STRATEGY STUDIO / PUBLIC DATA EXPLORER

PRIME HEALTH FOUNDATION: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
PRIME HEALTH FOUNDATION (EIN 43-1057862)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-05-05
IRS object ID
202201259349101790
Schema version
2021v4.1
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)
Return2022-05-05T19:00:20-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN346565596PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12100 ONE PPG PLACEAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15222ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN431057862EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRIME HEALTH FOUNDATION 10026400BusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPRIMBusinessNameControlTxt
Phone8168601933PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1UMB BANK NA P O BOX 415044 M/SAddressLine1Txt
CityKANSAS CITYCityNm
State AbbreviationMOStateAbbreviationCd
ZIP641416692ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUSAN WILSONPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone8168601933PhoneNum
Signature2022-05-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIC W COURSEYPreparerPersonNm
PTINP00387963PTIN
Phone4126445302PhoneNum
Preparation2022-05-05PreparationDt

Additional Filer Information AdditionalFilerInformation

FieldValueIRS element (for citing)
Trusted CustomerTrustedCustomerGrp
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$4,994,913FMVAssetsEOYAmt

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Dividends Rev And Expnss$91,882DividendsRevAndExpnssAmt
Dividends Net Invst Incm$85,817DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$386,928NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$1,568,911GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$386,928CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm$0NetSTCapitalGainAdjNetIncmAmt
Other Income Rev And Expnss$2,638OtherIncomeRevAndExpnssAmt
Total Rev And Expnss$481,448TotalRevAndExpnssAmt
Total Net Invst Incm$472,745TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$101,285CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$50,643CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$50,643CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm$0OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$0OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Net Invst Incm$0PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Adj Net Incm$0PensionEmplBnftAdjNetIncmAmt
Legal Fees Rev And Expnss$6,329LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm$1,582LegalFeesNetInvstIncmAmt
Legal Fees Adj Net Incm$0LegalFeesAdjNetIncmAmt
Legal Fees Dsbrs Chrtbl$4,747LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$800AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm$0AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps$800AccountingFeesChrtblPrpsAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Interest Dsbrs Chrtbl$0InterestDsbrsChrtblAmt
Taxes Rev And Expnss$1,076TaxesRevAndExpnssAmt
Taxes Net Invst Incm$713TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$0DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$0DeprecAndDpltnNetInvstIncmAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm$0TravConfMeetingAdjNetIncmAmt
Printing And Pub Net Invst Incm$0PrintingAndPubNetInvstIncmAmt
Printing And Pub Adj Net Incm$0PrintingAndPubAdjNetIncmAmt
Other Expenses Rev And Expnss$2,358OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$2,358OtherExpensesNetInvstIncmAmt
Tot Opr Expenses Rev And Expnss$111,848TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$55,296TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$0TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$56,190TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$268,483ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$268,483ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$380,331TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$55,296TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$0TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$324,673TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$101,117ExcessRevenueOverExpensesAmt
Net Investment Income$417,449NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$198,851SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$193,042SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$193,042SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl EOY$0AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$0AcctRcvblEOYFMVAmt
Other Rcvbl Allwnc Dbtfl Acct$0OtherRcvblAllwncDbtflAcctAmt
Other Investments BOY$3,530,664OtherInvestmentsBOYAmt
Other Investments EOY$3,629,866OtherInvestmentsEOYAmt
Other Investments EOYFMV$4,801,871OtherInvestmentsEOYFMVAmt
Total Assets BOY$3,729,515TotalAssetsBOYAmt
Total Assets EOY$3,822,908TotalAssetsEOYAmt
Total Assets EOYFMV$4,994,913TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Capital Stock BOY$3,729,515CapitalStockBOYAmt
Capital Stock EOY$3,822,908CapitalStockEOYAmt
Tot Net Ast Or Fund Balances BOY$3,729,515TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$3,822,908TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,729,515TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$3,822,908TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$3,729,515TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$101,117ExcessRevenueOverExpensesAmt
Other Increases$245OtherIncreasesAmt
Subtotal$3,830,877SubtotalAmt
Other Decreases$7,969OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$3,822,908TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (202 entries)

PropertyPropertyDescAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmtHow AcquiredHowAcquiredCd
20000. HOST HOTELS & RESORTS LP DTD 8/9/2012 4.750% 3/1/20232017-06-202021-01-04$21,798$20,593$1,205$1,205
41. META PLATFORMS INC-CLASS A2019-07-112021-01-14$10,102$8,239$1,863$1,863
275. MERCK & CO. INC.2018-11-192021-01-14$22,587$21,031$1,556$1,556
702. TWITTER INC2020-09-102021-01-14$32,048$23,228$8,820$8,820
7219.6964 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-01-15$202$203-$1-$1
6071.1108 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-01-15$127$127
.5805 FHR 3609 LA 4% 15 DEC 20242012-09-172021-01-15
1533.4811 GOVERNMENT NATIONAL MORGAGE ASSN DTD 7/1/2012 1.66736% 5/16/2012-07-242021-01-19$66$66
7. ALPHABET INC2018-12-132021-02-11$14,571$7,494$7,077$7,077
78. APPLE COMPUTER INC2016-02-112021-02-11$10,508$1,821$8,687$8,687
360. BROWN FORMAN CORPORATION CLASS B2018-05-102021-02-11$27,421$20,328$7,093$7,093
190. MARSH & MCLENNAN COMPANY INC2019-11-132021-02-11$21,443$19,964$1,479$1,479
7098.5024 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-02-16$121$122-$1-$1
5945.8983 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-02-16$125$125
.477 FHR 3609 LA 4% 15 DEC 20242012-09-172021-02-16
1407.6223 GOVERNMENT NATIONAL MORGAGE ASSN DTD 7/1/2012 1.66736% 5/16/2012-07-242021-02-16$126$126
31. ADOBE SYSTEMS INC2017-02-092021-03-15$13,767$3,612$10,155$10,155
200. CVS CORPORATION2021-01-142021-03-15$14,939$15,027-$88-$88
30. COSTAR GROUP INC2019-11-132021-03-15$25,071$16,919$8,152$8,152
125. DOLLAR GENERAL CORP2019-02-142021-03-15$24,238$14,894$9,344$9,344
6853.3076 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-03-15$245$246-$1-$1
5822.908 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-03-15$123$123
.3965 FHR 3609 LA 4% 15 DEC 20242012-09-172021-03-15
25000. NORTHROP GRUMMAN CORP DTD 11/8/2010 3.500% 3/15/20212015-12-092021-03-15$25,000$25,000
1167.5458 GOVERNMENT NATIONAL MORGAGE ASSN DTD 7/1/2012 1.66736% 5/16/2012-07-242021-03-16$240$240
953.289 DOUBLELINE TTL RTRN BND-I2013-01-242021-04-05$9,990$10,867-$877-$877
3442.051 DRIEHAUS SMALL CAP GROW-INST2020-02-062021-04-05$92,281$55,555$36,726$36,726
174. ISHARES INTERMEDIATE GOVERNM2016-08-302021-04-05$19,972$19,656$316$316
836.12 MTRPLTN WST UNCONS BND-I2020-02-062021-04-05$9,992$10,000-$8-$8
6211.18 RIVERPARK S/T HI YLD-INST2013-07-102021-04-05$60,062$62,048-$1,986-$1,986
6506.1968 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-04-15$347$348-$1-$1
5702.1035 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-04-15$121$121
.3255 FHR 3609 LA 4% 15 DEC 20242012-09-172021-04-15
41. FIVE BELOW2019-02-142021-04-15$8,067$5,343$2,724$2,724
61. LULULEMON ATHLETICA INC2020-09-102021-04-15$19,859$19,282$577$577
423.5648 GOVERNMENT NATIONAL MORGAGE ASSN DTD 7/1/2012 1.66736% 5/16/22012-07-242021-04-16$744$744
25000. ALTRIA GROUP INC DTD 5/5/2011 4.750% 5/5/20212015-12-092021-05-05$25,000$25,000
46. REGENERON PHARMACEUTICALS2021-01-142021-05-13$23,745$25,775-$2,030-$2,030
58. ROCKWELL INTERNATIONAL CORP2020-08-132021-05-13$15,432$13,574$1,858$1,858
6251.2916 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-05-17$255$256-$1-$1
5583.448 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-05-17$119$119
.259 FHR 3609 LA 4% 15 DEC 20242012-09-172021-05-17
11.876 GOVERNMENT NATIONAL MORGAGE ASSN DTD 7/1/2012 1.66736% 5/16/2052012-07-242021-05-17$412$412
73. APPLE COMPUTER INC2016-02-112021-06-10$9,199$1,704$7,495$7,495
37. DOCUSIGN INC2020-03-122021-06-10$8,951$2,448$6,503$6,503
130. ECOLAB INC2018-09-132021-06-10$27,793$19,767$8,026$8,026
53. HOME DEPOT INC2018-06-142021-06-10$16,336$10,552$5,784$5,784
6036.3024 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-06-15$215$216-$1-$1
5466.9058 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-06-15$117$117
.222 FHR 3609 LA 4% 15 DEC 20242012-09-172021-06-15
25000. GOVERNMENT NATIONAL MORGAGE ASSN DTD 7/1/2012 1.66736% 5/16/2052012-07-242021-06-17$12$12
5872.2792 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-07-15$164$165-$1-$1
5352.4415 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-07-15$114$114
.192 FHR 3609 LA 4% 15 DEC 20242012-09-172021-07-15
162. ACTIVISION BLIZZARD INC2020-03-122021-08-12$13,782$8,940$4,842$4,842
145. BOEING CO2021-03-152021-08-12$34,519$33,594$925$925
49. DISNEY WALT HOLDING CO2020-08-132021-08-12$8,783$6,443$2,340$2,340
165. DISNEY WALT HOLDING CO2018-12-132021-08-12$29,576$18,698$10,878$10,878
149. INTERCONTINENTAL EXCHANGE IN2021-01-142021-08-12$17,578$17,218$360$360
214. MICRON TECHNOLOGY INC2021-04-152021-08-12$15,088$19,342-$4,254-$4,254
5704.312 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-08-16$168$168
5240.021 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-08-16$112$112
.1545 FHR 3609 LA 4% 15 DEC 20242012-09-172021-08-16
1029. AMER CENT MID CAP VAL-I2013-09-272021-08-17$20,477$16,063$4,414$4,414
4542.133 BLACKROCK EVNT DRVN EQ-INST2019-07-092021-08-17$44,377$44,377
3014.362 GOTHAM ABSOLUTE RETURN-INS2013-07-112021-08-17$51,696$36,594$15,102$15,102
439. OAKMARK INTERNATIONAL-INST2013-09-272021-08-17$12,643$11,493$1,150$1,150
2288. PRINCIPAL MIDCAP FUND-R62012-08-312021-08-17$96,302$34,750$61,552$61,552
994. TRIBUTARY SMALL COMP-INST+2020-04-292021-08-17$35,386$22,633$12,753$12,753
588. VANGUARD DEV MKT INDX-ADM2015-07-212021-08-17$9,814$7,662$2,152$2,152
5369.9468 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-09-15$334$335-$1-$1
5129.61 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-09-15$110$110
.126 FHR 3609 LA 4% 15 DEC 20242012-09-172021-09-15
120. ABBVIE INC2020-05-142021-09-17$12,928$10,813$2,115$2,115
92. ABBVIE INC2021-01-142021-09-17$9,911$10,294-$383-$383
193. MARRIOTT INTERNATIONAL INC CLASS A2021-03-152021-09-17$27,799$27,043$756$756
128. STARBUCKS CORP2020-06-112021-09-17$14,513$9,154$5,359$5,359
40000. PACKAGING CORP OF AMERICA DTD 10/22/2013 4.500% 11/1/20232017-06-022021-10-08$43,204$41,138$2,066$2,066
136. CATERPILLAR INC2021-03-152021-10-14$26,357$28,729-$2,372-$2,372
119. META PLATFORMS INC-CLASS A2019-07-112021-10-14$39,114$16,749$22,365$22,365
61. FEDEX CORP2020-10-152021-10-14$13,843$17,165-$3,322-$3,322
36. BLOCK INC2021-08-122021-10-14$8,937$9,704-$767-$767
670. WELLS FARGO & CO2021-06-102021-10-14$30,181$30,828-$647-$647
5072.506 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-10-15$297$298-$1-$1
5021.1748 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-10-15$108$108
.095 FHR 3609 LA 4% 15 DEC 20242012-09-172021-10-15
2167.326 BLACKROCK EQTY DVDND-K2020-02-062021-11-11$50,564$45,557$5,007$5,007
107. PAYPAL HOLDINGS INC2021-02-112021-11-11$21,596$23,260-$1,664-$1,664
59.995 VANGUARD INST INDEX-INST2020-05-182021-11-11$24,400$15,848$8,552$8,552
183.87 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-11-15$184$184
106.49 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-11-15$106$106
.02 FHR 3609 LA 4% 15 DEC 20242012-09-172021-11-15
25000. ROPER TECHNOLOGIES INC DTD 12/19/2016 2.800% 12/15/20212017-03-212021-11-15$25,000$25,000
75. CROWDSTRIKE HOLDINGS INC - A2021-08-122021-12-09$14,995$18,338-$3,343-$3,343
232. STARBUCKS CORP2020-03-262021-12-09$26,849$16,173$10,676$10,676
70. TEXAS INSTRUMENTS INC2019-09-132021-12-09$13,607$9,099$4,508$4,508
281.46 FHR 4104 AJ 1.5% 15 SEP 20272012-09-262021-12-15$281$282-$1-$1
104.58 FHR 4142 AT 1.75% 15 DEC 20322013-05-162021-12-15$105$105
.02 FHR 3609 LA 4% 15 DEC 20242012-09-172021-12-15
72.456 VANGUARD INST INDEX-INST2020-05-182021-12-20$29,000$18,866$10,134$10,134
402. ISHARES INTERMEDIATE GOVERNM2019-07-262021-12-27$45,788$44,887$901$901
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
CAPITAL GAIN DIVIDENDS$84,332P
FieldValueIRS element (for citing)
Capital Gain Net Income$386,928CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$5,803InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$5,803SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$5,803TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$363EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Total Payments And Credits$363TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Tax Due$5,440TaxDueAmt
Applied To ES Tax$0AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateMOOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsfalseNewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1UMB BANK NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8168601933PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line11010 GRANDAddressLine1Txt
CityKANSAS CITYCityNm
State AbbreviationMOStateAbbreviationCd
ZIP64106ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

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

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmt
UMB BANK N A
1010 GRANDKANSAS CITYMO64106CO-TRUSTEE1$41,285
EDNA RINDNER
2915 W 93RD TERRACELEAWOODKS66206CO-TRUSTEE1$60,000
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt
FieldValueIRS element (for citing)
Summary Of Direct Chrtbl ActySummaryOfDirectChrtblActyGrp
Sum Of Program Related InvstSumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$4,703,754AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$115,788AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$4,819,542TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$4,819,542AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$72,293CashDeemedCharitableAmt
Net Vl Noncharitable Assets$4,747,249NetVlNoncharitableAssetsAmt
Minimum Investment Return$237,362MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$237,362MinimumInvestmentReturnAmt
Tax Based On Investment Income$5,803TaxBasedOnInvestmentIncomeAmt
Total Tax$5,803TotalTaxAmt
Distributable Before Adj$231,559DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$231,559DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$231,559DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$324,673ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$324,673QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$231,559DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$572,353ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$133,540ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$126,983ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$100,574ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$43,231ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$976,681TotalExcessDistributionCyovAmt
Qualifying Distributions$324,673QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$231,559AppliedToCurrentYearAmt
Remaining Distri From Corpus$93,114RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$1,069,795TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$572,353ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$497,442ExcessDistriCyovToNextYrAmt
Excess From Year4$133,540ExcessFromYear4Amt
Excess From Year3$126,983ExcessFromYear3Amt
Excess From Year2$100,574ExcessFromYear2Amt
Excess From Year1$43,231ExcessFromYear1Amt
Excess From Current Year$93,114ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerNAContributingManagerNm
Shareholder ManagerNAShareholderManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (21 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
COMMUNITY LINC INC
4012 TROOST AVEKANSAS CITYKS64110NONEPCSUPPORT OF CHARITABLE$5,750
KANSAS CITY COMMUNITY GARDENS
6917 KENSINGTONKANSAS CITYMO64132NONEPCSUPPORT OF CHARITABLE$12,000
ADHOC GROUP AGAINST CRIME
3116 PROSPECT AVEKANSAS CITYMO64128NONEPCHEALTH PROGRAM/EVENT$16,500
MATTIE RHODES CENTER
1740 JEFFERSON STKANSAS CITYMO64108NONEPCSUPPORT OF CHARITABLE$26,000
METRO LUTHERAN MINISTRY
3031 HOLMES STKANSAS CITYMO64109NONEPCSUPPORT OF CHARITABLE$20,000
CONNECTIONS TO SUCCESS
3000 LITTLE HILLS EXPRESSWAY STE 1ST CHARLESMO63301NONEPCHEALTH PROGRAM/EVENT$11,500
WELCOME HOUSE INC
1991 LEE RDCLEVELANDOH44118NONEPCHEALTH PROGRAM/EVENT$15,000
UNITED INNER CITY SERVICES
2008 E 12TH STKANSAS CITYMO64127NONEPCHEALTH PROGRAM/EVENT$15,000
ROSE BROOKS CENTER INC
PO BOX 320599KANSAS CITYMO64132NONEPCHEALTH PROGRAM/EVENT$10,000
SAVING KIDSIGHT
10560 N AMBASSADOR DR STE 210KANSAS CITYMO64153NONEPCHEALTH PROGRAM/EVENT$5,000
AMETHYST PLACE
2735A TROOST AVEKANSAS CITYMO64109NONEPCSUPPORT OF CHARITABLE$10,000
KC CARE CLINIC
3515 BROADWAY BLVDKANSAS CITYMO64111NONEPCSUPPORT OF CHARITABLE$29,297
REDISCOVER
6801 E 117TH STKANSAS CITYMO64134NONEPCSUPPORT OF CHARITABLE$15,000
NORTHLAND HEALTHCARE ACCESS
5810 NW BARRY RDKANSAS CITYMO64154NONEPCSUPPORT OF CHARITABLE$15,000
NORTHLAND SHEPHERD'S CENTER
5601 NE ANTIOCH RDGLADSTONEMO64119NONEPCSUPPORT OF CHARITABLE$12,000
HOPE NETWORK
3075 ORCHARD VISTA DR SEGRAND RAPIDSMI49546NONEPCSUPPORT OF CHARITABLE$10,000
ROSEDALE DEVELOPMENT ASSOCIATION
1403 SOUTHWEST BLVDKANSAS CITYKS66103NONEPCSUPPORT OF CHARITABLE$10,000
YOUNG MEN'S CHRISTIAN ASSOCIATION OF GRE
3100 BROADWAY STREET SUITE 1020KANSAS CITYMO64111NONEPCSUPPORT OF CHARITABLE$7,500
LAGOM DESIGN
520 AVENIDA CESAR E CHAVEZKANSAS CITYMO64108NONEPCSUPPORT OF CHARITABLE$936
MERCY & TRUTH MEDICAL MISSIONS INC
721 NORTH 31ST STREETKANSAS CITYKS66102NONEPCSUPPORT OF CHARITABLE$12,000
MARC COMMUNITY SERVICES CORPORATION
25 INDUSTRIAL PARK RDMIDDLETOWNCT06457NONEPCSUPPORT OF CHARITABLE$10,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$268,483TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

FieldValueIRS element (for citing)
Fees Contracts From Govt AgFeesContractsFromGovtAgGrp
Membership Dues And AssmntMembershipDuesAndAssmntGrp
Int On Sav And Temp Cash InvstIntOnSavAndTempCashInvstGrp

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$91,882ExclusionAmt
FieldValueIRS element (for citing)
Net Rntl Incm Re Debt Fincd PropNetRntlIncmReDebtFincdPropGrp
Net Rntl Incm Re Not Debt Fincd PropNetRntlIncmReNotDebtFincdProp
Net Rental Income Personal PropNetRentalIncomePersonalPropGrp
Other Investment IncomeOtherInvestmentIncomeGrp

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$386,928ExclusionAmt
FieldValueIRS element (for citing)
Net Income Loss From Special EvtNetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of InvntryGrossProfitLossSlsOfInvntryGrp

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Exclusion1ExclusionCd
Exclusion$2,638ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$481,448ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$481,448TotalIncomeProducingActyAmt
FieldValueIRS element (for citing)
Rln Of Acty To Accom Of Exmpt PrpsRlnOfActyToAccomOfExmptPrpsGrp

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryTAX PREPARATION FEE (NON-ALLOCCategoryTxt
Amt$800Amt
Disbursements Charitable Prps$800DisbursementsCharitablePrpsAmt

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryLEGAL FEES - PRINCIPAL (ALLOCACategoryTxt
Legal Fees$6,329LegalFeesAmt
Net Investment Income$1,582NetInvestmentIncomeAmt
Disbursements Charitable Prps$4,747DisbursementsCharitablePrpsAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail (2 entries)

DescDescAmtAmt
ACCRUED INTEREST PAID - C/O$25
COST BASIS ADJUSTMENT$7,944

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

FieldValueIRS element (for citing)
DescOTHER ALLOCABLE EXPENSE-PRINCIDesc
Revenue And Expenses Per Books$2,358RevenueAndExpensesPerBooksAmt
Net Investment Income$2,358NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescREFUND OF FEESDesc
Amt$245Amt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FEDERAL ESTIMATES - PRINCIPAL$363$0$0
FOREIGN TAXES ON QUALIFIED FOR$651$651$0
FOREIGN TAXES ON NONQUALIFIED$62$62$0