STRATEGY STUDIO / PUBLIC DATA EXPLORER

C&K CLARK FAMILY FOUNDATION: Form 990PF, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
C&K CLARK FAMILY FOUNDATION (EIN 20-2047246)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-03-30
IRS object ID
202330899349100433
Schema version
2022v5.0
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)
Return2023-03-30T14:51:34-07:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN205395756PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Serra & Company CPA LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16118 W Corporate Oaks DriveAddressLine1Txt
CityCrystal RiverCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34429ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN202047246EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE C&K CLARK FAMILY FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlC&KCBusinessNameControlTxt
Phone3522708425PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11725 N SKY GLEN PATHAddressLine1Txt
CityHERNANDOCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34442ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATHLEEN A CLARKPersonNm
Person TitleVice PresidentPersonTitleTxt
Signature2023-03-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKATHLEEN APersonFirstNm
Person LastCLARKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEdward J Serra CPAPreparerPersonNm
PTINP00010682PTIN
Phone3527943879PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,756,612FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$169,600ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$525InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$525InterestOnSavNetInvstIncmAmt
Interest On Savings Adj Net Incm$525InterestOnSavingsAdjNetIncmAmt
Dividends Rev And Expnss$44,800DividendsRevAndExpnssAmt
Dividends Net Invst Incm$44,800DividendsNetInvstIncmAmt
Dividends Adj Net Incm$44,800DividendsAdjNetIncmAmt
Net Gain Sale Ast Rev And Expnss$103,512NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$104,476GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$103,512CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm$103,512NetSTCapitalGainAdjNetIncmAmt
Total Rev And Expnss$318,437TotalRevAndExpnssAmt
Total Net Invst Incm$148,837TotalNetInvstIncmAmt
Total Adj Net Incm$148,837TotalAdjNetIncmAmt
Accounting Fees Rev And Expnss$3,400AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$3,400AccountingFeesNetInvstIncmAmt
Other Prof Fees Rev And Expnss$5,124OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$5,124OtherProfFeesNetInvstIncmAmt
Other Expenses Rev And Expnss$60OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$60OtherExpensesNetInvstIncmAmt
Tot Opr Expenses Rev And Expnss$8,584TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$8,584TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$184,070ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$184,070ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$192,654TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$8,584TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$184,070TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$125,783ExcessRevenueOverExpensesAmt
Net Investment Income$140,253NetInvestmentIncomeAmt
Adjusted Net Income$148,837AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$23,081SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$148,864SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$45,352SavAndTempCashInvstEOYFMVAmt
Corporate Stock EOYFMV$3,711,260CorporateStockEOYFMVAmt
Total Assets BOY$23,081TotalAssetsBOYAmt
Total Assets EOY$148,864TotalAssetsEOYAmt
Total Assets EOYFMV$3,756,612TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind
No Donor Rstr Net Assests BOY$23,081NoDonorRstrNetAssestsBOYAmt
No Donor Rstr Net Assests EOY$148,864NoDonorRstrNetAssestsEOYAmt
Tot Net Ast Or Fund Balances BOY$23,081TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$148,864TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$23,081TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$148,864TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$23,081TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$125,783ExcessRevenueOverExpensesAmt
Subtotal$148,864SubtotalAmt
Tot Net Ast Or Fund Balances EOY$148,864TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp

FieldValueIRS element (for citing)
Property200 United Health GroupPropertyDesc
How AcquiredPHowAcquiredCd
Acquired2022-04-21AcquiredDt
Sold2022-04-28SoldDt
Gross Sales Price$104,476GrossSalesPriceAmt
Cost Or Other Basis$964CostOrOtherBasisAmt
Gain Or Loss$103,512GainOrLossAmt
Gains Minus Excess Or Losses$103,512GainsMinusExcessOrLossesAmt
FieldValueIRS element (for citing)
Capital Gain Net Income$103,512CapitalGainNetIncomeAmt
Net Short Term Capital Gain Loss$103,512NetShortTermCapitalGainLossAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$1,950InvestmentIncomeExciseTaxAmt
Subtotal$1,950SubtotalAmt
Tax Based On Investment Income$1,950TaxBasedOnInvestmentIncomeAmt
Tax Due$1,950TaxDueAmt
Applied To ES Tax$0AppliedToESTaxAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedfalseSection508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateMDOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsfalseNewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1KATHLEEN CLARKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3522708425PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line11725 N SKY GLEN PATHAddressLine1Txt
CityHERNANDOCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34442ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnfalseSaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnfalseBrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnfalseFurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnfalsePayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Acts Fail To Qlfy As ExceptionsfalseActsFailToQlfyAsExceptionsInd
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmt
CHARLES R CLARK MD
1725 N SKY GLEN PATHHERNANDOFL34442President1.00$0
KATHLEEN A CLARK
1725 N SKY GLEN PATHHERNANDOFL34442Vice President1.00$0
EMILY ANN CLARK WIERSCHKE
5 FORDHAM CTMILLERSVILLEMD21108Treasurer0.00$0
LAURA BETH CLARK
1440 HARDING PL APT 629CHARLOTTENC28204Secretary0.00$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$0AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$0AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$0TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Adjusted Total FMV Of Unused Ast$0AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$0CashDeemedCharitableAmt
Net Vl Noncharitable Assets$0NetVlNoncharitableAssetsAmt
Minimum Investment Return$0MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Tax Based On Investment Income$1,950TaxBasedOnInvestmentIncomeAmt
Total Tax$1,950TotalTaxAmt
Distributable Before Adj$1,950DistributableBeforeAdjAmt
Distributable Before Ded$1,950DistributableBeforeDedAmt
Distributable As Adjusted$0DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$184,070ExpensesAndContributionsAmt
Qualifying Distributions$184,070QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$0DistributableAsAdjustedAmt
Excess Distribution Cyov Yr4$9,835ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr1$131,228ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$141,063TotalExcessDistributionCyovAmt
Qualifying Distributions$184,070QualifyingDistributionsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Remaining Distri From Corpus$184,070RemainingDistriFromCorpusAmt
Total Corpus$325,133TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov To Next Yr$325,133ExcessDistriCyovToNextYrAmt
Excess From Year4$9,835ExcessFromYear4Amt
Excess From Year1$131,228ExcessFromYear1Amt
Excess From Current Year$184,070ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonCHARLES KATHLEEN CLARKRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line11725 N SKY GLEN PATHAddressLine1Txt
CityHERNANDOCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34442ZIPCd
FieldValueIRS element (for citing)
Recipient Phone3522708425RecipientPhoneNum
Form And Info And MaterialsNO SPECIFIC FORMAT REQUIREDFormAndInfoAndMaterialsTxt
Submission DeadlinesNONESubmissionDeadlinesTxt
Restrictions On AwardsNONERestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (42 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
PI KAPPA ALPHA EDUCATION FOUNDATION
8347 WEST RANGE COVEMEMPHISTN38125NONE501c3FELLOWSHIP$1,000
ASPCA
424 EAST 92ND STREETNEW YORKNY10128NONE501c3HELP Homeless$20
FLORIDA SHERIFFS YOUTH RANCH
P O BOX 2000Boys RanchFL32064NONE501c3ASSIST LAW PROGRAMS$5,000
CITRUS COUNTY FOUNDATION FOR ANIMAL
P O BOX 1164INVERNESSFL34451NONE501c3Education$5,000
KEY TRAINING CENTER
5399 W GULF TO LAKE HWYLECANTOFL34461NONE501c3Education FOR GIFTED$2,000
ALPHA SIGMA TAU NATIONAL FOUNDATION
3334 FOUNDERS RDINDIANAPOLISIN46268NONE501c3education$2,000
JOHNS HOPKINS UNIVERSITY
550 N BROADWAYBALTIMOREMD21205NONE501c3MEDICAL Education$20,000
UNITY
1901 NW BLUE PARKWAYUNITY VILLAGEMO64065NONE501c3Education$1,000
BALTMORE HUMANE SOCIETY
1601 NICODEMUS ROADREISTERTOWNMD21136NONE501c3Animal Care$2,000
JOHN HOPKINS MEDICINE
PO BOX 49143BALTIMOREMD21297NONE501c3YOUTH Education$5,000
JOHN HOPKINS UNIVERSITY SURGERY
550 N BROADWAYBALTIMOREMD21205NONE501c3Animal Shelter$10,000
WOUNDED WARRIOR PROJECT
PO BOX 758517TOPEKAKS66675NONE501c3Wounded Veterans$2,000
LIGHTHOUSE FOR THE VISUALLY IMPAIRE
8610 GALEN WILSON BLVDPORT RICHEYFL34668NONE501c3Help the Blind$5,000
FREDERICK CHURCH OF THE BRETHREN
201 FAIRVIEW AVEFREDERICKMD21701NONE501c3IMpoverished Children$2,000
MEDICAL ALUMNI ASSOCIATION OF UNIV
522 W LOMBARD STREETBALTIMOREMD21201NONE501c3NURSING Education$1,000
PAULA TAKACS FOUNDATION
PO Box 784146CharlotteNC28271NONE501c3Medical Research$5,000
DEFENDERS OF ANIMAL RIGHTS INC
PO BOX 25PHOENIXMD21131NONE501c3Animal Rights$5,000
HILLSDALE COLLEGE
POBOX 96607WASHINGTONDC20090NONE501c3Education$1,000
GUIDING EYES FOR THE BLIND
P O BOX 709Yorktown HeightsNY10598NONE501c3Helping the Blind$5,000
NATIONAL DISASTER SEARCH DOG FOUNDA
6800 WHEELER CANYON RDSANTA PAULACA93060NONE501C3DISASTER RELIEF$5,000
BEST FRIENDS ANIMAL SOCIETY
5001 ANGEL CANYON RDKANABUT84741NONE501c3SAVE ANIMAL LIVES$10,000
THE NICKY FUND
P O BOX 253FULTONMD20759NONE501c3DISABLED CHILD LAST WISH$1,000
PATH OF CITRUS COUNTY
PO BOX 3024INVERNESSFL34451NONE501C3BATTERED WOMEN & CHILDREN SHELTER$1,000
ALPHA XI DELTA
8702 FOUNDERS ROADINDIANAPOLISIN46268NONE501C3EDUCATION$2,000
JOHNS HOPKINS MEDICINE
600 N WOLFE STREET CMSC 130BALTIMOREMD21287NONE501c3FUND FOR JOHNS HOPKINS MEDICINE$15,000
LABRADOR RETRIEVER RESCUE OF FLORID
1950 NE 6TH ST 10365POMPANO BEACHFL33060NONE501C3RESCUE OF DOGS$1,000
KAPPA ALPHA THETA FOUNDATION
8740 FOUNDERS ROADINDIANAPOLISIN46268NONE501c3EDUCATION$2,000
SOUTHEASTERN GUIDE DOGS
4210 77TH STREET EASTPALMETTOFL34221NONE501C3EDUCATION$5,000
MARYLAND SPCA
3300 FALLS RDBALTIMOREMD21211NONE501c3FELLOWSHIP$3,000
MARYLAND FOOD BANK
2200 HALETHORPE FARMS ROADBALTIMOREMD21227NONE501c3Supply Funds for Food$1,000
REGENTS OF THE UC
PO BOX 7145PASADENACA91109NONE501c3FUND GIFT$10,000
WARRIOR CANINE CONNECTION
14934 SCHAEFFER ROADBOYODSMD20841NONE501c3GIFT$2,000
SPCA INTERNATIONAL
P O BOX 2008MILFORDNH03055NONE501c3YOUTH EDUCATION$50
CATHERINE OF VIOLET HUBBARD FOUNDAT
PO BOX 3571NEWTONCT06470NONE501c3ANIMAL SANCTUARY AND ANIMAL MEDICINE$1,000
WILMER EYE INSTITUTE
600 N WOLFE STREETBALTIMOREMD21287NONE501C3RESEARCH$10,000
DELTA GAMMA FOUNDATION
3250 RIVERSIDE DRCOLUMBUSOH43211NONEEOFCHARITY$2,000
UNIVERSITY OF FLORIDA FOUNDATION
PO BOX 100125GAINESVILLEFL32610NONEEOFEDUCATION$5,000
PI KAPPA ALPHA FOUNDATION
8347 WEST RANGE COVEMEMPHISTN38125NONEEOFCHARITY$1,000
BALTIMORE ANIMAL RESCUE AND CARE SO
2490 GILES RDBALTIMOREMD21225NONE5013CANIMAL CARE AND RESCUE$2,000
JOHN HOPKINS MEDICINE CARDIOLOGY
3910 KESWICK RD STE N2100BALTIMOREMD21211NONE5013CFUND FOR JOHN HOPKINS MEDICINE$20,000
TOYS FOR TOTS
18251 QUATICO GATEWAY DRTRIANGLEVA22172NONE501C3PROVIDE FOR UNDERPRIVILEGED CHILDREN$1,000
TUNNEL TO TOWERS FOUNDATION
PO BOX 70719PHILADELPHIAPA19179NONE501C39/11/2001 FUND$5,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$184,070TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$525ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$44,800ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion1ExclusionCd
Exclusion$103,512ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$148,837ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$148,837TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EOfalseTrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EOfalseTrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EOfalsePurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth AssetsfalseRentalOfFacilitiesOthAssetsInd
Reimbursement ArrangementsfalseReimbursementArrangementsInd
Loans Or Loan GuaranteesfalseLoansOrLoanGuaranteesInd
Performance Of Services EtcfalsePerformanceOfServicesEtcInd
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOfalseRelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Contributor PersonCHARLES KATHLEEN CLARKContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line11725 N Sky Glen PathAddressLine1Txt
CityHernandoCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34442ZIPCd
FieldValueIRS element (for citing)
Total Contributions$169,600TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd
Noncash ContributionYes (X)NoncashContributionInd

Non Cash Property Contribution NonCashPropertyContributionGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Noncash Property200 SHARES OF UNH STOCKNoncashPropertyDesc
Fair Market Value$109,600FairMarketValueAmt
Received2022-04-21ReceivedDt

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail (2 entries)

AmtAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
$3,100$3,100$0$0
$300$300$0$0

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

FieldValueIRS element (for citing)
DescPOSTAGEDesc
Revenue And Expenses Per Books$60RevenueAndExpensesPerBooksAmt
Net Investment Income$60NetInvestmentIncomeAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
Categorymanagement feesCategoryTxt
Amt$5,124Amt
Net Investment Income$5,124NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt