOLIC CHARITIES | |||||||
| 1200 2ND AVENUE SOUTH | MINNEAPOLIS | MN | 55403 | N/A | PUBLIC CHARITY | OPERATING FUND | $500 |
| CHRISTIAN FOUNDATION FOR CHILDREN AND AGING | |||||||
| ONE ELMWOOD AVENUE | KANSAS CITY | KS | 661032118 | N/A | PUBLIC CHARITY | OPERATING FUND | $1,600 |
| CHURCH OF THE ASCENSION | |||||||
| 1723 BRYANT AVE N | MINNEAPOLIS | MN | 55411 | N/A | PUBLIC CHARITY | EAST GATEWAY PARTNERSHIP | $25,000 |
| CRISTO REY JESUIT HIGH SCHOOL | |||||||
| 2924 4TH AVE S | MINNEAPOLIS | MN | 554084194 | N/A | PUBLIC CHARITY | TWIN CITIES BUILDING FUND | $312,500 |
| FRASER | |||||||
| 2400 WEST 64TH STREET | MINNEAPOLIS | MN | 55423 | N/A | PUBLIC CHARITY | OPERATING FUND | $1,000 |
| GUTHRIE THEATRE | |||||||
| 818 SOUTH 2ND STREET | MINNEAPOLIS | MN | 55415 | N/A | PUBLIC CHARITY | OPERATING FUND | $7,500 |
| INTERFAITH OUTREACH & COMMUNITY PARTNERS | |||||||
| 110 GRAND AVE S | WAYZATA | MN | 553911872 | N/A | PUBLIC CHARITY | OPERATING FUND | $150,000 |
| MARYWOOD UNIVERSITY | |||||||
| 2300 ADAMS AVENUE | SCRANTON | PA | 18509 | N/A | PUBLIC CHARITY | OPERATING FUND | $5,000 |
| MINNEAPOLIS INSTITUTE OF ARTS | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | OPERATING FUND | $25,000 |
| MINNEAPOLIS INSTITUTE OF ARTS | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | FUNDING FOR ART PERCHANCE EVENT | $10,000 |
| MINNESOTA PUBLIC RADIO | |||||||
| 480 CEDAR STREET | ST PAUL | MN | 55101 | N/A | PUBLIC CHARITY | OPERATING FUND | $50,000 |
| PRESERVATION MARYLAND | |||||||
| 24 WEST SARATOGA STREET | BALTIMORE | MD | 21201 | N/A | PUBLIC CHARITY | OPERATING FUND | $500 |
| RISEN CHRIST SCHOOL | |||||||
| 1120 EAST 37TH STREET | MINNEAPOLIS | MN | 55407 | N/A | PUBLIC CHARITY | OPERATING FUND | $250,000 |
| STANFORD UNIVERSITY | |||||||
| 326 GALVEZ STREET | STANFORD | CA | 943056105 | N/A | PUBLIC CHARITY | OPERATING FUND FOR GRADUATE SCHOOL OF BUSINESS | $750,000 |
| STANFORD UNIVERSITY | |||||||
| 326 GALVEZ STREET | STANFORD | CA | 943056105 | N/A | PUBLIC CHARITY | MBA CLASS OF 2006 REUNION | $10,000 |
| THE CHILDREN'S THEATRE | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 554043597 | N/A | PUBLIC CHARITY | CAPITAL CAMPAIGN | $50,000 |
| THE CLOVER FIELDS PRESERVATION FOUNDATION INC | |||||||
| C/O D BARR 50 S 6TH ST STE 1500 | MINNEAPOLIS | MN | 554021498 | N/A | PRIVATE FOUNDATION | CEMETERY RESTORATION | $3,706 |
| THE SAINT PAUL SEMINARY | |||||||
| 2260 SUMMIT AVENUE | ST PAUL | MN | 551051094 | N/A | PUBLIC CHARITY | OPERATING FUND | $405,000 |
| UNITED HEALTHCARE CHILDREN'S FOUNDATION | |||||||
| MN012-S286 PO BOX 41 | MINNEAPOLIS | MN | 554400041 | N/A | PUBLIC CHARITY | FUNDING FOR MEDICAL GRANTS OF CHILDREN IN NEED | $12,000 |
| UNITED HEALTH FOUNDATION | |||||||
| MN008-W175 9900 BREN RD E | MINNETONKA | MN | 55343 | N/A | PRIVATE FOUNDATION | DONATIONS FOR UNITEDHEALTH GROUP GIVING CAMPAIGN | $6,000 |
| UNITED WAY OF MINNEAPOLIS | |||||||
| 404 SOUTH 8TH STREET | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | OPERATING FUND | $10,000 |
| UNIVERSITY OF ST THOMAS | |||||||
| 2115 SUMMIT AVENUE | ST PAUL | MN | 55105 | N/A | PUBLIC CHARITY | OPERATING FUND | $500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 2619806 | 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 | $282,701 | ExclusionAmount |
Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 18 | ExclusionCode |
| Exclusion | $2,252,911 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Income | $0 | UnrelatedBusinessIncomeAmount |
| Exclusion | $2,535,612 | ExclusionAmount |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 2535612 | 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 |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | X | Organization501c3ExemptPF |
| General Rule | X | GeneralRule |
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | 1 | ContributorNumber |
| Contributor Name Individual | STEPHEN J AND BARBARA K HEMSLEY | ContributorNameIndividual |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 622 FERNDALE ROAD WEST | AddressLine1 |
| City | WAYZATA | City |
| State | MN | State |
| ZIP Code | 55391 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | 450000 | AggregateContributions |
| Person Contribution Type | X | PersonContributionType |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees AccountingFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | DORSEY & WHITNEY | Category |
| Amount | $9,000 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Expenditure Responsibility Stmt ExpenditureResponsibilityStmt
Expenditure Responsibility ExpenditureResponsibility
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CLOVER FIELDS PRESERVATION FOUNDATION INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O DEAN BARR 50 S 6TH STREET STE | AddressLine1 |
| Address Line2 | 1500 | AddressLine2 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554021498 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Date | 2012-01-19 | GrantDate |
| Grant | $3,706 | GrantAmount |
| Grant Purpose | CEMETERY RESTORATION | GrantPurpose |
| Amount Expended By Grantee | 3706 | AmountExpendedByGrantee |
| Any Diversion By Grantee | NO | AnyDiversionByGrantee |
| Dates Of Reports By Grantee | NOVEMBER 4, 2013 | DatesOfReportsByGrantee |
| Results Of Verification | CEMETERY RESTORATION | ResultsOfVerification |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corp Bonds InvestmentsCorpBonds (2 entries)
| Name Of BondNameOfBond | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| SEARIVER MARITIME FINL HLDG | 0 | 0 |
| AMGEN INC SR CV | 0 | 0 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corp Stock InvestmentsCorpStock (35 entries)
| Name Of StockNameOfStock | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| 2900 SHS ACE LIMITED | 131058 | 231420 |
| 5000 SHS AON CORP | 245400 | 278050 |
| 270 SHS APPLE INC | 198107 | 175617 |
| 1000 SHS BAXTER INTERNATIONAL INC | 53211 | 66660 |
| 1800 SHS BOEING CO | 133871 | 135648 |
| 9700 SHS BROADRIDGE FINANCIAL SOLUTIONS | 220205 | 221936 |
| 2100 SHS CHECK POINT SOFTWARE | 62530 | 100044 |
| 1500 SHS CHEVRON | 115815 | 162210 |
| 5000 SHS CHUBB CORP | 247000 | 376600 |
| 2100 SHS CIT GROUP INC | 76010 | 81144 |
| 2300 SHS COMCAST CORP | 41829 | 85928 |
| 4200 SHS DELPHI AUTOMOTIVE | 131630 | 160650 |
| 900 SHS DEVON ENERGY CORPORATION | 66384 | 46836 |
| 11,150 SHS DIGITAL GENERATION | 171535 | 67642 |
| 340 SHS GOOGLE INC | 144324 | 205140 |
| 2500 SHS HOLOGIC INC | 0 | 0 |
| 3900 SHS IMAX CORP | 105365 | 87672 |
| 8500 SHS JOHNSON CONTROLS INC | 276429 | 260695 |
| 1664 SHS KINDER MORGAN MGMT LLC | 0 | 0 |
| 2500 SHS LIFE TECHNOLOGIES CORPORATION | 121718 | 122575 |
| 6000 SHS MARATHON OIL CORP | 158571 | 183960 |
| 4000 SHS METLIFE INC | 136200 | 131760 |
| 2300 SHS MICROSOFT CORP | 64083 | 61432 |
| 3900 SHS ORACLE CORP | 88648 | 129948 |
| 3900 SHS REPUBLIC SERVICES INC | 119850 | 114387 |
| 2800 SHS SCHLUMBERGER LTD | 188663 | 194036 |
| 2000 SHS ST JUDE MEDICAL INC | 0 | 0 |
| 1500 SHS STATE STREET CORP | 0 | 0 |
| 3200 SHS THERMO FISHER SCIENTIFIC INC | 155712 | 204096 |
| 2000 SHS UNITED PARCEL SVC INC | 143588 | 147460 |
| 150,000 SHS UNITEDHEALTH GROUP | 4627500 | 8136000 |
| 33,244 SHS UNITEDHEALTH GROUP | 1193127 | 1803155 |
| 58,900 SHS UNITEDHEALTH GROUP | 2999777 | 3194736 |
| 4000 SHS WESTERN UNION CO | 0 | 0 |
| 3100 SHS WILLIAMS COMPANIES INC | 70365 | 101494 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | GATHER INC | CategoryOrItem |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMV |
| Book Value | 250000 | BookValue |
| EOYFMV | 250000 | EOYFMV |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases OtherDecreases (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| STOCK BASIS ADJ (DONOR BASIS VS FMV) | $569,080 |
| PRIOR YEAR BASIS ADJUSTMENT | $3,025 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER | Description |
| Revenue And Expenses Per Books | 11794 | RevenueAndExpensesPerBooks |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees OtherProfessionalFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT FEES | Category |
| Amount | $48,725 | Amount |
| Net Investment Income | 48725 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Taxes Schedule TaxesSchedule
Taxes Taxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | EXCISE TAXES | Category |
| Amount | $61,400 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
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