CHAD A JACOBS MEMORIAL FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CHAD A JACOBS MEMORIAL FOUNDATION (EIN 27-2884884)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201223189349300902
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)
Timestamp2012-11-13T08:22:35-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN113080565EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SCHWARTZ & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12580 SUNRISE HIGHWAYAddressLine1
CityBELLMORECity
StateNYState
ZIP Code11710ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN272884884EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHAD A JACOBS MEMORIAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHADNameControl
Phone2032472133Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16 SLEIGH RIDGEAddressLine1
CityWESTPORTCity
StateCTState
ZIP Code06880ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKAREN JACOBSName
TitleCHAIRTitle
Phone2032472133Phone
Date Signed2012-11-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMICHAEL J SCHWARTZ CPAName
PTINP00115049PTIN
Phone5164095000Phone
Date Prepared2012-11-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKAREN JACOBSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16 SLEIGH RIDGEAddressLine1
CityWESTPORTCity
StateCTState
ZIP Code06880ZIPCode
FieldValueIRS element (for citing)
Gross Receipts159074GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CAJFOUNDATION.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2010YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionTHE CHAD A. JACOBS MEMORIAL FOUNDATION PROVIDES ACADEMIC AND ATHLETIC SCHOLARSHIP TO CHILDREN IN FINANCIAL NEED FOCUSING ON CHILDREN WHO RESIDE IN CONNECTICUT.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year190020ContributionsGrantsPriorYear
Contributions Grants Current Year158224ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year519InvestmentIncomePriorYear
Investment Income Current Year850InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year190539TotalRevenuePriorYear
Total Revenue Current Year159074TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY13450GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year25057TotalFundrsngExpCurrentYear
Other Expense Prior Year115OtherExpensePriorYear
Other Expenses Current Year27524OtherExpensesCurrentYear
Total Expenses Prior Year115TotalExpensesPriorYear
Total Expenses Current Year40974TotalExpensesCurrentYear
Revenues Less Expenses Prior Year190424RevenuesLessExpensesPriorYear
Revenues Less Expenses CY118100RevenuesLessExpensesCY
Total Assets BOY190424TotalAssetsBOY
Total Assets EOY308524TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY190424NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY308524NetAssetsOrFundBalancesEOY
Mission DescriptionTHE FOUNDATION WILL FUND ATHLETIC AND ACADEMIC SCHOLARSHIPS TO KIDS IN NEED AT FAIRFIELD PREPARATORY SCHOOL AND AT WONDERLAND OF ICE IN BRIDGEPORT, CT.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense13450Expense
Grants13450Grants
Revenue850Revenue
DescriptionTHE FOUNDATION WILL FUND ATHLETIC AND ACADEMIC SCHOLARSHIPS TO KIDS IN NEED AT FAIRFIELD PREPARATORY SCHOOL AND AT WONDERLAND OF ICE IN BRIDGEPORT, CT.Description
Total Program Service Expense13450TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DON JACOBSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2032472133TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 414AddressLine1
CitySOUTHPORTCity
StateCTState
ZIP Code06890ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KAREN JACOBS
CHAIR10.00XX000
TOM RYAN
ASSISTANT CHAIR2.00XX000
DON JACOBS
TREASURER2.00XX000
GINNY JACOBS
SECRETARY1.00XX000
SCOTT SANTARELLA
BOARD MEMBER1.00X000
BRENDON FREY
BOARD MEMBER1.50X000
JOSEPH TEKLITS
BOARD MEMBER1.50X000
DOUG TINKLER
BOARD MEMBER1.00X000
CHRIS HARBERT
BOARD MEMBER1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions158224AllOtherContributions
Total Contributions158224TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column850TotalRevenueColumn
Related Or Exempt Function Income850RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column159074TotalRevenueColumn
Related Or Exempt Function Income850RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total13450Total
Program Services13450ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total50Total
Management And General50ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalFundraisingFundraisingManagement And GeneralManagementAndGeneral
FUNDRAISER EXPENSES2505725057
CREDIT CARD FEES24072407
BANK SERVICE CHARGE1010

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total40974Total
Program Services13450ProgramServices
Management And General2467ManagementAndGeneral
Fundraising25057Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY190424BOY
EOY308224EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY300EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY190424BOY
EOY308524EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY190424BOY
EOY308524EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY190424BOY
EOY308524EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY190424BOY
EOY308524EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses118100ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year190020CurrentTaxYearMinus1Year
Current Tax Year158224CurrentTaxYear
Total348244Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year190020CurrentTaxYearMinus1Year
Current Tax Year158224CurrentTaxYear
Total348244Total
FieldValueIRS element (for citing)
Public Support Total170348244PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year519CurrentTaxYearMinus1Year
Current Tax Year850CurrentTaxYear
Total1369Total
FieldValueIRS element (for citing)
Total Support349613TotalSupport
Public Support Pertcentage1700.99610PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99730PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue159074TotalRevenue
Total Expenses40974TotalExpenses
Excess Or Deficit For Year118100ExcessOrDeficitForYear
Excess Or Deficit Per FS118100ExcessOrDeficitPerFS

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
FAIRFIELD COLLEGE PREPARATORY SCHOOL
1073 NORTH BENSON ROADFAIRFIELDCT068240606466236500PROVIDES ACADEMIC AND ATHLETIC SCHOLARSHIP TO CHILDREN IN FINANCIAL NEED FOCUSING ON CHILDREN WHO RESIDE IN CONNECTICUT.
WONDERLAND WIZARDS YOUTH HOCKEY ASSOCIATION INC
PO BOX 55348BRIDGEPORTCT066102001480706950PROVIDES ACADEMIC AND ATHLETIC SCHOLARSHIP TO CHILDREN IN FINANCIAL NEED FOCUSING ON CHILDREN WHO RESIDE IN CONNECTICUT.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 2DON JACOBS AND GINNY JACOBS ARE HUSBAND AND WIFE. DON JACOBS AND GINNY JACOBS ARE KAREN JACOBS IN-LAWS. KAREN JACOBS AND BRENDON FREY ARE 1ST COUSINS. TOM RYAN IS SECOND COUSIN TO KAREN JACOBS AND BRENDON FREY.
FORM 990, PART VI, SECTION B, LINE 11THE GOVERNING BODY MEETS TO REVIEW FORM 990.
FORM 990, PART VI, SECTION C, LINE 19"CHAD A JACOBS MEMORIAL FOUNDATION" GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.