PATCH FOUNDATION: Form 990PF, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PATCH FOUNDATION (EIN 41-1873951)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-04-23
IRS object ID
201201149349100515
Schema version
2011v1.2
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)
Timestamp2012-04-23T14:50:52-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY & PULLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1801 NICOLLET MALL SUITE 1100AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411873951EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE PATCH FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPATCNameControl
Phone6127817677Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROADAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55418ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCAROLYN SAMPLEName
TitlePRESIDENTTitle
Phone6127817677Phone
Date Signed2012-04-18DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTODD A JACKSONName
PTINP00092672PTIN
Phone6123324300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY6707797FMVAssetsEOY
Method Of Accounting CashXMethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Received Rev And Expnss7551ContriReceivedRevAndExpnss
Dividends Rev And Expnss170426DividendsRevAndExpnss
Dividends Net Invst Incm146575DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss0NetGainSaleAssetsRevAndExpnss
Gross Sales Price270000GrossSalesPrice
Capital Gain Net Incm Net Invst Incm0CapitalGainNetIncmNetInvstIncm
Total Revenue And Expenses177977TotalRevenueAndExpenses
Total Net Investment Income146575TotalNetInvestmentIncome
Comp Ofcr Dir Trst Rev And Expnss0CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm0CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps0CompOfcrDirTrstDsbrsChrtblPrps
Accounting Fees Rev And Expnss1700AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm1700AccountingFeesNetInvstIncm
Accounting Fees Dsbrs Chrtbl Prps0AccountingFeesDsbrsChrtblPrps
Taxes Rev And Expnss2117TaxesRevAndExpnss
Taxes Net Invst Incm0TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps0TaxesDsbrsChrtblPrps
Other Expenses Rev And Expnss61OtherExpensesRevAndExpnss
Other Expenses Net Invst Incm0OtherExpensesNetInvstIncm
Other Expenses Dsbrs Chrtbl Prps25OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss3878TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm1700TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps25TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss516000ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps516000ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss519878TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm1700TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps516025TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses-341901ExcessOfRevenueOverExpenses
Net Investment Income144875NetInvestmentIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Cash BOY91236CashBOY
Cash EOY29262CashEOY
Cash EOYFMV29262CashEOYFMV
Savings And Temp Cash Invst BOY234199SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY224272SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV224272SavingsAndTempCashInvstEOYFMV
Investments Govt Oblig BOY795000InvestmentsGovtObligBOY
Investments Govt Oblig EOY525000InvestmentsGovtObligEOY
Investments Govt Oblig EOYFMV545354InvestmentsGovtObligEOYFMV
Investments Corp Stock BOY354571InvestmentsCorpStockBOY
Investments Corp Stock EOY354571InvestmentsCorpStockEOY
Investments Corp Stock EOYFMV408559InvestmentsCorpStockEOYFMV
Investments Other BOY4144953InvestmentsOtherBOY
Investments Other EOY4144953InvestmentsOtherEOY
Investments Other EOYFMV5500350InvestmentsOtherEOYFMV
Total Assets BOY5619959TotalAssetsBOY
Total Assets EOY5278058TotalAssetsEOY
Total Assets EOYFMV6707797TotalAssetsEOYFMV
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 BOY5619959RetainedEarningsBOY
Retained Earnings EOY5278058RetainedEarningsEOY
Total Net Assets BOY5619959TotalNetAssetsBOY
Total Net Assets EOY5278058TotalNetAssetsEOY
Total Liabilities Net Assets BOY5619959TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY5278058TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY5619959TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses-341901ExcessOfRevenueOverExpenses
Other Increases0OtherIncreases
Subtotal5278058Subtotal
Other Decreases0OtherDecreases
Total Net Assets Fund Balances EOY5278058TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (2 entries)

Description Of AssetDescriptionOfAssetHow AcquiredHowAcquiredDate AcquiredDateAcquiredDate SoldDateSoldGross Sales PriceGrossSalesPriceCost Or Other BasisCostOrOtherBasisGain Or LossGainOrLossGains Minus Excess Or LossesGainsMinusExcessOrLosses
ANOKA CNTY MINN PUB SAFETY RADIO SYS-SER DP2008-12-232011-02-01150000160301-10301-10301
WARROAD MINN INDPT SCH DIST NO 690 RFDG-SCH BLDG-SER AP2008-12-232011-02-01120000659452-539452-539452
FieldValueIRS element (for citing)
Capital Gain Net Income-549753CapitalGainNetIncome

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 Tax0LiableFor4942Tax
Qualifying Distributions Year1420225QualifyingDistributionsYear1
Noncharitable Assets Year16583022NoncharitableAssetsYear1
Distribution Ratio Year10.063835DistributionRatioYear1
Qualifying Distributions Year2353125QualifyingDistributionsYear2
Noncharitable Assets Year26380069NoncharitableAssetsYear2
Distribution Ratio Year20.055348DistributionRatioYear2
Qualifying Distributions Year3959585QualifyingDistributionsYear3
Noncharitable Assets Year31974911NoncharitableAssetsYear3
Distribution Ratio Year30.485888DistributionRatioYear3
Qualifying Distributions Year4119325QualifyingDistributionsYear4
Noncharitable Assets Year41259839NoncharitableAssetsYear4
Distribution Ratio Year40.094714DistributionRatioYear4
Qualifying Distributions Year5120875QualifyingDistributionsYear5
Noncharitable Assets Year51288992NoncharitableAssetsYear5
Distribution Ratio Year50.093775DistributionRatioYear5
Total Distribution Ratio0.793560TotalDistributionRatio
Average Distribution Ratio0.158712AverageDistributionRatio
Net Noncharitable Assets6563116NetNoncharitableAssets
Adjusted Noncharitable Assets1041645AdjustedNoncharitableAssets
One Percent Net Investment Income1449OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One1043094AdjNonchrtblAssetsAndOnePct
Qualifying Distributions516025QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Investment Income Excise Tax2898InvestmentIncomeExciseTax
Tax Under Section5110TaxUnderSection511
Subtotal2898Subtotal
Subtitle A Tax0SubtitleATax
Tax Based On Investment Income2898TaxBasedOnInvestmentIncome
Est Tax Payments And Overpayment2800EstTaxPaymentsAndOverpayment
Total Credits And Payments2800TotalCreditsAndPayments
Tax Due98TaxDue

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 Sect508e1RequirementsOfSect508e
At Least5000 In Assets1AtLeast5000InAssets
States Filed WithMNStatesFiledWith
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 Business Name BooksInCareOfBusinessName

FieldValueIRS element (for citing)
Business Name Line1THE FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Books In Care Of Phone Number6127817677BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROADAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55418ZIPCode
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 (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
WILLIAM C PETERSON
1245 NORTH COURTNEW BRIGHTONMN55112DIRECTOR0.50000
CAROLYN SAMPLE
3201 RANKIN RDMINNEAPOLISMN55418PRESIDENT2.00000
ERNEST LINDSTROMLINDSTROM LAW OFFIC
7600 PARKLAWN AVE 444EDINAMI55435DIRECTOR0.50000
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 Securities6397584AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances265478AvgMonthlyCashBalances
FMV All Other Noncharitable Assets0FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets6663062TotalFMVOfUnusedAssets
Reduction Claimed0ReductionClaimed
Acquisition Indebtedness0AcquisitionIndebtedness
Adj Total FMV Of Unused Assets6663062AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable99946CashDeemedCharitable
Net Noncharitable Assets6563116NetNoncharitableAssets
Minimum Investment Return328156MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return328156MinimumInvestmentReturn
Tax Based On Investment Income2898TaxBasedOnInvestmentIncome
Total Tax2898TotalTax
Distributable Amount Before Adj325258DistributableAmountBeforeAdj
Recoveries Qlfy Distributions0RecoveriesQlfyDistributions
Distributable Amount Before Ded325258DistributableAmountBeforeDed
Deduction Fr Distributable$0DeductionFrDistributableAmount
Distributable Amount As Adjusted325258DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions516025ExpensesAndContributions
Program Related Investments Total0ProgramRelatedInvestmentsTotal
Qualifying Distributions516025QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm0OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions516025AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted325258DistributableAmountAsAdjusted
Undistributed Income Prior Year0UndistributedIncomePriorYear
Total For Prior Years0TotalForPriorYears
Excess Distri Carryover Year558739ExcessDistriCarryoverYear5
Excess Distri Carryover Year456531ExcessDistriCarryoverYear4
Excess Distri Carryover Year3862119ExcessDistriCarryoverYear3
Excess Distri Carryover Year237229ExcessDistriCarryoverYear2
Excess Distri Carryover Year193591ExcessDistriCarryoverYear1
Total Excess Distri Carryover1108209TotalExcessDistriCarryover
Qualifying Distributions516025QualifyingDistributions
Applied To Year10AppliedToYear1
Applied To Prior Years0AppliedToPriorYears
Treated As Distri From Corpus0TreatedAsDistriFromCorpus
Applied To Current Year325258AppliedToCurrentYear
Remaining Distri From Corpus190767RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus0ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY0ExcessDistriCyovAppliedCY
Total Corpus1298976TotalCorpus
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 Year558739ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year1240237ExcessDistriCyovToNextYear
Excess From Year456531ExcessFromYear4
Excess From Year3862119ExcessFromYear3
Excess From Year237229ExcessFromYear2
Excess From Year193591ExcessFromYear1
Excess From Current Year190767ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

Appication Submission Info AppicationSubmissionInfo

FieldValueIRS element (for citing)
Recipient NameCAROLYN P SAMPLERecipientName

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROAD NEAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55418ZIPCode
FieldValueIRS element (for citing)
Recipient Phone Number6127817677RecipientPhoneNumber
Form And Info And MaterialsSEE STATEMENT 7FormAndInfoAndMaterials
Submission DeadlinesSEE STATEMENT 7SubmissionDeadlines
Restrictions On AwardsSEE STATEMENT 7RestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (39 entries)

Address Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient RelationshipRecipientRelationshipRecipient Foundation StatusRecipientFoundationStatusPurpose Of Grant Or ContributionPurposeOfGrantOrContributionAmountAmount
AMERICAN HEART ASSOCIATION
4701 WEST 77TH STREETMINNEAPOLISMN55435NONEPUBLIC CHARITYPROGRAM SUPPORT - HEALTH ASSOCIATION$1,000
AMERICAN LUNG ASSOCIATION
PO BOX 7000ALBERT LEAMN56007NONEPUBLIC CHARITYPROGRAM SUPPORT - HEALTH ASSOCIATION$1,000
ARC OF HENNEPIN COUNTY
106 NORTH CHESTNUT STREETCHASKAMN55318NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$5,000
CAMP KNUTSON
11169 WHITE FISH AVENUECROSSLAKEMN56442NONEPUBLIC CHARITYPROGRAM SUPPORT - RELIGIOUS$5,000
CARE
151 ELLIS STREET NEATLANTAGA30303NONEPUBLIC CHARITYPROGRAM SUPPORT$5,000
CATHOLIC CHARITIES
1200 SECOND AVENUE SOMINNEAPOLISMN55403NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$5,000
CHILDREN'S HOME SOCIETY
1605 EUSTIS STREETST PAULMN55108NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANIZATION$3,000
COURAGE CENTER
3915 GOLDEN VALLEY ROADMINNEAPOLISMN55422NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANIZATION$7,000
COVENANT RETIREMENT COMMUNITIES OF MN
5800 ST CROIX AVENUE NGOLDEN VALLEYMN55422NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$5,000
COVENANT WORLD RELIEF
5101 NORTH FRANCISCO AVENUECHICAGOIL60625NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$75,000
DUNWOODY COLLEGE OF TECHNOLOGY
818 DUNWOODY BLVDMINNEAPOLISMN55403NONEEDUCATIONALPROGRAM SUPPORT - EDUCATION$5,000
EAST SIDE NEIGHBORHOOD
1700 SECOND STREET NEMINNEAPOLISMN55413NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANIZATION$2,000
EVANGELICAL COVENANT CHURCH
5101 NORTH FRANCISCO AVENUECHICAGOIL60625NONERELIGIOUSPROGRAM SUPPORT- RELIGIOUS$100,000
FEED MY STARVING CHILDREN
401 93RD AVE NWCOON RAPIDSMN55433NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$5,000
FRIENDSHIP VENTURES
10509 108TH STREET NWANNANDALEMN55302NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$7,000
GREATER MINNEAPOLIS CRISIS NURSERY
5400 GLENWOOD AVEGOLDEN VALLEYMN55422NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$2,000
HABITAT FOR HUMANITY
121 HABITAT STREETAMERICUSGA31709NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$5,000
HOMEWARD BOUND
13895 INDUSTRIAL PARK BLVD 100PLYMOUTHMN55441NONEPUBLIC CHARITYPROGRAM SUPPORT - HEALTH ASSOCIATION$7,000
HOUSE OF CHARITY
510 SOUTH EIGHTH STREETMINNEAPOLISMN55404NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$12,000
KIWANIS CLUB OF NE MPLS
C/O WALT SENTYRZ 1612 SECOND ST NEMINNEAPOLISMN554131138NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$1,000
LITTLE BROTHERS FRIENDS OF THE ELDERLY
1845 EAST LAKE STREETMINNEAPOLISMN55407NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$8,000
LITTLE SISTERS OF THE POOR
330 EXCHANGE STREET SST PAULMN55102NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$3,000
LOAVES AND FISHES
1917 LOGAN AVENUE SOUTHMINNEAPOLISMN55403NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$5,000
MARCH OF DIMES
1275 MAMARONECK AVENUEWHITE PLAINSNY10605NONEPUBLIC CHARITYPROGRAM SUPPORT - HEALTH ASSOCIATION$1,000
METRO HOPE MINISTRIES
2739 CEDAR AVENUE SOUTHMINNEAPOLISMN55407NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$20,000
MINNEAPOLIS HEART INSTITUTE FOUNDATION
920 EAST 28TH STREET 100MINNEAPOLISMN55407NONEPUBLIC CHARITYPROGRAM SUPPORT - HEALTH ASSOCIATION$5,000
MINNESOTA TEEN CHALLENGE
1619 PORTLANT AVENUE SOUTHMINNEAPOLISMN55404NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$10,000
NORTHEAST SENIOR SERVICES
2580 KENZIE TERRACE SUITE 2AST ANTHONYMN55418NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$3,000
PEOPLE SERVING PEOPLE
614 SOUTH THIRD STREETMINNEAPOLISMN55415NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$10,000
SALEM COVENANT CHURCH
2655 FIFTH STREET NWNEW BRIGHTONMN55112NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$75,000
SECOND HARVEST FOOD BANK
1140 GERVAIS AVENUEST PAULMN55109NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$10,000
SIMPSON HOUSING SERVICES
2740 FIRST AVENUE SOUTHMINNEAPOLISMN55408NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$10,000
SISTER KENNY INSTITUTE
800 EAST 28TH STREETMINNEAPOLISMN55407NONEPUBLIC CHARITYPROGRAM SUPPORT - HEALTH ASSOCIATION$7,000
SUNSHINE ACRES
3405 NORTH HIGLEY ROADMESAAZ85215NONEPUBLIC CHARITYPROGRAM SUPPORT$5,000
THE GIDEONS
PO BOX 140800NASHVILLETN37214NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$3,000
THE SALVATION ARMY
2445 PRIOR AVENUE NORTHROSEVILLEMN55113NONERELIGIOUSPROGRAM SUPPORT - RELIGIOUS$50,000
UNION GOSPEL MISSION
77 NINTH STREET EST PAULMN55101NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$7,000
UNIVERSITY OF MINNESOTA FOUNDATION
200 OAK STREET SE 500MINNEAPOLISMN55455NONEEDUCATIONALPROGRAM SUPPORT - EDUCATION$25,000
SHARING & CARING HANDS
525 NORTH 7TH STREETMINNEAPOLISMN554051523NONEPUBLIC CHARITYPROGRAM SUPPORT - COMMUNITY ORGANZATION$1,000
FieldValueIRS element (for citing)
Tot Grant Or Contri Paid During Year516000TotGrantOrContriPaidDuringYear
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$170,426ExclusionAmount

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

FieldValueIRS element (for citing)
Exclusion Code18ExclusionCode

Subtotals Part XVIA SubtotalsPartXVIA

FieldValueIRS element (for citing)
Unrelated Business Income$0UnrelatedBusinessIncomeAmount
Exclusion$170,426ExclusionAmount
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Part XVIA170426TotalPartXVIA

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 IndividualESTATE OF EARL PATCHContributorNameIndividual

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROADAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code554182505ZIPCode
FieldValueIRS element (for citing)
Aggregate Contributions7551AggregateContributions
Person Contribution TypeXPersonContributionType

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategory
Amount$1,700Amount
Net Investment Income1700NetInvestmentIncome
Disbursements Charitable Prps0DisbursementsCharitablePrps

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock (3 entries)

Name Of StockNameOfStockEOY Book ValueEOYBookValueEOYFMVEOYFMV
3M157950159374
TECO3262136385
CHEVRON164000212800

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Securities EOY Book Value0USGovtSecuritiesEOYBookValue
US Govt Securities EOYFMV0USGovtSecuritiesEOYFMV
State Local Securities EOY Book Val525000StateLocalSecuritiesEOYBookVal
State Local Securities EOYFMV545354StateLocalSecuritiesEOYFMV

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOther

FieldValueIRS element (for citing)
Category Or ItemO.N. EQUITY - MEDTRONIC STOCKCategoryOrItem
Listed At Cost Or FMVAT COSTListedAtCostOrFMV
Book Value4144953BookValue
EOYFMV5500350EOYFMV

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionRevenue And Expenses Per BooksRevenueAndExpensesPerBooksNet Investment IncomeNetInvestmentIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
STATE OF MN FILING FEE25025
MISCELLANEOUS3600

Taxes Schedule TaxesSchedule

Taxes Taxes (2 entries)

CategoryCategoryAmountAmountNet Investment IncomeNetInvestmentIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
FEDERAL EXCISE TAX PAID - 12/31/2010$000
ESTIMATED EXCISE TAX PAID - CURRENT YEAR$2,11700

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