KIOWA COUNTY HEALTH FOUNDATION: Form 990PF, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
KIOWA COUNTY HEALTH FOUNDATION (EIN 48-1064221)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-05-12
IRS object ID
201111329349101501
Schema version
2010v3.2
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)
Timestamp2011-05-12T12:06:51-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SMOLL & BANNING CPA'S LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12410 CENTRAL AVEAddressLine1
CityDODGE CITYCity
StateKSState
ZIP Code67801ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN481064221EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KIOWA COUNTY HEALTH FOUNDATION CO TOM CORNSBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKIOWNameControl
Phone6207233341Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1304 S SPRUCEAddressLine1
CityGREENSBURGCity
StateKSState
ZIP Code67054ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTOM CORNSName
TitleTREASURERTitle
Phone6207233341Phone
Date Signed2011-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameE KENT SMOLL CPAPFSName
Phone6202256100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY566869FMVAssetsEOY
Method Of Accounting CashXMethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Received Rev And Expnss3494ContriReceivedRevAndExpnss
Not Required To Attach Schedule BXNotRequiredToAttachScheduleB
Interest On Savings Rev And Expnss8433InterestOnSavingsRevAndExpnss
Interest On Savings Net Invst Incm8433InterestOnSavingsNetInvstIncm
Capital Gain Net Incm Net Invst Incm0CapitalGainNetIncmNetInvstIncm
Total Revenue And Expenses11927TotalRevenueAndExpenses
Total Net Investment Income8433TotalNetInvestmentIncome
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 Expnss775AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm581AccountingFeesNetInvstIncm
Accounting Fees Dsbrs Chrtbl Prps194AccountingFeesDsbrsChrtblPrps
Taxes Rev And Expnss224TaxesRevAndExpnss
Taxes Net Invst Incm0TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps40TaxesDsbrsChrtblPrps
Other Expenses Rev And Expnss1380OtherExpensesRevAndExpnss
Other Expenses Net Invst Incm0OtherExpensesNetInvstIncm
Other Expenses Dsbrs Chrtbl Prps1380OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss2379TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm581TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps1614TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss7750ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps7750ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss10129TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm581TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps9364TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses1798ExcessOfRevenueOverExpenses
Net Investment Income7852NetInvestmentIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Savings And Temp Cash Invst BOY457520SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY508799SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV508799SavingsAndTempCashInvstEOYFMV
Other Notes And Loans Receivable42874OtherNotesAndLoansReceivable
Allwnc For Dbtfl Acct Other Rcvbl0AllwncForDbtflAcctOtherRcvbl
Other Notes And Loans Rcvbl BOY92355OtherNotesAndLoansRcvblBOY
Other Notes And Loans Rcvbl EOY42874OtherNotesAndLoansRcvblEOY
Other Notes And Loans Rcvbl EOYFMV42874OtherNotesAndLoansRcvblEOYFMV
Investments Other BOY15196InvestmentsOtherBOY
Investments Other EOY15196InvestmentsOtherEOY
Investments Other EOYFMV15196InvestmentsOtherEOYFMV
Total Assets BOY565071TotalAssetsBOY
Total Assets EOY566869TotalAssetsEOY
Total Assets EOYFMV566869TotalAssetsEOYFMV
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Org That Do Not Follow SFAS117XOrgThatDoNotFollowSFAS117
Capital Stock BOY331991CapitalStockBOY
Capital Stock EOY331991CapitalStockEOY
Paid In Or Capital Surplus BOY0PaidInOrCapitalSurplusBOY
Paid In Or Capital Surplus EOY0PaidInOrCapitalSurplusEOY
Retained Earnings BOY233080RetainedEarningsBOY
Retained Earnings EOY234878RetainedEarningsEOY
Total Net Assets BOY565071TotalNetAssetsBOY
Total Net Assets EOY566869TotalNetAssetsEOY
Total Liabilities Net Assets BOY565071TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY566869TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY565071TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses1798ExcessOfRevenueOverExpenses
Other Increases0OtherIncreases
Subtotal566869Subtotal
Other Decreases0OtherDecreases
Total Net Assets Fund Balances EOY566869TotalNetAssetsFundBalancesEOY

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 Tax0LiableFor4942Tax
Qualifying Distributions Year17401QualifyingDistributionsYear1
Noncharitable Assets Year1553289NoncharitableAssetsYear1
Distribution Ratio Year10.013376DistributionRatioYear1
Qualifying Distributions Year214716QualifyingDistributionsYear2
Noncharitable Assets Year2542508NoncharitableAssetsYear2
Distribution Ratio Year20.027126DistributionRatioYear2
Qualifying Distributions Year320881QualifyingDistributionsYear3
Noncharitable Assets Year3184445NoncharitableAssetsYear3
Distribution Ratio Year30.113210DistributionRatioYear3
Qualifying Distributions Year422700QualifyingDistributionsYear4
Noncharitable Assets Year4105718NoncharitableAssetsYear4
Distribution Ratio Year40.214722DistributionRatioYear4
Total Distribution Ratio0.368434TotalDistributionRatio
Average Distribution Ratio0.092109AverageDistributionRatio
Net Noncharitable Assets557480NetNoncharitableAssets
Adjusted Noncharitable Assets51349AdjustedNoncharitableAssets
One Percent Net Investment Income79OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One51428AdjNonchrtblAssetsAndOnePct
Qualifying Distributions9364QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Investment Income Excise Tax157InvestmentIncomeExciseTax
Tax Under Section5110TaxUnderSection511
Subtotal157Subtotal
Subtitle A Tax0SubtitleATax
Tax Based On Investment Income157TaxBasedOnInvestmentIncome
Total Credits And Payments0TotalCreditsAndPayments
Tax Due157TaxDue

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 Sect508e0RequirementsOfSect508e
At Least5000 In Assets1AtLeast5000InAssets
States Filed WithKSStatesFiledWith
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 Person NameTOM CORNSBooksInCareOfPersonName
Books In Care Of Phone Number6207232131BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line1GREENSBURG STATE BANK 240 SOUTHAddressLine1
Address Line2MAINAddressLine2
CityGREENSBURGCity
StateKSState
ZIP Code67054ZIPCode
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 (8 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
ROGER STAATS
418 S POPLARGREENSBURGKS67054PRESIDENT1.00000
TOM CORNS
304 S SPRUCEGREENSBURGKS67054TREASURER1.00000
ELMER DAVIS
RR 2 BOX 32HAVILANDKS67059DIRECTOR1.00000
VERA CUTRIGHT
402 N EMPORIAHAVILANDKS67059VICE-PRESIDENT1.00000
KENNETH UNRUH
RR 2 BOX 32LEWISKS67552DIRECTOR1.00000
PAUL KENDALL
318 E KINGMANMULLINVILLEKS67109DIRECTOR1.00000
MARY SWEET
603 S SPRUCEGREENSBURGKS67054DIRECTOR1.00000
DORIS HEADRICK
120 N MAINMULLINVILLEKS67109DIRECTOR1.00000
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

Summary Of Direct Charitable Acty SummaryOfDirectCharitableActy

FieldValueIRS element (for citing)
Description1GRANTS TO VARIOUS ORGANIZATIONS IN KIOWA COUNTY THAT PROVIDE HEALTH CARE IN KIOWA COUNTY.Description1
Expenses11500Expenses1
Description2THE ORGANIZATION HAS PROVIDED SCHOLARSHIPS FOR AREA STUDENTS TAKING MEDICIAL RELATED STUDIES.Description2
Expenses26250Expenses2

Sum Of Program Related Investments SumOfProgramRelatedInvestments

FieldValueIRS element (for citing)
Total0Total

Minimum Investment Return MinimumInvestmentReturn

FieldValueIRS element (for citing)
Avg Monthly FMV Of Securities15196AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances341760AvgMonthlyCashBalances
FMV All Other Noncharitable Assets209014FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets565970TotalFMVOfUnusedAssets
Reduction Claimed0ReductionClaimed
Acquisition Indebtedness0AcquisitionIndebtedness
Adj Total FMV Of Unused Assets565970AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable8490CashDeemedCharitable
Net Noncharitable Assets557480NetNoncharitableAssets
Minimum Investment Return27874MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return27874MinimumInvestmentReturn
Tax Based On Investment Income157TaxBasedOnInvestmentIncome
Total Tax157TotalTax
Distributable Amount Before Adj27717DistributableAmountBeforeAdj
Recoveries Qlfy Distributions0RecoveriesQlfyDistributions
Distributable Amount Before Ded27717DistributableAmountBeforeDed
Deduction Fr Distributable$0DeductionFrDistributableAmount
Distributable Amount As Adjusted27717DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions9364ExpensesAndContributions
Program Related Investments Total0ProgramRelatedInvestmentsTotal
Qualifying Distributions9364QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm0OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions9364AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted27717DistributableAmountAsAdjusted
Undistributed Income Prior Year2424UndistributedIncomePriorYear
Total For Prior Years0TotalForPriorYears
Total Excess Distri Carryover0TotalExcessDistriCarryover
Qualifying Distributions9364QualifyingDistributions
Applied To Year12424AppliedToYear1
Applied To Prior Years0AppliedToPriorYears
Treated As Distri From Corpus0TreatedAsDistriFromCorpus
Applied To Current Year6940AppliedToCurrentYear
Remaining Distri From Corpus0RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus0ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY0ExcessDistriCyovAppliedCY
Total Corpus0TotalCorpus
Prior Year Undistributed Income0PriorYearUndistributedIncome
Prior Year Deficiency Or Tax0PriorYearDeficiencyOrTax
Taxable Amount10TaxableAmount1
Taxable Amount20TaxableAmount2
Undistributed Income CY20777UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g30DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year50ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year0ExcessDistriCyovToNextYear

Supplementary Information SupplementaryInformation

Appication Submission Info AppicationSubmissionInfo (2 entries)

Recipient NameRecipientNameAddress Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient Phone NumberRecipientPhoneNumberForm And Info And MaterialsFormAndInfoAndMaterialsSubmission DeadlinesSubmissionDeadlinesRestrictions On AwardsRestrictionsOnAwards
TOM CORNS304 S SPRUCEGREENSBURGKS670546207232131SCHOLARSHIPS APPLICATIONS REQUIRE BASIC PERSONAL INFORMATION AND THE APPLICANT'S GRADE POINT AVERAGE.THE SCHOLARSHIP DEADLINE IS SET ANNUALLY BY THE SCHOLARSHIP ADMINISTRATOR.SCHOLARHIP RECIPIENTS MUST BE IN THE MEDICAL FIELD WITH THE POSSIBILITY OF BEING KIOWA COUNTY MEMORIAL HOSPITAL EMPLOYEES. SCHOLARSHIPS ARE LIMITED TO $1,000 PER RECIPIENT PER YEAR.
TOM CORNS304 S SPRUCEGREENSBURGKS670546207232131LETTERS ARE SUBMITTED BY THOSE REQUESTING GRANT AWARDS.GRANT LETTERS ARE DUE PRIOR TO THE ANNUAL MEETING HELD IN JANUARY.GRANT AWARDEES MUST PROVIDE SERVICES TO KIOWA COUNTY RESIDENTS.

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (13 entries)

Address Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient RelationshipRecipientRelationshipPurpose Of Grant Or ContributionPurposeOfGrantOrContributionAmountAmount
DELICIA TORRES
410 S SYCAMOREGREENSBURGKS67054NONESCHOLARSHIP$500
JOSHUA KIMBLE
PO BOX 62MULLINVILLEKS67109NONESCHOLARSHIP$500
BROOKE MAIER
1222 S MAINGREENSBURGKS67059NONESCHOLARSHIP$1,000
BRANDON YOHN
17252 G STREETGREENSBURGKS67054NONESCHOLARSHIP$500
JESSICA DAVIS
PO BOX 335HAVILANDKS67059NONESCHOLARSHIP$500
IROQUOIS CENTER FOR HUMAN DEVELOPMENT INC
610 E GRANTGREENSBURGKS67054NONEMENTAL HEALTH CENTER$500
KIOWA COUNTY MEMORIAL HOSPITAL
721 W KANSASGREENSBURGKS67054NONEHOSPITAL$500
LANE KENDALL
RR 1 BOX 96HAVILANDKS67059NONESCHOLARSHIP$500
MACI COLCLAZIER
603 S SPRUCEGREENSBURGKS67124NONESCHOLARSHIP$750
NICHOLE ROSE
702 N WICHITAHAVILANDKS67059NONESCHOLARSHIP$1,000
SOUTHWIND HOSPICE
126 S MAINPRATTKS67124NONEMEDICAL CARE$500
LINDSEY HEFT
410 S POPLARGREENSBURGKS67054NONESCHOLARSHIP$500
SUSAN KAMES
530 E WISCONSIN AVEGREENSBURGKS67054NONESCHOLARSHIP$500
FieldValueIRS element (for citing)
Tot Grant Or Contri Paid During Year7750TotGrantOrContriPaidDuringYear
Tot Grant Or Contri Approved Future0TotGrantOrContriApprovedFuture

Analysis Income Producing Acty AnalysisIncomeProducingActy

Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst

FieldValueIRS element (for citing)
Exclusion Code14ExclusionCode
Exclusion$8,433ExclusionAmount

Subtotals Part XVIA SubtotalsPartXVIA

FieldValueIRS element (for citing)
Unrelated Business Income$0UnrelatedBusinessIncomeAmount
Exclusion$8,433ExclusionAmount
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Part XVIA8433TotalPartXVIA

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

FieldValueIRS element (for citing)
CategoryACCOUNTINGCategory
Amount$775Amount
Net Investment Income581NetInvestmentIncome
Disbursements Charitable Prps194DisbursementsCharitablePrps

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOther

FieldValueIRS element (for citing)
Category Or ItemSOUTH CENTRAL COMMUNITY FOUNDATIONCategoryOrItem
Listed At Cost Or FMVFMVListedAtCostOrFMV
Book Value15196BookValue
EOYFMV15196EOYFMV

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionRevenue And Expenses Per BooksRevenueAndExpensesPerBooksNet Investment IncomeNetInvestmentIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
DEVELOPMENT PROGRAMS125701257
SUPPLIES1230123

Taxes Schedule TaxesSchedule

Taxes Taxes (2 entries)

CategoryCategoryAmountAmountNet Investment IncomeNetInvestmentIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
CORPORATE ANNUAL FEE$40040
INVESTMENT EXCISE TAX$18400

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