DR DONALD N & JANE L BERNING: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DR DONALD N & JANE L BERNING (EIN 45-2457323)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2023-02-28
- IRS object ID
- 202300599349101110
- Schema version
- 2021v4.2
- 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
- Form 990-PF
- Depreciation Schedule
- Investments Corp Stock Schedule
- Investments Land Schedule2
- Investments Other Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-02-28T16:15:46-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation Source | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3333 New Hyde Park Rd Ste 406 | AddressLine1Txt |
| City | New Hyde Park | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452457323 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dr Donald N & Jane L Berning Private | BusinessNameLine1Txt |
| Business Name Line2 | Foundation | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Foundation Source | InCareOfNm |
| Business Name Control | DRDO | BusinessNameControlTxt |
| Phone | 8008391754 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Foundation Source 501 Silverside Rd | AddressLine1Txt |
| City | Wilmington | CityNm |
| State Abbreviation | DE | StateAbbreviationCd |
| ZIP | 198091377 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD JACK BENSON | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8008391754 | PhoneNum |
| Signature | 2023-02-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RONALD JACK | PersonFirstNm |
| Person Last | BENSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeffrey D Haskell | PreparerPersonNm |
| PTIN | P01345770 | PTIN |
| Phone | 8008391754 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $8,858,583 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $0 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $1,267 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $1,267 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $6,650 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $6,650 | DividendsNetInvstIncmAmt |
| Gross Rents Rev And Expnss | $5,700 | GrossRentsRevAndExpnssAmt |
| Gross Rents Net Invst Incm | $5,700 | GrossRentsNetInvstIncmAmt |
| Net Rental Income Or Loss | -$13,300 | NetRentalIncomeOrLossAmt |
| Net Gain Sale Ast Rev And Expnss | $2,816 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $586,091 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $3,123 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $392,376 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $380,523 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $408,809 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $397,263 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $110,640 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $110,640 | CompOfcrDirTrstDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $9,000 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $9,000 | PensionEmplBnftDsbrsChrtblAmt |
| Other Prof Fees Rev And Expnss | $3,397 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $3,397 | OtherProfFeesNetInvstIncmAmt |
| Taxes Rev And Expnss | $6,359 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $4,281 | TaxesNetInvstIncmAmt |
| Deprec And Dpltn Rev And Expnss | $4,606 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $4,606 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $0 | DeprecAndDpltnAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $62,525 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $10,272 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $52,253 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $196,527 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $22,556 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $171,893 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $185,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $185,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $381,527 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $22,556 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $356,893 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $27,282 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $374,707 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $218,870 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $416,819 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $416,819 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl | $8,265 | AcctRcvblAmt |
| Acct Rcvbl EOY | $8,265 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $8,265 | AcctRcvblEOYFMVAmt |
| Corporate Stock BOY | $331,132 | CorporateStockBOYAmt |
| Corporate Stock EOY | $335,308 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $347,120 | CorporateStockEOYFMVAmt |
| Invst Land Cost Or Other Basis | $350,564 | InvstLandCostOrOtherBasisAmt |
| Invst Land Accum Depreciation | $59,878 | InvstLandAccumDepreciationAmt |
| Land Bldg Investments BOY | $169,728 | LandBldgInvestmentsBOYAmt |
| Land Bldg Investments EOY | $290,686 | LandBldgInvestmentsEOYAmt |
| Land Bldg Investments EOYFMV | $373,064 | LandBldgInvestmentsEOYFMVAmt |
| Other Investments BOY | $8,673,805 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $8,369,814 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $7,713,315 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $9,393,535 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,420,892 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $8,858,583 | TotalAssetsEOYFMVAmt |
| Other Liabilities BOY | $4,212 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $4,287 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $4,212 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,287 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Retained Earning BOY | $9,389,323 | RetainedEarningBOYAmt |
| Retained Earning EOY | $9,416,605 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $9,389,323 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $9,416,605 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $9,393,535 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $9,420,892 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $9,389,323 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $27,282 | ExcessRevenueOverExpensesAmt |
| Subtotal | $9,416,605 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $9,416,605 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)
| PropertyPropertyDesc | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt |
|---|---|---|---|---|---|---|---|
| Publicly-traded Securities | $40,463 | $37,340 | $3,123 | $3,123 | |||
| FIDELITY & GUARANTY LIFE INSURANCE - ANNUITY POLICY # L9241745 | $545,628 | $545,628 | P | 2012-04-26 | 2021-06-22 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $3,123 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $5,208 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $5,208 | SubtotalAmt |
| Tax Based On Investment Income | $5,208 | TaxBasedOnInvestmentIncomeAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $5,208 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | DE | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation Source | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8008391754 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 Silverside Road Suite 123 | AddressLine1Txt |
| City | Wilmington | CityNm |
| State Abbreviation | DE | StateAbbreviationCd |
| ZIP | 198091377 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| Faith Benson | ||||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Sec | 1.0 | $0 | $0 | $0 |
| Jack Benson | ||||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir, Pres | 40.0 | $110,640 | $0 | $0 |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation Source | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Walls Drive 3rd Fl | AddressLine1Txt |
| City | Fairfield | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06824 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Service Type | Administrative | ServiceTypeTxt |
| Compensation | $51,532 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $354,324 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $359,763 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $7,810,672 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $8,524,759 | TotalFMVOfUnusedAssetsAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $8,524,759 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $127,871 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $8,396,888 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $419,844 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $419,844 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $5,208 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $5,208 | TotalTaxAmt |
| Distributable Before Adj | $414,636 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $414,636 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $414,636 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $356,893 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $356,893 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $414,636 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $294,180 | UndistributedIncomePYAmt |
| Prior Year1 | 2019 | PriorYear1Yr |
| Prior Year2 | 2018 | PriorYear2Yr |
| Prior Year3 | 2017 | PriorYear3Yr |
| Qualifying Distributions | $356,893 | QualifyingDistributionsAmt |
| Applied To Year1 | $294,180 | AppliedToYear1Amt |
| Applied To Current Year | $62,713 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Undistributed Income CY | $351,923 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
| Excess From Current Year | $0 | ExcessFromCurrentYearAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Foundations | PrivateOperatingFoundationsGrp |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | NONE | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (5 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| FRIENDS OF THE ROSE GARDEN MISSION INC | |||||||
| PO BOX 122089 | COVINGTON | KY | 41012 | N/A | PC | General & Unrestricted | $25,000 |
| GO PANTRY CORPORATION | |||||||
| 7960 KENTUCKY DR | FLORENCE | KY | 41042 | N/A | PC | General & Unrestricted | $10,000 |
| NORTHERN KENTUCKY AREA DEVELOPMENT DISTRICT | |||||||
| 22 SPIRAL DR | FLORENCE | KY | 41042 | N/A | PC | Meals on Wheels | $100,000 |
| PADDLING FOR CANCER AWARENESS INC | |||||||
| PO BOX 76213 | HIGHLAND HGTS | KY | 41076 | N/A | PC | General & Unrestricted | $15,000 |
| SUNRISE CHILDRENS SERVICES | |||||||
| PO BOX 1429 | MT WASHINGTON | KY | 40047 | N/A | PC | General & Unrestricted | $35,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $185,000 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp |
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $1,267 | ExclusionAmt |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $6,650 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp |
Net Rntl Incm Re Not Debt Fincd Prop NetRntlIncmReNotDebtFincdProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 16 | ExclusionCd |
| Exclusion | -$13,300 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Income | OtherInvestmentIncomeGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $2,816 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Other Revenue Described OtherRevenueDescribedGrp (3 entries)
| DescDesc | ExclusionExclusionCd | ExclusionExclusionAmt |
|---|---|---|
| NET INCOME FROM ANNUITIES | 14 | $380,523 |
| INCOME FROM LIFE INSURANCE POLICIES | 14 | $10,154 |
| FEDERAL TAX REFUND | 01 | $1,699 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $389,809 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $389,809 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp (4 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | Cost Or Other BasisCostOrOtherBasisAmt | Prior Year DepreciationPriorYearDepreciationAmt | Computation MethodComputationMethodTxt | LifeLifeRt | Current Year ExpenseCurrentYearExpenseAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|---|---|---|---|---|
| BLDG-1 SUNNYMEDE | 2010-12-31 | $190,000 | $55,272 | SL | 27 | $4,606 | $0 | $0 |
| LAND-1 SUNNYMEDE | 2012-12-31 | $35,000 | L | |||||
| LAND IMPR -1 SUNNY | $74,065 | SL | 15 | $0 | $0 | $0 | ||
| BLDG IMPR-1 SUNNY | $51,499 | SL | 27 | $0 | $0 | $0 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (27 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| AMAZON COM | $22,846 | $40,012 |
| BORG WARNER INC | $18,719 | $13,521 |
| CLEAN ENERGY FUELS CORP | $17,609 | $12,260 |
| GILEAD SCIENCES INC | $12,280 | $7,261 |
| GLOBAL X FDS GLOBAL X MLP ETF | $1,995 | $2,903 |
| INVESCO PREFERRED ETF | $7,025 | $7,035 |
| INVESCO SENIOR LOAN ETF | $4,521 | $4,553 |
| ISHARES BROAD USD HIGH YIELD C | $8,569 | $8,815 |
| ISHARES CORE US REIT ETF | $4,983 | $7,232 |
| ISHARES JP MORGAN USD EM MKTS | $7,042 | $6,762 |
| KINDER MORGAN INC | $21,458 | $7,930 |
| POLARIS INDUSTRIES | $15,236 | $10,991 |
| SCHWAB STRATEGIC TRINTL SMALL | $9,911 | $10,806 |
| SCHWAB U.S. SMALL-CA | $6,003 | $8,294 |
| SCHWAB US MID CAP | $16,522 | $19,866 |
| SCHWAB US TIPS | $6,701 | $6,855 |
| SPDR PORTFOLIO AGGREGATE BOND | $11,286 | $10,900 |
| SPDR PORTFOLIO DEVELOPED WORLD | $19,775 | $22,873 |
| SPDR PORTFOLIO EMERGING MARKET | $17,066 | $18,048 |
| SPDR PORTFOLIO LONG TERM CORPO | $4,738 | $4,596 |
| SPDR S&P 500 GROWTH | $29,378 | $40,800 |
| SPDR S&P 500 VALUE | $22,625 | $29,442 |
| SPDR SER TR BARCLAYS CAP CONV | $4,113 | $4,646 |
| TWITTER INC | $25,434 | $21,610 |
| VANGUARD MORTGAGE-BACKED SEC I | $4,593 | $4,491 |
| VANGUARD SHORT TERM CORPORATE | $6,735 | $6,582 |
| WORLD GOLD TRUST SPDR GOLD MIN | $8,145 | $8,036 |
Investments Land Schedule2 InvestmentsLandSchedule2
Investment Land InvestmentLandGrp (4 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|---|
| BLDG-1 SUNNYMEDE | $190,000 | $59,878 | $130,122 | $127,819 |
| LAND-1 SUNNYMEDE | $35,000 | $35,000 | $119,681 | |
| LAND IMPR -1 SUNNY | $74,065 | $0 | $74,065 | $74,065 |
| BLDG IMPR-1 SUNNY | $51,499 | $0 | $51,499 | $51,499 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (17 entries)
| Category Or ItemCategoryOrItemTxt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| AMERICAN NATIONAL DEFERRED ANN | $700,000 | $682,238 |
| AMERICO FIN - ANNUITY R57535 | $316,234 | $294,097 |
| AMERICO FIN - ANNUITY R59225 | $672,204 | $618,428 |
| AMERICO FIN - ANNUITY R60947 | $649,197 | $597,261 |
| ASSURITY LIFE INSURANCE CO - P | $301,000 | $279,727 |
| ATHENE LIFE INSURANCE -138443 | $523,478 | $499,005 |
| ATHENE LIFE INSURANCE -148688 | $623,517 | $589,749 |
| EQUITRUST LIFE INS CO -1139642 | $547,491 | $486,386 |
| EQUITRUST LIFE INS CO -1134581 | $359,591 | $359,591 |
| FIDELITY &GUARANTY LIFE 3983 | $385,010 | $365,138 |
| FIDELITY &GUARANTY LIFE 23224 | $711,502 | $654,582 |
| NAT WESTERN LIFE - ANNUIT 3591 | $479,475 | $451,546 |
| NAT WESTERN LIFE - ANNUIT 9169 | $646,618 | $557,123 |
| NAT WESTERN LIFE - ANNUIT 2588 | $180,479 | $153,254 |
| NATIONWIDE - ANNUITY POLICY # | $191,521 | $183,315 |
| SILAC (EQUITABLE) INSURANCE CO | $582,497 | $441,875 |
| DELAWARE LIFE INS - ANNUITY | $500,000 | $500,000 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|---|
| Administrative Fees | $51,532 | $51,532 | |
| Bank Charges | $93 | $93 | |
| POSTAGE/DELIVERY FEES | $66 | $66 | |
| Payroll Processing Fees | $696 | $696 | |
| Property insurance | $4,582 | $4,582 | |
| Property Maintenance | $5,531 | $5,531 | |
| State or Local Filing Fees | $25 | $25 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| net income from annuities | $380,523 | $380,523 |
| income from life insurance policies | $10,154 | |
| Federal Tax Refund | $1,699 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYROLL TAX WITHHOLDINGS | Desc |
| BOY Book Value | $4,212 | BOYBookValueAmt |
| EOY Book Value | $4,287 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Investment Management Services | CategoryTxt |
| Amt | $3,397 | Amt |
| Net Investment Income | $3,397 | NetInvestmentIncomeAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| 990-PF Excise Tax for 2020 | $2,078 | |
| Property Taxes | $4,281 | $4,281 |