JACOBSON FOUNDATION INC: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- JACOBSON FOUNDATION INC (EIN 83-2452568)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-03-15
- IRS object ID
- 202320749349100712
- Schema version
- 2022v4.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-03-15T11:23:47-04:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 871635668 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Khan & Associates PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6330 Belmont Rd - 2 | AddressLine1Txt |
| City | Downers Grove | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60516 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 832452568 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jacobson Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JACO | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N2809 Demynck RD | AddressLine1Txt |
| City | Lodi | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53555 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lisa A Jacobson | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 6084820707 | PhoneNum |
| Signature | 2023-03-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Lisa | PersonFirstNm |
| Person Last | Jacobson | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Faraz Khan CPA | PreparerPersonNm |
| PTIN | P01756439 | PTIN |
| Phone | 6308521961 | PhoneNum |
| Preparation | 2023-03-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | 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 | $4,014 | 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 | $2,650 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Total Rev And Expnss | $2,650 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $0 | TotalNetInvstIncmAmt |
| Accounting Fees Rev And Expnss | $300 | AccountingFeesRevAndExpnssAmt |
| Other Expenses Rev And Expnss | $54 | OtherExpensesRevAndExpnssAmt |
| Tot Opr Expenses Rev And Expnss | $354 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $2,500 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $2,854 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $0 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$204 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $2,501 | CashBOYAmt |
| Cash EOY | $2,013 | CashEOYAmt |
| Cash EOYFMV | $2,013 | CashEOYFMVAmt |
| Sav And Temp Cash Invst EOY | $2,001 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $2,001 | SavAndTempCashInvstEOYFMVAmt |
| Total Assets BOY | $2,501 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,014 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,014 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $2,501 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $4,014 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $2,501 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $4,014 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $2,501 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $4,014 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $2,501 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$204 | ExcessRevenueOverExpensesAmt |
| Subtotal | $2,297 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $2,297 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $0 | TaxBasedOnInvestmentIncomeAmt |
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 | false | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | false | AtLeast5000InAssetsInd |
| Org Report Or Register State | WI | OrgReportOrRegisterStateCd |
| 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 |
| Individual With Books | Lisa A Jacobson | IndividualWithBooksNm |
| Phone | 6084820707 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N2809 Demynck Rd | AddressLine1Txt |
| City | Lodi | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53555 | ZIPCd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|
| Bruce L Jacobson | ||||||||
| N2809 Demynck Rd | Lodi | WI | 53555 | SecretaryVP | 1.00 | $0 | $0 | $0 |
| Lisa A Jacobson | ||||||||
| N2809 Demynck Rd | Lodi | WI | 53555 | President | 1.00 | $0 | $0 | $0 |
| Xander L Jacobson | ||||||||
| N2809 Demynck RD | Lodi | WI | 53555 | Director | 0.00 | $0 | $0 | $0 |
| Zachary J Jacobson | ||||||||
| N2809 Demynck RD | Lodi | WI | 53555 | Director | 0.00 | $0 | $0 | $0 |
| Austin R Jacobson | ||||||||
| N2809 Demynck RD | Lodi | WI | 53555 | Director | 0.00 | $0 | $0 | $0 |
| Kaitlin N Jacobson | ||||||||
| N2809 Demynck RD | Lodi | WI | 53555 | Director | 0.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | Hodan Community Center Donation to Golf Event Fundraiser | Description1Txt |
| Expenses1 | $2,000 | Expenses1Amt |
| Description2 | Wisconsin Dells School Holiday Gifts | Description2Txt |
| Expenses2 | $500 | Expenses2Amt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $2,000 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $2,000 | TotalFMVOfUnusedAssetsAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $2,000 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $30 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $1,970 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $99 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $99 | MinimumInvestmentReturnAmt |
| Distributable Before Adj | $99 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $99 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $99 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $0 | ExpensesAndContributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $99 | DistributableAsAdjustedAmt |
| Undistributed Income CY | $99 | UndistributedIncomeCYAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $0 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
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 |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Accounting | CategoryTxt |
| Amt | $300 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Foundation Wisc Filing Fees | Desc |
| Revenue And Expenses Per Books | $54 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |