COMMUNITY HEALTH FOUNDATION OF WARREN AND HENDERSON COUNTIES: Form 990PF, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH FOUNDATION OF WARREN AND HENDERSON COUNTIES (EIN 20-8070870)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-30
- IRS object ID
- 201332429349100508
- 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
- Compensation Explanation
- Gain Loss Sale Other Assets Sch
- General Explanation Attachment
- Other Assets Schedule
- Other Expenses Schedule
- Other Increases Schedule
- Other Professional Fees Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-30T14:20:24-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAVANAUGH DAVIES BLACKMAN & CRAMBLET | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 N MAIN ST PO BOX 318 | AddressLine1 |
| City | MONMOUTH | City |
| State | IL | State |
| ZIP Code | 614620318 | 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 | 208070870 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH FOUNDATION OF WARR | BusinessNameLine1 |
| Business Name Line2 | %G MCCLINTOCK | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 3097345214 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 717 NORTH 11TH STREET | AddressLine1 |
| City | MONMOUTH | City |
| State | IL | State |
| ZIP Code | 61462 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREG MCCLINTOCK | Name |
| Title | PRESIDENT | Title |
| Phone | 3097345214 | Phone |
| Date Signed | 2013-08-30 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | R CRAIG CAVANAUGH | Name |
| Phone | 3097342330 | Phone |
| Date Prepared | 2013-08-27 | 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 | 14020426 | 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 | 1542 | InterestOnSavingsRevAndExpnss |
| Interest On Savings Net Invst Incm | 1542 | InterestOnSavingsNetInvstIncm |
| Dividends Rev And Expnss | 304725 | DividendsRevAndExpnss |
| Dividends Net Invst Incm | 304725 | DividendsNetInvstIncm |
| Net Gain Sale Assets Rev And Expnss | 209331 | NetGainSaleAssetsRevAndExpnss |
| Gross Sales Price | 965814 | GrossSalesPrice |
| Capital Gain Net Incm Net Invst Incm | 203154 | CapitalGainNetIncmNetInvstIncm |
| Total Revenue And Expenses | 515598 | TotalRevenueAndExpenses |
| Total Net Investment Income | 509421 | TotalNetInvestmentIncome |
| Accounting Fees Rev And Expnss | 1000 | AccountingFeesRevAndExpnss |
| Accounting Fees Net Invst Incm | 1000 | AccountingFeesNetInvstIncm |
| Other Prof Fees Rev And Expnss | 60682 | OtherProfFeesRevAndExpnss |
| Other Prof Fees Net Invst Incm | 60682 | OtherProfFeesNetInvstIncm |
| Other Expenses Rev And Expnss | 1124 | OtherExpensesRevAndExpnss |
| Other Expenses Net Invst Incm | 1124 | OtherExpensesNetInvstIncm |
| Tot Opr Expenses Rev And Expnss | 62806 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 62806 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 0 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 610379 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 610379 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 673185 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 62806 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 610379 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | -157587 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 446615 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Savings And Temp Cash Invst BOY | 266442 | SavingsAndTempCashInvstBOY |
| Savings And Temp Cash Invst EOY | 507460 | SavingsAndTempCashInvstEOY |
| Savings And Temp Cash Invst EOYFMV | 507460 | SavingsAndTempCashInvstEOYFMV |
| Other Assets BOY | 12522433 | OtherAssetsBOY |
| Other Assets EOY | 12273828 | OtherAssetsEOY |
| Other Assets EOYFMV | 13512966 | OtherAssetsEOYFMV |
| Total Assets BOY | 12788875 | TotalAssetsBOY |
| Total Assets EOY | 12781288 | TotalAssetsEOY |
| Total Assets EOYFMV | 14020426 | TotalAssetsEOYFMV |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Follow SFAS117 | X | OrgThatFollowSFAS117 |
| Unrestricted BOY | 12788875 | UnrestrictedBOY |
| Unrestricted EOY | 12781288 | UnrestrictedEOY |
| Total Net Assets BOY | 12788875 | TotalNetAssetsBOY |
| Total Net Assets EOY | 12781288 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 12788875 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 12781288 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 12788875 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | -157587 | ExcessOfRevenueOverExpenses |
| Other Increases | 150000 | OtherIncreases |
| Subtotal | 12781288 | Subtotal |
| Total Net Assets Fund Balances EOY | 12781288 | TotalNetAssetsFundBalancesEOY |
Capital Gains And Losses CapitalGainsAndLosses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | 203154 | CapitalGainNetIncome |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | false | LiableFor4942Tax |
| Qualifying Distributions Year1 | 527749 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 13613473 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.038767 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 543301 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 12663233 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.042904 | DistributionRatioYear2 |
| Noncharitable Assets Year3 | 10602306 | NoncharitableAssetsYear3 |
| Qualifying Distributions Year4 | 71815 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 12102869 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.005934 | DistributionRatioYear4 |
| Noncharitable Assets Year5 | 12164502 | NoncharitableAssetsYear5 |
| Total Distribution Ratio | 0.087605 | TotalDistributionRatio |
| Average Distribution Ratio | 0.029202 | AverageDistributionRatio |
| Net Noncharitable Assets | 13582427 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 396634 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 4466 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 401100 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 610379 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | X | DomesticOrgMeetingSect4940e |
| Investment Income Excise Tax | 4466 | InvestmentIncomeExciseTax |
| Subtotal | 4466 | Subtotal |
| Tax Based On Investment Income | 4466 | TaxBasedOnInvestmentIncome |
| Est Tax Payments And Overpayment | 1660 | EstTaxPaymentsAndOverpayment |
| Total Credits And Payments | 1660 | TotalCreditsAndPayments |
| Tax Due | 2806 | TaxDue |
Statements Regarding Activities StatementsRegardingActivities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Activities | false | LegislativePoliticalActivities |
| More Than100 Spent | false | MoreThan100Spent |
| Form1120 POL Filed | false | Form1120POLFiled |
| Activities Not Prev Reported | false | ActivitiesNotPrevReported |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylaws |
| Unrelated Bus Income Over1000 | false | UnrelatedBusIncomeOver1000 |
| Termination Etc | false | TerminationEtc |
| Requirements Of Sect508e | true | RequirementsOfSect508e |
| At Least5000 In Assets | true | AtLeast5000InAssets |
| States Filed With | IL | StatesFiledWith |
| Form990 PF Filed With AG | true | Form990PFFiledWithAG |
| Private Operating Foundation | false | PrivateOperatingFoundation |
| New Substantial Contributors | false | NewSubstantialContributors |
| Interest In Controlled Entity | false | InterestInControlledEntity |
| Applicable Insurance Contract | false | ApplicableInsuranceContract |
| Comply With Public Inspection Rqr | true | ComplyWithPublicInspectionRqr |
| Website Address | N/A | WebsiteAddress |
| Books In Care Of Person Name | R CRAIG CAVANAUGH | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 3097342330 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NORTH MAIN STREET | AddressLine1 |
| City | MONMOUTH | City |
| State | IL | State |
| ZIP Code | 61462 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Bank | false | ForeignBank |
Statements Regarding Acty4720 StatementsRegardingActy4720
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exchange With Dsqfly Person | false | SaleOrExchangeWithDsqflyPerson |
| Borrow Or Lend With Dsqfly Person | false | BorrowOrLendWithDsqflyPerson |
| Furnished Goods With Dsqfly Person | false | FurnishedGoodsWithDsqflyPerson |
| Pay Compensation To Dsqfly Person | false | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | false | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | false | PaymentToGovernmentOffical |
| Undistributed Income Prior Years | false | UndistributedIncomePriorYears |
| Business Holdings | false | BusinessHoldings |
| Jeopardy Investments | false | JeopardyInvestments |
| Uncorrected Jeopardy Investments | false | UncorrectedJeopardyInvestments |
| Influence Legislation | false | InfluenceLegislation |
| Influence Election | false | InfluenceElection |
| Grants To Individuals | false | GrantsToIndividuals |
| Grants To Organizations | false | GrantsToOrganizations |
| Noncharitable Purpose | false | NoncharitablePurpose |
| Rcv Funds To Pay Prsnl Bnft Contract | false | RcvFundsToPayPrsnlBnftContract |
| Pay Premiums Prsnl Bnft Contract | false | PayPremiumsPrsnlBnftContract |
| Prohibited Tax Shelter Transactn | false | ProhibitedTaxShelterTransactn |
Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo
Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (11 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 |
|---|---|---|---|---|---|---|---|---|
| GREG MCCLINTOCK | ||||||||
| 707 NORTH 11TH ST | MONMOUTH | IL | 61462 | CHAIRMAN | 2.00 | 0 | 0 | 0 |
| GARY HEATON | ||||||||
| 715 NORTH 9TH ST | MONMOUTH | IL | 61462 | VICE CHAIR | 0.00 | 0 | 0 | 0 |
| DOROTHY RICKETTS | ||||||||
| 202 NORTH G | MONMOUTH | IL | 61462 | SECRETARY | 0.00 | 0 | 0 | 0 |
| DR JAMES BATTENBURG | ||||||||
| 2028 62ND ST | MONMOUTH | IL | 61462 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| DON GLADFELTER | ||||||||
| 861 210TH AVE | MONMOUTH | IL | 61462 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| MIKE CONNELL | ||||||||
| 1150 WARREN SCHOOL RD | MONMOUTH | IL | 61462 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| SPUD RILEY | ||||||||
| 1361 EAST BROADWAY | MONMOUTH | IL | 61462 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| CAROL SHAW | ||||||||
| 1008 HWY 116 | ROSEVILLE | IL | 61473 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| MARY REED | ||||||||
| RR 1 BOX 80 | LITTLE YORK | IL | 61453 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| JON FERGUSON | ||||||||
| 17 FAIRWAY DRIVE | MONMOUTH | IL | 61462 | DIRECTOR | 0.00 | 0 | 0 | 0 |
| PATTY LUKER | ||||||||
| OSF HOLY FAMILY MD CTR 1000 W HARLE | MONMOUTH | IL | 61462 | EX-OFFICIO | 0.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Highest Paid Empl NONE | NONE | CompOfHighestPaidEmplNONE |
| Comp Of Hghst Paid Cntrct NONE | NONE | CompOfHghstPaidCntrctNONE |
Sum Of Program Related Investments SumOfProgramRelatedInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1 |
Minimum Investment Return MinimumInvestmentReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Avg Monthly FMV Of Securities | 13540877 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 248389 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 13789266 | TotalFMVOfUnusedAssets |
| Adj Total FMV Of Unused Assets | 13789266 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 206839 | CashDeemedCharitable |
| Net Noncharitable Assets | 13582427 | NetNoncharitableAssets |
| Minimum Investment Return | 679121 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 679121 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 4466 | TaxBasedOnInvestmentIncome |
| Total Tax | 4466 | TotalTax |
| Distributable Amount Before Adj | 674655 | DistributableAmountBeforeAdj |
| Distributable Amount Before Ded | 674655 | DistributableAmountBeforeDed |
| Distributable Amount As Adjusted | 674655 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 610379 | ExpensesAndContributions |
| Qualifying Distributions | 610379 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 4466 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 605913 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 674655 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 104927 | UndistributedIncomePriorYear |
| Qualifying Distributions | 610379 | QualifyingDistributions |
| Applied To Year1 | 104927 | AppliedToYear1 |
| Applied To Current Year | 505452 | AppliedToCurrentYear |
| Undistributed Income CY | 169203 | UndistributedIncomeCY |
Supplementary Information SupplementaryInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contributes To Preselected | X | OnlyContributesToPreselected |
Appication Submission Info AppicationSubmissionInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Name | GREG MCCLINTOCK | RecipientName |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 NORTH 11TH STREET | AddressLine1 |
| City | MONMOUTH | City |
| State | IL | State |
| ZIP Code | 61462 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone Number | 3097345214 | RecipientPhoneNumber |
| Recipient Email Address | NONE | RecipientEmailAddress |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (3 entries)
| Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient RelationshipRecipientRelationship | Recipient Foundation StatusRecipientFoundationStatus | Purpose Of Grant Or ContributionPurposeOfGrantOrContribution | AmountAmount |
|---|---|---|---|---|---|---|---|
| HENDERSON COUNTY HEALTH D | |||||||
| COUNTY COURT HOUSE | OQUAWKA | IL | 61469 | NONE | GOVERNMENTAL | GRANT FOR EQUIPMENT | $13,080 |
| OAKLANE NURSING CENTER | |||||||
| PO BOX | STRONGHURST | IL | 61480 | NONE | NOT FOR PROF | CAPITAL GRANT | $97,299 |
| OSF HEALTHCARE SYSTEMS FO | |||||||
| 1000 WEST HARLEM AVENUE | MONMOUTH | IL | 61462 | NONE | NOT FOR PROF | GRANT FOR EXPANSION | $500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 610379 | TotGrantOrContriPaidDuringYear |
Analysis Income Producing Acty AnalysisIncomeProducingActy
Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $1,542 | ExclusionAmount |
Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $304,725 | ExclusionAmount |
Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $209,331 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $515,598 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 515598 | TotalPartXVIA |
Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Noncharitable EO | false | TrnsfrOfCashToNoncharitableEO |
| Trnsfr Oth Assets Noncharitable EO | false | TrnsfrOthAssetsNoncharitableEO |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssets |
| Purchase Assets Noncharitable EO | false | PurchaseAssetsNoncharitableEO |
| Rental Of Facilities Etc | false | RentalOfFacilitiesEtc |
| Reimbursement Arrangements | false | ReimbursementArrangements |
| Loans Or Loan Guarantees | false | LoansOrLoanGuarantees |
| Performance Of Services Etc | false | PerformanceOfServicesEtc |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtc |
| Relationships Noncharitable E Os | false | RelationshipsNoncharitableEOs |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees AccountingFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | PREPARATION OF 990'S | Category |
| Amount | $1,000 | Amount |
| Net Investment Income | 1000 | NetInvestmentIncome |
Compensation Explanation CompensationExplanation
Compensation Compensation (11 entries)
| GREG MCCLINTOCK |
| GARY HEATON |
| DOROTHY RICKETTS |
| DR JAMES BATTENBURG |
| DON GLADFELTER |
| MIKE CONNELL |
| SPUD RILEY |
| CAROL SHAW |
| MARY REED |
| JON FERGUSON |
| PATTY LUKER |
Gain Loss Sale Other Assets Sch GainLossSaleOtherAssetsSch
Gain Loss Sale Other Asset GainLossSaleOtherAsset (11 entries)
| NameName | Date AcquiredDateAcquired | How AcquiredHowAcquired | Date SoldDateSold | BasisBasis | Total NetTotalNet | Gross Sales PriceGrossSalesPrice |
|---|---|---|---|---|---|---|
| BHMS LARGE CAP - K1 LOSSES | 2009-11 | PURCHASE | 2012-12 | 56869 | -56869 | |
| BHMS LARGE CAP - K1 LOSSES | 2009-11 | PURCHASE | 2012-12 | 3277 | -3277 | |
| 324.983 SHS BHMS LARGE CAP | 2009-11 | PURCHASE | 2012-02 | 4937 | 37 | 4974 |
| 350.584 SHS BHMS LARGE CAP | 2009-11 | PURCHASE | 2012-05 | 5326 | -175 | 5151 |
| 326.781 SHS BHMS LARGE CAP | 2009-11 | PURCHASE | 2012-08 | 4964 | 190 | 5154 |
| 18936.673 SHS BHMS LARGE CAP | 2009-11 | PURCHASE | 2012-11 | 287660 | 12340 | 300000 |
| 334.991 SHS BHMS LARGE CAP | 2009-11 | PURCHASE | 2012-11 | 5089 | 313 | 5402 |
| 2263 SHS PERKINS MID CAP FD | 2008-01 | PURCHASE | 2012-11 | 50524 | -1440 | 49084 |
| 3568.880 SHS HARBOR CAP APPRECIATION | 2009-11 | PURCHASE | 2012-11 | 115132 | 31662 | 146794 |
| 6595. SHS LONG LEAF SMALL CAP FD | 2009-11 | PURCHASE | 2012-11 | 179179 | 17652 | 196831 |
| 1944.010 SHS ASTON MONTAG GROWTH FD | 2009-11 | PURCHASE | 2012-11 | 43526 | 5744 | 49270 |
General Explanation Attachment GeneralExplanationAttachment
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | GENERAL ELECTIONS | Identifier |
Other Assets Schedule OtherAssetsSchedule
Other Assets OtherAssets (9 entries)
| DescriptionDescription | BOY Book ValueBOYBookValue | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|---|
| PIMCO MOD DURATION BOND FD | 2385179 | 2525550 | 2715299 |
| JANUS-PERKINS MID CAP VALUE FD | 996179 | 986897 | 975570 |
| LONGLEAF PARTNERS SMALL CAP FD | 1012878 | 899291 | 992002 |
| DODGE & COX INTL STK FD | 1140357 | 1163712 | 1106413 |
| BHMS LARGE VALUE FD | 2368816 | 2084162 | 2652965 |
| HARBOR CAPITAL APPRECIATION FD | 1173088 | 1063510 | 1399324 |
| ASTON M&C GROWTH FD | 1216897 | 1277197 | 1356243 |
| HARTFORD GLOBAL REAL | 1322835 | 1334340 | 1252241 |
| WM BLAIR INTL GROWTH FD | 906204 | 939169 | 1062909 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | Revenue And Expenses Per BooksRevenueAndExpensesPerBooks | Net Investment IncomeNetInvestmentIncome |
|---|---|---|
| EXPENSES | ||
| INSURANCE | 954 | 954 |
| FEES AND BANK CHARGES | 170 | 170 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases OtherIncreases
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | AMOUNTS FROM COMMUNITY MED CENTER | Description |
| Amount | $150,000 | Amount |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees OtherProfessionalFees (2 entries)
| CategoryCategory | AmountAmount | Net Investment IncomeNetInvestmentIncome |
|---|---|---|
| INVESTMENT ADVISORY AND FILING | $40,000 | 40000 |
| BHMS LARGE CAP VALUE K-1 | $20,682 | 20682 |
Comments