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DR HANS AND BETTY RUBIN MEMORIAL FUND: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
DR HANS AND BETTY RUBIN MEMORIAL FUND (EIN 34-6884022)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-05-08
IRS object ID
202531289349300418
Schema version
2024v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-08T10:01:26-04:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN920460586PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PWC US TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14300 E CAMELBACK ROAD STE 475AddressLine1Txt
CityPHOENIXCityNm
State AbbreviationAZStateAbbreviationCd
ZIP85018ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN346884022EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DR HANS J RUBIN AND BETTY RUBIN MEMORIAL FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRUBIBusinessNameControlTxt
Phone2166897663PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14900 TIEDEMAN ROAD OH-01-49-0381AddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44144ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEYBANK BY JOSEPH VELKOSPersonNm
Person TitleVICE PRESIDENTPersonTitleTxt
Phone2166897663PhoneNum
Signature2025-04-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJEFFREY E KUHLINPreparerPersonNm
PTINP00353001PTIN
Phone4123556000PhoneNum
Preparation2025-04-16PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Keybank NA TrusteeBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14900 TiedemanAddressLine1Txt
CityBrooklynCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44144ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$259,267GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1987FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionGrants 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 Body1VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$30,258PYInvestmentIncomeAmt
CY Investment Income$204,429CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$30,258PYTotalRevenueAmt
CY Total Revenue$204,429CYTotalRevenueAmt
PY Grants And Similar Paid$105,988PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$101,491CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,395PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$22,188CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,360PYOtherExpensesAmt
CY Other Expenses$2,221CYOtherExpensesAmt
PY Total Expenses$127,743PYTotalExpensesAmt
CY Total Expenses$125,900CYTotalExpensesAmt
PY Revenues Less Expenses-$97,485PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$78,529CYRevenuesLessExpensesAmt
Total Assets BOY$1,975,593TotalAssetsBOYAmt
Total Assets EOY$2,053,880TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,975,593NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,053,880NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionGrants 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$60,895ExpenseAmt
Grant$60,895GrantAmt
DescGrants made to the Mt. Sinai Medical Center will be used for support of an Opthamology/Botulinum Toxin ProgramDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$10,149ExpenseAmt
Grant$10,149GrantAmt
DescGrants made to the Holy Family Home will be used to purchase air mattresses for the patients.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$10,149ExpenseAmt
Grant$10,149GrantAmt
DescGrants made to Lutheran Medical Center will be used to the support of their Hospice Program.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$20,298ExpenseAmt
Grant$20,298GrantAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$20,298TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$20,298TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$101,491TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Excs Tax Sect4951 Or4952 Or4953falseExcsTaxSect4951Or4952Or4953Ind
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members1GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KeyBank NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2168134556PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14900 Tiedeman OH-01-49-0150AddressLine1Txt
CityBrooklynCityNm
State AbbreviationOHStateAbbreviationCd
ZIP441442302ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Keybank NABusinessNameLine1Txt
FieldValueIRS element (for citing)
TitleTrusteeTitleTxt
Average Hours Per Week Rltd Org1.0AverageHoursPerWeekRltdOrgRt
Institutional TrusteeYes (X)InstitutionalTrusteeInd
Reportable Comp From Org$22,188ReportableCompFromOrgAmt
Reportable Comp From Rltd Org$0ReportableCompFromRltdOrgAmt
Other Compensation$0OtherCompensationAmt
FieldValueIRS element (for citing)
Total Reportable Comp From Org$22,188TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,206TotalRevenueColumnAmt
Exclusion$25,206ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$234,061SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$54,838SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$179,223SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$179,223TotalRevenueColumnAmt
Exclusion$179,223ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$204,429TotalRevenueColumnAmt
Exclusion$204,429ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$101,491TotalAmt
Program Services$101,491ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$22,188TotalAmt
Management And General$22,188ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,050TotalAmt
Management And General$1,050ManagementAndGeneralAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,171TotalAmt
Management And General$1,171ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$125,900TotalAmt
Program Services$101,491ProgramServicesAmt
Management And General$24,409ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$82,791BOYAmt
EOY$43,645EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,892,802BOYAmt
EOY$2,010,235EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,975,593BOYAmt
EOY$2,053,880EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$1,975,593BOYAmt
EOY$2,053,880EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,975,593BOYAmt
EOY$2,053,880EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,975,593BOYAmt
EOY$2,053,880EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$78,529ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$242OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
Acct Compile Or Review BasisAcctCompileOrReviewBasisGrp
FS AuditedfalseFSAuditedInd
FS Audited BasisFSAuditedBasisGrp
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Non FuncYes (X)SupportingOrgType3NonFuncInd
Supported Organizations5SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (5 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
National Jewish Center
7420446473Yes (true)$10,149$0
Holy Family Cancer Home
3408774633Yes (true)$10,149$0
Lutheran Medical Center
3407146843Yes (true)$10,149$0
Judson Retirement Community
3407145393Yes (true)$10,149$0
Mt Sinai Health Care
3417778783Yes (true)$60,895$0
FieldValueIRS element (for citing)
Supported Organizations Total5SupportedOrganizationsTotalCnt
Support Sum$101,491SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesYes (true)ExcessBusinessHoldingsRulesInd
Excess Business HoldingsfalseExcessBusinessHoldingsInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsYes (true)TimelyProvidedDocumentsInd
Officers Close RelationshipfalseOfficersCloseRelationshipInd
Supported Org Voice InvestmentYes (true)SupportedOrgVoiceInvestmentInd

Adjusted Net Income AdjustedNetIncomeGrp

Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Recoveries PY Distributions RecoveriesPYDistributionsGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Other Gross Income OtherGrossIncomeGrp

FieldValueIRS element (for citing)
Prior Year$28,736PriorYearAmt
Current Year$25,206CurrentYearAmt

Adjusted Gross Income AdjustedGrossIncomeGrp

FieldValueIRS element (for citing)
Prior Year$28,736PriorYearAmt
Current Year$25,206CurrentYearAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Production Income ProductionIncomeGrp

FieldValueIRS element (for citing)
Prior Year$21,755PriorYearAmt
Current Year$24,409CurrentYearAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Total Adjusted Net Income TotalAdjustedNetIncomeGrp

FieldValueIRS element (for citing)
Prior Year$6,981PriorYearAmt
Current Year$797CurrentYearAmt

Minimum Asset Amount MinimumAssetAmountGrp

Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp

FieldValueIRS element (for citing)
Prior Year$2,029,820PriorYearAmt
Current Year$2,254,642CurrentYearAmt

Average Monthly Cash Balances AverageMonthlyCashBalancesGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp

FieldValueIRS element (for citing)
Prior Year$2,029,820PriorYearAmt
Current Year$2,254,642CurrentYearAmt
FieldValueIRS element (for citing)
Discount Claimed$0DiscountClaimedAmt

Acquisition Indebtedness AcquisitionIndebtednessGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp

FieldValueIRS element (for citing)
Prior Year$2,029,820PriorYearAmt
Current Year$2,254,642CurrentYearAmt

Cash Deemed Charitable CashDeemedCharitableGrp

FieldValueIRS element (for citing)
Prior Year$30,447PriorYearAmt
Current Year$33,820CurrentYearAmt

Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp

FieldValueIRS element (for citing)
Prior Year$1,999,373PriorYearAmt
Current Year$2,220,822CurrentYearAmt

Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp

FieldValueIRS element (for citing)
Prior Year$69,978PriorYearAmt
Current Year$77,729CurrentYearAmt

Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp

FieldValueIRS element (for citing)
Prior Year$0PriorYearAmt

Total Minimum Asset TotalMinimumAssetGrp

FieldValueIRS element (for citing)
Prior Year$69,978PriorYearAmt
Current Year$77,729CurrentYearAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
CY Adj Net Income Distributable$6,981CYAdjNetIncomeDistributableAmt
CY Pct85 Adjusted Net Income$5,934CYPct85AdjustedNetIncomeAmt
CY Total Min Ast Distributable$69,978CYTotalMinAstDistributableAmt
CY Greater Adjusted Minimum$69,978CYGreaterAdjustedMinimumAmt
CY Income Tax Imposed PY$0CYIncomeTaxImposedPYAmt
CY Distributable As Adjusted$69,978CYDistributableAsAdjustedAmt

Distributions DistributionsGrp

FieldValueIRS element (for citing)
CY Paid Accomplish Exempt Prps$101,491CYPaidAccomplishExemptPrpsAmt
CY Pd In Excess Income Activity$0CYPdInExcessIncomeActivityAmt
CY Administrative Expense Paid$0CYAdministrativeExpensePaidAmt
Exempt Use Assets Acquis Paid$0ExemptUseAssetsAcquisPaidAmt
Qualified Set Aside$0QualifiedSetAsideAmt
CY Other Distributions$0CYOtherDistributionsAmt
CY Total Annual Distributions$101,491CYTotalAnnualDistributionsAmt
CY Distri Attentive Suprt Org$101,491CYDistriAttentiveSuprtOrgAmt
CY Distributable As Adjusted$69,978CYDistributableAsAdjustedAmt
CY Distribution Yr1.0CYDistributionYrRt

Distribution Allocations DistributionAllocationsGrp

FieldValueIRS element (for citing)
CY Distributable As Adjusted$69,978CYDistributableAsAdjustedAmt
Underdistributions$0UnderdistributionsAmt
Excess Distribution Cyov Yr5$0ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$0ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$74,351ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$123,500ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$105,988ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$303,839TotalExcessDistributionCyovAmt
Cyov Applied Underdistri PY$0CyovAppliedUnderdistriPYAmt
Cyov Applied Underdistr CPY$69,978CyovAppliedUnderdistrCPYAmt
Carryover PY Not Applied$0CarryoverPYNotAppliedAmt
Excess Distribution Cyov$233,861ExcessDistributionCyovAmt
CY Total Annual Distributions$101,491CYTotalAnnualDistributionsAmt
CY Distrib App Underdistri PY$0CYDistribAppUnderdistriPYAmt
Excess Distribution$101,491ExcessDistributionAmt
Remaining Underdistri PY$0RemainingUnderdistriPYAmt
Remaining Underdistri CY$0RemainingUnderdistriCYAmt
Excess Distri Cyov To Next Yr$335,352ExcessDistriCyovToNextYrAmt
Excess From Year5$0ExcessFromYear5Amt
Excess From Year4$4,373ExcessFromYear4Amt
Excess From Year3$123,500ExcessFromYear3Amt
Excess From Year2$105,988ExcessFromYear2Amt
Excess From Year1$101,491ExcessFromYear1Amt

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Line 2KeyBank 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 3KeyBank, as Trustee, welcomes the input of the charitable beneficiaries as to investments.
Line 8KeyBank, 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)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
CHARITABLE MULTI ASSET FUND$2,010,235C
KT SHORT TERM DEPOSIT FUNDC
FieldValueIRS element (for citing)
Total Book Value Securities$2,010,235TotalBookValueSecuritiesAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtBusiness Name Line2RecipientBusinessName/BusinessNameLine2Txt
MT SINAI MEDICAL CENTER
11000 EUCLID AVE 3RD FLCLEVELANDOH44106341777878170(b)(1)(A$60,895Support of an Opthomolagy program
HOLY FAMILY CANCER HOME
6707 STATE RDPARMAOH44134340877463170(b)(1)(A)$10,149To purchase air mattresses for patients.
LUTHERAN MEDICAL CENTER
6801 BRECKSVILLE RD STE 20 RK45INDEPENDENCEOH44131340714684170(b)(1)(A)$10,149Support of their Hospice program
NATIONAL JEWISH CENTER
1400 JACKSON ST ROOM M220DENVERCO802062761742044647170(b)(1)(A)$10,149Asthma researchATTN SERENA FERRIN
JUDSON RETIREMENT COMMUNITY
1890 E 107TH STCLEVELANDOH44106340714539170(b)(1)(A)$10,149

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceEXPLANATION FOR FORM 990, SCHEDULE I, PART 1, LINE 2FormAndLineReferenceDesc
ExplanationGRANTS 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI Line 12 aNo conflict of interest policy exists for the trust. Keybank, N.A. has a corporate document retention and destruction policy.
Part VI, Line 14The 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 4dThe 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 1aKeybank is sole trustee
FORM 990, PAGE 6, PART VI, LINE 11-DESCRIPTION OF PROCESS FOR REVIEWALL RETURNS ARE PREPARED AND THOROUGHLY REVIEWED BY OUR TAX VENDOR AND/OR INTERNAL PROFESSIONAL TAX DEPARTMENT.
FORM 990, PAGE 6, PART VI, LINE 19Documents are available upon request by mail or phone and delivered within two weeks.
EXPLANATION FOR FORM 990, PART XI, LINE 9ROC ON CY SALES ADJUSTMENT ($243), ROUNDING $1

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
NATIONAL JEWISH CENTER
1400 JACKSON ST ROOM M220DENVERCO802062761742044647ASTHMA RESEARCHCO501(c)3170(b)(1)(A)N/Afalse
LUTHERAN MEDICAL CENTER
6801 BRECKSVILLE RD STE 20INDEPENDENCEOH44131340714684SUPPORT OF HOSPICE PROGRAMOH501(c)3170(b)(1)(A)N/Afalse
HOLY FAMILY CANCER HOME
6707 STATE RDPARMAOH44134340877463PURCHASE AIR MATTRESSES FOR PATIENTSOH501(c)3170(b)(1)(A)N/Afalse
MT SINAI MEDICAL CENTER
11000 EUCLID AVE 3RD FLCLEVELANDOH44106341777878SUPPORT OF OPHTHALMOLOGY PROGRAM501(c)3170(b)(1)(A)N/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd