DR HANS AND BETTY RUBIN MEMORIAL FUND: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- DR HANS AND BETTY RUBIN MEMORIAL FUND (EIN 34-6884022)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-05-08
- IRS object ID
- 202311289349302281
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-08T13:00:30-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 134008324 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRICEWATERHOUSECOOPERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1850 N CENTRAL AVE STE 700 | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346884022 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DR HANS J RUBIN AND BETTY RUBIN MEMORIAL FUND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RUBI | BusinessNameControlTxt |
| Phone | 2166897663 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4900 TIEDEMAN ROAD OH-01-49-0381 | AddressLine1Txt |
| City | BROOKLYN | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44144 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEYBANK BYP S CHMURA | PersonNm |
| Person Title | VICE PRESIDENT | PersonTitleTxt |
| Phone | 2166897663 | PhoneNum |
| Signature | 2023-04-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY E KUHLIN | PreparerPersonNm |
| PTIN | P00353001 | PTIN |
| Phone | 4123556000 | PhoneNum |
| Preparation | 2023-04-26 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Keybank NA Trustee | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4900 Tiedeman | AddressLine1Txt |
| City | Brooklyn | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44144 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $150,462 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | Grants are made according to Trust Agreement dated June 16, 1987. Keybank, as Trustee, makes distributions as follows: 10% to National Jewish Center, 10% to Holy Family Cancer Home, 10% to Lutheran Medical Center, 10% to Judson Retirement Community, and 60% to Mt. Sinai Health Care FDN. Keybank maintains a responsiveness to the needs and activities of each beneficiary organization in the attainment of its mission. The Charity has the right to remove the Trustee, authority to appoint Co-Trustees or Committee Members, and authority to withdraw principal. The Trustee has the authority to amend the document to insure the continuation to qualify as a 509(a)3. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $282,524 | PYInvestmentIncomeAmt |
| CY Investment Income | -$11,935 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $282,524 | PYTotalRevenueAmt |
| CY Total Revenue | -$11,935 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $106,106 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $123,500 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,957 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,425 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,688 | PYOtherExpensesAmt |
| CY Other Expenses | $1,250 | CYOtherExpensesAmt |
| PY Total Expenses | $132,751 | PYTotalExpensesAmt |
| CY Total Expenses | $146,175 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $149,773 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$158,110 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,231,188 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,073,080 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,231,188 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,073,080 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Grants are made according to Trust Agreement dated June 16, 1987. Keybank, as Trustee, makes distributions as follows: 10% to National Jewish Center, 10% to Holy Family Cancer Home, 10% to Lutheran Medical Center, 10% to Judson Retirement Community, and 60% to Mt. Sinai Health Care FDN. Keybank maintains a responsiveness to the needs and activities of each beneficiary organization in the attainment of its mission. The Charity has the right to remove the Trustee, authority to appoint Co-Trustees or Committee Members, and authority to withdraw principal. The Trustee has the authority to amend the document to insure the continuation to qualify as a 509(a)3. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $74,100 | ExpenseAmt |
| Grant | $74,100 | GrantAmt |
| Desc | Grants made to the Mt. Sinai Medical Center will be used for support of an Opthamology/Botulinum Toxin Program | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,350 | ExpenseAmt |
| Grant | $12,350 | GrantAmt |
| Desc | Grants made to the Holy Family Home will be used to purchase air mattresses for the patients. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,350 | ExpenseAmt |
| Grant | $12,350 | GrantAmt |
| Desc | Grants made to Lutheran Medical Center will be used to the support of their Hospice Program. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,350 | ExpenseAmt |
| Grant | $12,350 | GrantAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $12,350 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $12,350 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $111,150 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Excs Tax Sect4951 Or4952 Or4953 | false | ExcsTaxSect4951Or4952Or4953Ind |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 1 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KeyBank NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2168134556 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4900 Tiedeman OH-01-49-0150 | AddressLine1Txt |
| City | Brooklyn | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 441442302 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Keybank NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | Trustee | TitleTxt |
| Average Hours Per Week | 1.0 | AverageHoursPerWeekRt |
| Institutional Trustee | Yes (X) | InstitutionalTrusteeInd |
| Reportable Comp From Org | $42,850 | ReportableCompFromOrgAmt |
| Reportable Comp From Rltd Org | $0 | ReportableCompFromRltdOrgAmt |
| Other Compensation | $0 | OtherCompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $42,850 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,239 | TotalRevenueColumnAmt |
| Exclusion | $21,239 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $129,223 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $162,397 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$33,174 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$33,174 | TotalRevenueColumnAmt |
| Exclusion | -$33,174 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$11,935 | TotalRevenueColumnAmt |
| Exclusion | -$11,935 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,500 | TotalAmt |
| Program Services | $123,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,425 | TotalAmt |
| Management And General | $21,425 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,050 | TotalAmt |
| Management And General | $1,050 | ManagementAndGeneralAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200 | TotalAmt |
| Management And General | $200 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,175 | TotalAmt |
| Program Services | $123,500 | ProgramServicesAmt |
| Management And General | $22,675 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $62,753 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,188 | BOYAmt |
| EOY | $2,010,327 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,188 | BOYAmt |
| EOY | $2,073,080 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,188 | BOYAmt |
| EOY | $2,073,080 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,188 | BOYAmt |
| EOY | $2,073,080 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,188 | BOYAmt |
| EOY | $2,073,080 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$158,110 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| Acct Compile Or Review Basis | AcctCompileOrReviewBasisGrp | |
| FS Audited | false | FSAuditedInd |
| FS Audited Basis | FSAuditedBasisGrp | |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Non Func | Yes (X) | SupportingOrgType3NonFuncInd |
| Supported Organizations | 5 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (5 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| National Jewish Center | ||||
| 742044647 | 3 | Yes (true) | $12,350 | $0 |
| Holy Family Cancer Home | ||||
| 340877463 | 3 | Yes (true) | $12,350 | $0 |
| Lutheran Medical Center | ||||
| 340714684 | 3 | Yes (true) | $12,350 | $0 |
| Judson Retirement Community | ||||
| 340714539 | 3 | Yes (true) | $12,350 | $0 |
| Mt Sinai Health Care | ||||
| 341777878 | 3 | Yes (true) | $74,100 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 5 | SupportedOrganizationsTotalCnt |
| Support Sum | $123,500 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | Yes (true) | ExcessBusinessHoldingsRulesInd |
| Excess Business Holdings | false | ExcessBusinessHoldingsInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (true) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | false | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (true) | SupportedOrgVoiceInvestmentInd |
Adjusted Net Income AdjustedNetIncomeGrp
Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $26,884 | PriorYearAmt |
Recoveries PY Distributions RecoveriesPYDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
Other Gross Income OtherGrossIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $15,032 | PriorYearAmt |
| Current Year | $21,239 | CurrentYearAmt |
Adjusted Gross Income AdjustedGrossIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $41,916 | PriorYearAmt |
| Current Year | $21,239 | CurrentYearAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
Production Income ProductionIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $24,957 | PriorYearAmt |
| Current Year | $21,425 | CurrentYearAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
Total Adjusted Net Income TotalAdjustedNetIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $16,959 | PriorYearAmt |
Minimum Asset Amount MinimumAssetAmountGrp
Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $2,469,809 | PriorYearAmt |
| Current Year | $2,119,769 | CurrentYearAmt |
Average Monthly Cash Balances AverageMonthlyCashBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $2,469,809 | PriorYearAmt |
| Current Year | $2,119,769 | CurrentYearAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discount Claimed | $0 | DiscountClaimedAmt |
Acquisition Indebtedness AcquisitionIndebtednessGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $2,469,809 | PriorYearAmt |
| Current Year | $2,119,769 | CurrentYearAmt |
Cash Deemed Charitable CashDeemedCharitableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $37,047 | PriorYearAmt |
| Current Year | $31,797 | CurrentYearAmt |
Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $2,432,762 | PriorYearAmt |
| Current Year | $2,087,972 | CurrentYearAmt |
Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $85,147 | PriorYearAmt |
| Current Year | $73,079 | CurrentYearAmt |
Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
Total Minimum Asset TotalMinimumAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $85,147 | PriorYearAmt |
| Current Year | $73,079 | CurrentYearAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Adj Net Income Distributable | $16,959 | CYAdjNetIncomeDistributableAmt |
| CY Pct85 Adjusted Net Income | $14,415 | CYPct85AdjustedNetIncomeAmt |
| CY Total Min Ast Distributable | $85,147 | CYTotalMinAstDistributableAmt |
| CY Greater Adjusted Minimum | $85,147 | CYGreaterAdjustedMinimumAmt |
| CY Income Tax Imposed PY | $0 | CYIncomeTaxImposedPYAmt |
| CY Distributable As Adjusted | $85,147 | CYDistributableAsAdjustedAmt |
Distributions DistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Paid Accomplish Exempt Prps | $123,500 | CYPaidAccomplishExemptPrpsAmt |
| CY Pd In Excess Income Activity | $0 | CYPdInExcessIncomeActivityAmt |
| CY Administrative Expense Paid | $0 | CYAdministrativeExpensePaidAmt |
| Exempt Use Assets Acquis Paid | $0 | ExemptUseAssetsAcquisPaidAmt |
| Qualified Set Aside | $0 | QualifiedSetAsideAmt |
| CY Other Distributions | $0 | CYOtherDistributionsAmt |
| CY Total Annual Distributions | $123,500 | CYTotalAnnualDistributionsAmt |
| CY Distri Attentive Suprt Org | $123,500 | CYDistriAttentiveSuprtOrgAmt |
| CY Distributable As Adjusted | $85,147 | CYDistributableAsAdjustedAmt |
| CY Distribution Yr | 1.0 | CYDistributionYrRt |
Distribution Allocations DistributionAllocationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Distributable As Adjusted | $85,147 | CYDistributableAsAdjustedAmt |
| Underdistributions | $0 | UnderdistributionsAmt |
| Excess Distribution Cyov Yr5 | $0 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $0 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $20,589 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $105,882 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $106,106 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $232,577 | TotalExcessDistributionCyovAmt |
| Cyov Applied Underdistri PY | $0 | CyovAppliedUnderdistriPYAmt |
| Cyov Applied Underdistr CPY | $85,147 | CyovAppliedUnderdistrCPYAmt |
| Carryover PY Not Applied | $0 | CarryoverPYNotAppliedAmt |
| Excess Distribution Cyov | $147,430 | ExcessDistributionCyovAmt |
| CY Total Annual Distributions | $123,500 | CYTotalAnnualDistributionsAmt |
| CY Distrib App Underdistri PY | $0 | CYDistribAppUnderdistriPYAmt |
| Excess Distribution | $123,500 | ExcessDistributionAmt |
| Remaining Underdistri PY | $0 | RemainingUnderdistriPYAmt |
| Remaining Underdistri CY | $0 | RemainingUnderdistriCYAmt |
| Excess Distri Cyov To Next Yr | $270,930 | ExcessDistriCyovToNextYrAmt |
| Excess From Year5 | $0 | ExcessFromYear5Amt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $41,324 | ExcessFromYear3Amt |
| Excess From Year2 | $106,106 | ExcessFromYear2Amt |
| Excess From Year1 | $123,500 | ExcessFromYear1Amt |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Line 2 | KeyBank representatives have completed an extensive internal review of supporting organization accounts. This was done in concert with in house counsel and individual determinations were made with respect to the relationships.The beneficiaries have the right to remove the trustee and the trustee has the right to amend the trust to insure continuation of 509(a)3 status. |
| Line 3 | KeyBank, as Trustee, welcomes the input of the charitable beneficiaries as to investments. |
| Line 8 | KeyBank, as Trustee, maintains a close and continuous working relationship with National Jewish Center, Judson Retirement Community, Holy Family Cancer Home, Lutheran Medical Center and Mt. Sinai Health Care FDN. All five supported organizations maintain a significant voice as they have the right to remove the Trustee and replace with another corporate Trustee. The Trustee has the |
| Line 8 Continued. | authority to amend the document to insure the continuation of 509(a)3 status. The supported organizations receive periodic statements reflecting all activity in the trust regarding income, expenses, and investments. KeyBank welcomes the input of the supported organizations as to investments. |
Schedule D IRS990ScheduleD
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CHARITABLE MULTI ASSET FUND | $2,010,327 | C |
| KT SHORT TERM DEPOSIT FUND | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,010,327 | TotalBookValueSecuritiesAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Business Name Line2RecipientBusinessName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|
| MT SINAI MEDICAL CENTER | ||||||||
| 11000 EUCLID AVE 3RD FL | CLEVELAND | OH | 44106 | 341777878 | 170(b)(1)(A | $74,100 | Support of an Opthomolagy program | |
| HOLY FAMILY CANCER HOME | ||||||||
| 6707 STATE RD | PARMA | OH | 44134 | 340877463 | 170(b)(1)(A) | $12,350 | To purchase air mattresses for patients. | |
| LUTHERAN MEDICAL CENTER | ||||||||
| 6801 BRECKSVILLE RD STE 20 RK45 | INDEPENDENCE | OH | 44131 | 340714684 | 170(b)(1)(A) | $12,350 | Support of their Hospice program | |
| NATIONAL JEWISH CENTER | ||||||||
| 1400 JACKSON ST ROOM M220 | DENVER | CO | 802062761 | 742044647 | 170(b)(1)(A) | $12,350 | Asthma research | ATTN SERENA FERRIN |
| JUDSON RETIREMENT COMMUNITY | ||||||||
| 1890 E 107TH ST | CLEVELAND | OH | 44106 | 340714539 | 170(b)(1)(A) | $12,350 | ||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | EXPLANATION FOR FORM 990, SCHEDULE I, PART 1, LINE 2 | FormAndLineReferenceDesc |
| Explanation | GRANTS ARE MADE TO 501(C)3 ORGANIZATIONS THAT ARE NAMED IN THE TRUST DOCUMENT. OUR ADMINISTRATIVE REPRESENTATIVES ARE IN PERIODIC CONTACT WITH REPRESENTATIVES OF THE CHARITIES IN ORDER TO BE IN COMPLIANCE WITH THE TRUST PROVISIONS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 12 a | No conflict of interest policy exists for the trust. Keybank, N.A. has a corporate document retention and destruction policy. |
| Part VI, Line 14 | The trust has no written document retention or destruction policy.Keyb ank N.A. has a corporate document retention and destruction policy. |
| EXPLANATION FOR FORM 990, PAGE 2, PART III, LINE 4d | The National Jewish Center grants will be used for the Asthma Research program. Judson Retirement Comm grants will be used for in-service training. |
| EXPLANATION FOR FORM 990, PAGE 6, PART VI, LINE 1a | Keybank is sole trustee |
| FORM 990, PAGE 6, PART VI, LINE 11-DESCRIPTION OF PROCESS FOR REVIEW | ALL RETURNS ARE PREPARED AND THOROUGHLY REVIEWED BY OUR TAX VENDOR AND/OR INTERNAL PROFESSIONAL TAX DEPARTMENT. |
| FORM 990, PAGE 6, PART VI, LINE 19 | Documents are available upon request by mail or phone and delivered within two weeks. |
| EXPLANATION FOR FORM 990, PART XI, LINE 9 | ROUNDING |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NATIONAL JEWISH CENTER | ||||||||||
| 1400 JACKSON ST ROOM M220 | DENVER | CO | 802062761 | 742044647 | ASTHMA RESEARCH | CO | 501(c)3 | 170(b)(1)(A) | N/A | false |
| LUTHERAN MEDICAL CENTER | ||||||||||
| 6801 BRECKSVILLE RD STE 20 | INDEPENDENCE | OH | 44131 | 340714684 | SUPPORT OF HOSPICE PROGRAM | OH | 501(c)3 | 170(b)(1)(A) | N/A | false |
| HOLY FAMILY CANCER HOME | ||||||||||
| 6707 STATE RD | PARMA | OH | 44134 | 340877463 | PURCHASE AIR MATTRESSES FOR PATIENTS | OH | 501(c)3 | 170(b)(1)(A) | N/A | false |
| MT SINAI MEDICAL CENTER | ||||||||||
| 11000 EUCLID AVE 3RD FL | CLEVELAND | OH | 44106 | 341777878 | SUPPORT OF OPHTHALMOLOGY PROGRAM | 501(c)3 | 170(b)(1)(A) | N/A | false | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |