SAMPLE FOUNDATION INC: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SAMPLE FOUNDATION INC (EIN 59-6138602)
- Tax period
- 2021-11-01 to 2022-10-31
- Filed
- 2023-09-14
- IRS object ID
- 202332579349100828
- 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
- Schedule B
- Accounting Fees Schedule
- Depreciation Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Land Etc Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-09-14T14:48:13-05:00 | ReturnTs |
| Tax Period End | 2022-10-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 N 31ST ST STE 1120 | AddressLine1Txt |
| City | BILLINGS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 591011281 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2021-11-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 596138602 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMPLE FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMP | BusinessNameControlTxt |
| Phone | 4062450550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 279 | AddressLine1Txt |
| City | BILLINGS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BARBARA M SAMPLE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR/PRESIDENT | PersonTitleTxt |
| Phone | 4062450550 | PhoneNum |
| Signature | 2023-09-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BARBARA | PersonFirstNm |
| Person Last | SAMPLE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RONALD J YATES JR CPA | PreparerPersonNm |
| PTIN | P00543293 | PTIN |
| Phone | 4068962400 | PhoneNum |
| Preparation | 2023-09-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| 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 | $9,686,205 | 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 | $191,185 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $8,964 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $8,964 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $135,214 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $135,214 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $10,417 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $4,602,833 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $10,417 | CapGainNetIncmNetInvstIncmAmt |
| Incm Modifications Adj Net Incm | $6,500 | IncmModificationsAdjNetIncmAmt |
| Other Income Rev And Expnss | $14,164 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $11,157 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $359,944 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $165,752 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $6,500 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $4,500 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $2,250 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $2,250 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $24,111 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $24,111 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $1,792 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $1,792 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $3,889 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Other Expenses Rev And Expnss | $538 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $268 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $34,830 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $28,421 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $2,250 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $485,585 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $485,585 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $520,415 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $28,421 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $487,835 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$160,471 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $137,331 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $6,500 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $49,357 | CashBOYAmt |
| Cash EOY | $44,216 | CashEOYAmt |
| Cash EOYFMV | $44,216 | CashEOYFMVAmt |
| Corporate Stock BOY | $2,471,638 | CorporateStockBOYAmt |
| Corporate Stock EOY | $2,471,638 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $6,584,373 | CorporateStockEOYFMVAmt |
| Other Investments BOY | $3,180,396 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $3,025,255 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,054,116 | OtherInvestmentsEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $36,500 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,000 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $7,389 | LandBOYAmt |
| Land EOY | $3,500 | LandEOYAmt |
| Land EOYFMV | $3,500 | LandEOYFMVAmt |
| Total Assets BOY | $5,708,780 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,544,609 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $9,686,205 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $10,200 | AccountsPayableBOYAmt |
| Total Liabilities BOY | $10,200 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $5,698,580 | CapitalStockBOYAmt |
| Capital Stock EOY | $5,544,609 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $0 | RetainedEarningBOYAmt |
| Retained Earning EOY | $0 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $5,698,580 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $5,544,609 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $5,708,780 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $5,544,609 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $5,698,580 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$160,471 | ExcessRevenueOverExpensesAmt |
| Other Increases | $6,500 | OtherIncreasesAmt |
| Subtotal | $5,544,609 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $5,544,609 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| BNY MELLON - PUBLICLY TRADED SECURITIES | 2021-09-13 | 2022-10-06 | $4,592,416 | $4,592,416 | $0 | $0 | |
| CAPITAL GAINS DIVIDENDS | $10,417 | $10,417 | $10,417 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $10,417 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $1,909 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $1,909 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $1,909 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $3,137 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $3,137 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $1,228 | OverpaymentAmt |
| Applied To ES Tax | $1,228 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | MT | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | SAMPLEFOUNDATION.ORG | WebsiteAddressTxt |
| Individual With Books | BARBARA SAMPLE | IndividualWithBooksNm |
| Phone | 4062450550 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 279 | AddressLine1Txt |
| City | BILLINGS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
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 |
|---|---|---|---|---|---|---|---|---|
| JOSEPH S SAMPLE DECEASED 101322 | ||||||||
| 606 HIGHLAND PARK DRIVE | BILLINGS | MT | 59102 | CHAIRMAN | 0.10 | $0 | $0 | $0 |
| BRIDGET SAMPLE JOYNER | ||||||||
| 1298 TAMMANY LN | HAMILTON | MT | 59840 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| BARBARA SAMPLE | ||||||||
| 2517 IRVING PLACE | BILLINGS | MT | 59102 | EXEC. DIRECTOR/PRESIDENT | 1.00 | $0 | $0 | $0 |
| DAVID F SAMPLE | ||||||||
| 34174 CAMDEN LANE | POLSON | MT | 59860 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| PATRICK G SAMPLE | ||||||||
| PO BOX 410 | INDEX | WA | 98256 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| RONALD J YATES JR CPA | ||||||||
| PO BOX 7112 | BILLINGS | MT | 591037112 | TREASURER | 0.10 | $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 |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $6,801,506 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $3,245,458 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $10,046,964 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $10,046,964 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $150,704 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $9,896,260 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $494,813 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $494,813 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $1,909 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $1,909 | TotalTaxAmt |
| Distributable Before Adj | $492,904 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $6,500 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $499,404 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $499,404 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $487,835 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $487,835 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $499,404 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr3 | $4,917 | ExcessDistributionCyovYr3Amt |
| Total Excess Distribution Cyov | $4,917 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $487,835 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $487,835 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $4,917 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $4,917 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $6,652 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | JOSEPH S SAMPLE DECEASED 101322 | ContributingManagerNm |
| Contributing Manager | BARBARA SAMPLE | ContributingManagerNm |
| Contributing Manager | DAVID F SAMPLE | ContributingManagerNm |
| Contributing Manager | PATRICK G SAMPLE | ContributingManagerNm |
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | BARBARA SAMPLE | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 279 | AddressLine1Txt |
| City | BILLINGS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 591030279 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 4062565567 | RecipientPhoneNum |
| Form And Info And Materials | LETTER GIVING ORGANIZATIONAL BACKGROUND AND PURPOSES, SPECIFIC NEED & AMOUNT REQUESTED. ATTACH 501(C)(3) IRS DETERMINATION LETTER. | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | AUGUST 1 | SubmissionDeadlinesTxt |
| Restrictions On Awards | GENERALLY LIMITED TO ORGANIZATIONS IN THE STATE OF MONTANA & COLLIER COUNTY FLORIDA. NO GRANTS WILL BE PROVIDED TO RELIGIOUS OR POLITICAL ORGANIZATIONS OR TAX SUPPORTED INSTITUTIONS. | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (71 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt | Address Line2RecipientUSAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|
| ALLIANCE FOR YOUTH INC | |||||||
| 3220 11TH AVE S | GREAT FALLS | MT | 59405 | PC | FURNACES AND HVAC | $10,000 | |
| BIG BROTHERS BIG SISTERS OF BIG SKY COUNTRY | |||||||
| 15 S 8TH AVE | BOZEMAN | MT | 59715 | PC | TECHNOLOGY UPGRADE | $10,000 | |
| BIG SKY SENIOR SERVICES INC | |||||||
| 935 LAKE ELMO DR | BILLINGS | MT | 59105 | PC | SAFEGUARDING SENIORS THROUGH IN-HOME SUPPORTS | $15,000 | |
| BILLINGS PUBLIC LIBRARY FDN | |||||||
| 510 N 28TH STREET | BILLINGS | MT | 59101 | PC | GENERAL SERVICES | $6,000 | |
| BILLINGS PUBLIC SCHOOLS | |||||||
| 101 10TH STREET WEST | BILLINGS | MT | 59102 | GOV | PLAYGROUND & MAINTENANCE PROJECT 2022 | $15,000 | |
| BILLINGS SYMPHONY | |||||||
| 2820 2ND AVE N | BILLINGS | MT | 59101 | PC | PORTABLE PIANO KEYBOARD | $3,500 | |
| BITTER ROOT LAND TRUST | |||||||
| PO BOX 1806 | HAMILTON | MT | 59840 | PC | INCREASING CONSERVATION IMPACT | $7,000 | |
| BLUE MOUNTAIN CLINIC | |||||||
| 610 N CALIFORNIA ST | MISSOULA | MT | 59801 | PC | DESIGNATED | $1,000 | |
| BOYCE ANSLEY SCHOOL | |||||||
| 120 RALPH MCGILL BLVD NE BLDG 3 | ATLANTA | GA | 30308 | PC | DESIGNATED | $1,000 | SUITE B1 |
| BOYS & GIRLS CLUB OF MISSOULA COUNTY | |||||||
| 1515 FAIRVIEW AVE SUITE 243 | MISSOULA | MT | 59801 | PC | WHEELCHAIR ACCESSIBLE VAN | $13,195 | |
| BOYS & GIRLS CLUB OF RICHLAND COUNTY | |||||||
| PO BOX 416 | SIDNEY | MT | 59270 | PC | BGC PLAYGROUND | $12,500 | |
| BOYS & GIRLS CLUB OF THE FLATHEAD RESERVATION AND LAKE COUNTY | |||||||
| PO BOX 334 | RONAN | MT | 59864 | PC | BUILDING AND STABILIZING FLATHEAD BGC SPORTS | $15,000 | |
| BOYS & GIRLS CLUBS OF YELLOWSTONE COUNTY | |||||||
| 505 ORCHARD LANE | BILLINGS | MT | 59101 | PC | COMMITMENT TO SAFETY | $15,000 | |
| BULLETIN OF ATOMIC SCIENTISTS | |||||||
| 77 W WASHINGTON ST | CHICAGO | IL | 60602 | PC | DESIGNATED | $1,000 | |
| CASA OF LAKE CTY | |||||||
| 410 1ST STREET E | POLSON | MT | 59860 | PC | EXPANDED SERVICES | $3,000 | |
| CHILD'S PATH INC (FORMERLY COLLIER CHILD CARE RESOURCES INC - CCCR) | |||||||
| 15275 COLLIER BOULEVARD 201-359 | NAPLES | FL | 34119 | PC | CREATING SAFE SPACES | $30,700 | |
| CHILDREN'S ONCOLOGY FDN | |||||||
| 2110 S JOHNSON ST | MISSOULA | MT | 59801 | PC | DESIGNATED | $1,500 | |
| COUNCIL GROVES APARTMENTS | |||||||
| 1904 S 3RD STREET W | MISSOULA | MT | 59801 | PC | SNOW REMOVAL TRACTOR | $15,000 | |
| EAGLE MOUNT BOZEMAN | |||||||
| 6901 GOLDENSTEIN LANE | BOZEMAN | MT | 59715 | PC | COMPUTER UPGRADE | $8,000 | |
| EASTER SEALS | |||||||
| 157 ROY STREET | SEATTLE | WA | 98109 | PC | DESIGNATED | $3,500 | |
| EMMA'S HOUSE | |||||||
| 310 N 4TH STREET | HAMILTON | MT | 59840 | PC | DESIGNATED | $1,000 | |
| FAMILY FIRST LEARNING LAB | |||||||
| 455 E MAIN STREET | MISSOULA | MT | 59802 | PC | DESIGNATED | $3,000 | |
| FAMILY PROMISE GALLATIN VALLEY | |||||||
| 1603 TSCHACHE LANE | BOZEMAN | MT | 59718 | PC | TRANSITIONAL HOUSE RENOVATION | $15,000 | |
| FARMING FOR THE FUTURE ACADEMY INC | |||||||
| 80 13TH STREET EAST | COLUMBIA FALLS | MT | 59912 | PC | OFF GRID STEAM CLASSROOM | $6,000 | |
| FINLEY POINT FIRE DEPT | |||||||
| 35408 MT HIGHWAY 35 | POLSON | MT | 59860 | GOV | DESIGNATED | $1,000 | |
| FLORENCE CRITTENTON HOME & SERVICES | |||||||
| 901 N HARRIS ST | HELENA | MT | 59601 | PC | CHILD ENRICHMENT CENTER PLAY ZONES | $10,000 | |
| FOCUS FUSION | |||||||
| 128 LINCOLN BLVD | MIDDLESEX | NJ | 08846 | PC | DESIGNATED | $1,500 | |
| FOUNDATION FOR COMMUNITY HEALTH | |||||||
| 2831 FORT MISSOULA RD | MISSOULA | MT | 59804 | PC | MOBILE HEALTH & SAFETY BUS | $7,500 | |
| FRIENDS OF HEYBROOK RIDGE | |||||||
| 50606 INDEX-GALENA RD | INDEX | WA | 98256 | PC | DESIGNATED | $3,500 | |
| FRIENDS OF MT PUBLIC BROADCASTING | |||||||
| PO BOX 173340 | BOZEMAN | MT | 59717 | PC | DESIGNATED | $5,000 | |
| FRIENDS OF THE CHILDREN - MONTANA | |||||||
| 1649 W CENTRAL | MISSOULA | MT | 59801 | PC | PASSENGER VAN | $15,000 | |
| FRIENDS OF WHITEPINE GRANGE | |||||||
| 153 CHILDS RD | TROUT CREEK | MT | 59874 | PC | FURNACE AND DUCTWORK REPOSITIONING | $5,000 | |
| FRIENDSHIP CENTER OF HELENA INC | |||||||
| 1430 N SANDERS | HELENA | MT | 59601 | PC | TECHNOLOGY AND EQUIPMENT | $10,000 | |
| FUNTIME ACADEMY | |||||||
| 102 12TH ST N | NAPLES | FL | 34102 | PC | EQUIPMENT | $10,000 | |
| GARNETT PRESERVATION | |||||||
| PO BOX 18295 | MISSOULA | MT | 59808 | PC | DESIGNATED | $1,500 | |
| GUADALUPE CENTER | |||||||
| 509 HOPE CIRCLE | IMMOKALEE | FL | 34142 | PC | BABY FOOD AND FORMULA | $11,000 | |
| HABITAT FOR HUMANITY OF MISSOULA | |||||||
| PO BOX 7181 | MISSOULA | MT | 59807 | PC | BUILDING HOPE FOR 2022 | $20,000 | |
| HAVEN | |||||||
| PO BOX 752 | BOZEMAN | MT | 597710752 | PC | STORAGE UNITS FOR HAVEN'S NEW SHELTER | $10,000 | |
| HELENA FOOD SHARE | |||||||
| PO BOX 943 | HELENA | MT | 59624 | PC | COMPUTER REPLACEMENT PROJECT | $1,950 | |
| HELP COMMITTEE AND BOYS & GIRLS CLUB OF THE HI-LINE | |||||||
| 500 1ST AVE | HAVRE | MT | 59501 | PC | HVAC UPGRADE | $7,500 | |
| LIVINGSTON FOOD PANTRY | |||||||
| 202 S 2ND ST | LIVINGSTON | MT | 59047 | PC | LOCAL FOOD PROCUREMENT AND DISTRIBUTION | $6,176 | |
| MISSOULA AGING SERVICES | |||||||
| 337 STEPHENS AVE | MISSOULA | MT | 59801 | PC | MASONRY REPAIR | $5,000 | |
| MISSOULA YMCA | |||||||
| 3000 SOUTH RUSSELL | MISSOULA | MT | 59801 | PC | SAFE TRAVELS CAR SEAT FUNDING REQUEST | $3,413 | |
| MISSOULA INTERFAITH COLLABORATIVE | |||||||
| 2205 34TH STREET | MISSOULA | MT | 59801 | PC | IRRIGATION COMPRESSOR | $5,000 | |
| MISSOULA URBAN DEMONSTRATION PROJECT | |||||||
| 1527 WYOMING ST | MISSOULA | MT | 59801 | PC | MUD TRUCK SHARE | $10,000 | |
| MONTANA FOOD BANK NETWORK | |||||||
| 5625 EXPRESSWAY | MISSOULA | MT | 59808 | PC | VOLUNTEER REPACK ROOM CAPITAL EXPENSE | $15,000 | |
| MONTANA NON PROFIT | |||||||
| 7 W 6TH AVE | HELENA | MT | 59601 | PC | DESIGNATED | $3,000 | |
| MONTANA WILDERNESS SCHOOL | |||||||
| PO BOX 1183 | BOZEMAN | MT | 59771 | PC | EMPOWERING YOUTH OUTDOORS | $9,000 | |
| MOUNTAIN HOME | |||||||
| 2606 SOUTH AVE W | MISSOULA | MT | 59804 | PC | DESIGNATED | $1,000 | |
| MUSIC FOR NEWMAN SCHOOL | |||||||
| 605 S BILLINGS BLVD | BILLINGS | MT | 59101 | PC | DESIGNATED | $3,500 | |
| NAPLES COMMUNITY HOSPITAL | |||||||
| 680 2ND AVE N STE 304 | NAPLES | FL | 34102 | PC | DESIGNATED | $1,000 | |
| NORTH STAR SCHOOL DISTRICT 99M | |||||||
| 105 3RD AVE NE | RUDYARD | MT | 59540 | GOV | GROW IT | $10,000 | |
| NORTHEAST MONTANA HEALTH SERVICES CHARITABLE FOUNDATION | |||||||
| PO BOX 341 | POPLAR | MT | 59255 | PC | VAN PURCHASE | $3,000 | |
| OUTDOORS FOR ALL | |||||||
| 6344 NE 74TH ST STE 102 | SEATTLE | WA | 98115 | PC | DESIGNATED | $3,500 | |
| PED WILLOW LEARNING CENTER | |||||||
| 700 SOUTH AVENUE WEST | MISSOULA | MT | 59801 | PC | FREEDOM ON THE INSIDE | $3,468 | |
| REDLODGE YOUTH SOCCER | |||||||
| PO BOX 2167 | RED LODGE | MT | 59068 | PC | YOUTH SOCCER FIELD | $5,000 | |
| ROCKY MOUNTAIN COLLEGE | |||||||
| 1511 POLY DRIVE | BILLINGS | MT | 59102 | PC | SERVICES FOR ACADEMIC SUCCESS CULTURAL ENRICHMENT PROGRAM | $3,500 | |
| RONALD MCDONALD HOUSE CHARITIES OF WESTERN MONTANA | |||||||
| 3003 FORT MISSOULA RD | MISSOULA | MT | 59804 | PC | DESIGNATED | $3,000 | |
| SAFE HARBOR | |||||||
| PO BOX 497 | RONAN | MT | 59864 | PC | SECURITY & MAINTENANCE | $12,000 | |
| ST JOESPH HOSPITAL | |||||||
| 6 13TH AVE E | POLSON | MT | 59860 | PC | DESIGNATED | $3,500 | |
| START UP EVENT CENTER | |||||||
| 14315 366TH AVE SE | STARTUP | WA | 98293 | PC | DESIGNATED | $1,500 | |
| THOREAU ELEMENTARY PTO | |||||||
| 3870 NAKOMA RD | MADISON | WI | 53711 | PC | DESIGNATED | $1,000 | |
| UNIVERSITY OF MONTANA | |||||||
| 950 ARTHUR AVE | MISSOULA | MT | 59807 | GOV | DESIGNATED | $1,500 | |
| WATSON CHILDREN'S CENTER | |||||||
| 4978 BUCKHOUSE LANE | MISSOULA | MT | 59804 | PC | SEPTIC SYSTEM UPGRADE | $8,000 | |
| WESTERN MONTANA LGBT COMMUNITY CENTER | |||||||
| 127 N HIGGINS ST STE 202 | MISSOULA | MT | 59802 | PC | OWL VIDEO CONFERENCE CAMERA | $999 | |
| YELLOWSTONE CASA INC | |||||||
| PO BOX 688 | BILLINGS | MT | 59103 | PC | SECURITY AND SUPPORT | $2,986 | |
| YELLOWSTONE PUBLIC RADIO | |||||||
| 1500 UNIVERSITY DR | BILLINGS | MT | 59101 | PC | DESIGNATED | $5,000 | |
| YES YOUTH EMPOWERMENT SERVICES | |||||||
| 221 OAK STREET | ANACONDA | MT | 59711 | PC | YES LET'S CODE | $2,198 | |
| YRPA | |||||||
| PO BOX 1201 | BILLINGS | MT | 59013 | PC | DESIGNATED | $5,000 | |
| YWCA MISSOULA | |||||||
| 1800 S 3RD ST W | MISSOULA | MT | 59801 | PC | WHEELCHAIR ACCESSIBLE SHOWERS | $10,000 | |
| EASTERN MONTANA CASA GAL INC | |||||||
| 2200 BOX ELDER ST | MILES CITY | MT | 59301 | PC | TRAVEL EXPENSE | $6,000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $485,585 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $8,964 | ExclusionAmt |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $135,214 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $10,417 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp (3 entries)
| DescDesc | ExclusionExclusionCd | ExclusionExclusionAmt |
|---|---|---|
| ENTERPRISE PRODS PARTNERS | 18 | $11,130 |
| OTHER INCOME | 18 | $27 |
| NONDIVIDEND DISTRIBUTIONS | 18 | $3,007 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $168,759 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $168,759 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (4 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| DAVID F SAMPLE | ||||||
| 1 | 34174 CAMDEN LANE | POLSON | MT | 59860 | $59,101 | Yes (X) |
| JOSEPH S SAMPLE (DECEASED 10132022) | ||||||
| 2 | 606 HIGHLAND PARK DRIVE | BILLINGS | MT | 59102 | $18,222 | Yes (X) |
| PATRICK G SAMPLE | ||||||
| 3 | PO BOX 410 | INDEX | WA | 98256 | $59,085 | Yes (X) |
| BARBARA MSAMPLE | ||||||
| 4 | 2517 IRVING PLACE | BILLINGS | MT | 59102 | $54,777 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | CategoryTxt |
| Amt | $4,500 | Amt |
| Net Investment Income | $2,250 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $2,250 | DisbursementsCharitablePrpsAmt |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp (5 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | Cost Or Other BasisCostOrOtherBasisAmt | Prior Year DepreciationPriorYearDepreciationAmt | Computation MethodComputationMethodTxt | LifeLifeRt | Current Year ExpenseCurrentYearExpenseAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|---|---|---|---|---|
| SOFTWARE | 2013-06-20 | $8,500 | $8,500 | SL | 3.000000000000 | $0 | $0 |
| SOFTWARE | 2015-05-12 | $7,000 | $7,000 | SL | 3.000000000000 | $0 | $0 |
| SOFTWARE | 2017-05-20 | $7,000 | $7,000 | SL | 3.000000000000 | $0 | $0 |
| SOFTWARE | 2019-07-02 | $7,000 | $5,444 | SL | 3.000000000000 | $1,556 | $0 |
| SOFTWARE | 2021-05-11 | $7,000 | $1,167 | SL | 3.000000000000 | $2,333 | $0 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (22 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| ABBOT LABS | $35,390 | $247,350 |
| BP AMOCO | $57,031 | $88,059 |
| BRISTOL MYERS SQUIBB | $35,931 | $309,880 |
| EMERSON ELECTRIC | $17,062 | $519,600 |
| JOHNSON & JOHNSON | $60,089 | $403,610 |
| CANADIAN NATIONAL RAILWAY | $30,284 | $651,420 |
| PFIZER INC COM | $104,972 | $139,650 |
| CONOCOPHILLIPS | $90,469 | $441,315 |
| HONEYWELL INTERNATIONAL INC. | $113,673 | $408,040 |
| PROCTOR & GAMBLE COMPANY | $126,593 | $269,340 |
| CHEVRON CORPORATION | $153,457 | $271,350 |
| PHILLIPS 66 | $24,387 | $156,435 |
| VERIZON COMMUNICATIONS INC. | $168,020 | $119,584 |
| WEYERHAEUSER COMPANY | $121,800 | $197,952 |
| ALPHABET INC. | $177,094 | $283,530 |
| CVS HEALTH CORP COM | $180,576 | $284,100 |
| INVESCO EXCHANGE TRADED FD TR S&P 500 | $259,845 | $366,990 |
| JP MORGAN CHASE & CO | $161,297 | $188,820 |
| QUANTA SVCS INC | $166,261 | $710,200 |
| SELECT SECTOR SPDR TR CONSUMER | $232,061 | $288,060 |
| QUALCOMM, INC | $149,592 | $235,320 |
| VIATRIS INC COM | $5,754 | $3,768 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (2 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| DREYFUS/U.S. TREASURY OBLIGATIONS | AT COST | $2,898,190 | $2,902,616 |
| ENTERPRISE PRODUCTS PARTNERS LP | AT COST | $127,065 | $151,500 |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp (5 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt |
|---|---|---|---|
| SOFTWARE | $8,500 | $8,500 | $0 |
| SOFTWARE | $7,000 | $7,000 | $0 |
| SOFTWARE | $7,000 | $7,000 | $0 |
| SOFTWARE | $7,000 | $7,000 | $0 |
| SOFTWARE | $7,000 | $3,500 | $3,500 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS ADMINISTRATION | Desc |
| Revenue And Expenses Per Books | $538 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $268 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| ENTERPRISE PRODS PARTNERS | $11,130 | $11,130 | $11,130 |
| OTHER INCOME | $27 | $27 | $27 |
| NONDIVIDEND DISTRIBUTIONS | $3,007 | $3,007 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RECOVERY OF AMOUNT TREATED AS QUALIFYING DISTRIBUTIONS | Desc |
| Amt | $6,500 | Amt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT/BANK FEES | CategoryTxt |
| Amt | $24,111 | Amt |
| Net Investment Income | $24,111 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAXES | CategoryTxt |
| Amt | $1,792 | Amt |
| Net Investment Income | $1,792 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |