MEDLIN-HALE FOUNDATION INC: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MEDLIN-HALE FOUNDATION INC (EIN 35-2508317)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-09-20
- IRS object ID
- 202202639349100015
- 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
- Accounting Fees Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Assets Schedule
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-09-20T13:25:57-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 581540139 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERMAN & RUSENKO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3445 PEACHTREE ROAD NE SUITE 1150 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352508317 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEDLIN-HALE FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEDL | BusinessNameControlTxt |
| Phone | 4043500847 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 PEACHTREE BATTLE AVENUE | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELIZABETH HALE | PersonNm |
| Person Title | PRESIDENT, SECRETARY & TREASURER | PersonTitleTxt |
| Phone | 4043500847 | PhoneNum |
| Signature | 2022-09-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ELIZABETH | PersonFirstNm |
| Person Last | HALE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RONALD J GREEN | PreparerPersonNm |
| PTIN | P00153816 | PTIN |
| Phone | 4042622181 | PhoneNum |
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 | 2022-09-23 18:48:47Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $3,246,382 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $52,191 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $52,191 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $122,789 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $791,167 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $364,649 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $174,980 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $416,840 | TotalNetInvstIncmAmt |
| 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 | $5,500 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $4,125 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $1,375 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $14,621 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $14,621 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $19,698 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $698 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $39,819 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $19,444 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $1,375 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $121,060 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $121,060 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $160,879 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $19,444 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $122,435 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $14,101 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $397,396 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $9,994 | CashBOYAmt |
| Cash EOY | $21,759 | CashEOYAmt |
| Cash EOYFMV | $21,759 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $147,069 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $67,812 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $67,812 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $1,581,226 | CorporateStockBOYAmt |
| Corporate Stock EOY | $1,574,466 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $2,312,772 | CorporateStockEOYFMVAmt |
| Other Investments BOY | $765,627 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $852,918 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $842,977 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $0 | OtherAssetsBOYAmt |
| Other Assets EOY | $1,062 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $1,062 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $2,503,916 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,518,017 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,246,382 | TotalAssetsEOYFMVAmt |
| Other Liabilities BOY | $600 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $600 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $600 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $600 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $2,503,316 | CapitalStockBOYAmt |
| Capital Stock EOY | $2,517,417 | 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 | $2,503,316 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $2,517,417 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $2,503,916 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $2,518,017 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $2,503,316 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $14,101 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $2,517,417 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $2,517,417 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (11 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| 327.65 SHS. PRINCIPAL MIDCAP FUND | P | 2021-11-09 | 2020-12-16 | $15,000 | $11,618 | $3,382 | $3,382 |
| 1965.6 SHS. ABERDEEN EMERG MARKETS-INST | D | 2012-10-31 | 2021-11-09 | $40,000 | $29,523 | $10,477 | $10,477 |
| 10 SHS. AMAZON COM INC | D | 2011-09-22 | 2021-03-17 | $31,012 | $2,199 | $28,813 | $28,813 |
| 30 SHS. AMAZON COM INC | D | 2011-10-04 | 2021-09-02 | $104,029 | $6,183 | $97,846 | $97,846 |
| 335 SHS. INTEL CORP | D | 2010-09-21 | 2021-03-17 | $21,765 | $6,449 | $15,316 | $15,316 |
| 525 SHS. ELI LILLY & CO | D | 2016-11-30 | 2021-03-17 | $98,589 | $35,301 | $63,288 | $63,288 |
| 800 SHS. MERCK & CO | D | 2021-03-17 | $61,712 | $28,526 | $33,186 | $33,186 | |
| 625 SHS. PROCTER & GAMBLE CO | D | 2021-03-17 | $80,781 | $31,193 | $49,588 | $49,588 | |
| 26315.79 SHS. VANGUARD TOTAL BD | D | 2019-03-01 | 2021-09-02 | $300,000 | $275,526 | $24,474 | $24,474 |
| CLASS ACTION SETTELMENTS | P | 2021-12-31 | $22 | $22 | $22 | ||
| CAPITAL GAINS DIVIDENDS | P | $38,257 | $38,257 | $38,257 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $364,649 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $5,524 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $5,524 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $5,524 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $12,875 | 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 | $12,875 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $7,351 | OverpaymentAmt |
| Applied To ES Tax | $7,351 | 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 | GA | 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 | N/A | WebsiteAddressTxt |
| Individual With Books | ELIZABETH HALE | IndividualWithBooksNm |
| Phone | 4043500847 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 PEACHTREE BATTLE AVENUE | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELIZABETH M HALE | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 PEACHTREE BATTLE AVENUE | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | PRESIDENT, TREASURER & SEC | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 0.25 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $0 | CompensationAmt |
| Employee Benefit Program | $0 | EmployeeBenefitProgramAmt |
| Expense Account Other Allwnc | $0 | ExpenseAccountOtherAllwncAmt |
| 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 | $3,003,451 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $81,690 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,085,141 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $3,085,141 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $46,277 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,038,864 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $151,943 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $151,943 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $5,524 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $5,524 | TotalTaxAmt |
| Distributable Before Adj | $146,419 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $146,419 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $146,419 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $122,435 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $122,435 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $146,419 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $98,988 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $122,435 | QualifyingDistributionsAmt |
| Applied To Year1 | $98,988 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $23,447 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | 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 | $122,972 | 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) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (33 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ATLANTA SYMPHONY ORCHESTRA | |||||||
| 1280 PEACHTREE STREET NE | ATLANTA | GA | 30309 | N/A | PUBLIC | ANNUAL FUND RAISER | $500 |
| ATLANTA-FULTON PUBLIC LIBRARY FOUNDATION | |||||||
| ONE MARGARET MITCHELL SQUARE | ATLANTA | GA | 30303 | N/A | PUBLIC | FUNDING FOR PROGRAMS | $250 |
| CAMP SUNSHINE | |||||||
| 1850 CLAIRMONT RD | DECATUR | GA | 30033 | N/A | PUBLIC | GRANT FOR SUPPORT OF THE ORGANIZATIONS MISSION | $1,000 |
| CASA | |||||||
| 75 MARIETTA ST | ATLANTA | GA | 30303 | N/A | PUBLIC | GENERAL GIFTING | $1,000 |
| CHATTAHOOCHEE RIVERKEEPER | |||||||
| 916 JOSEPH E LOWERY BLVD | ATLANTA | GA | 30318 | N/A | PUBLIC | TO SUPPORT VARIOUS PROJECTS | $2,000 |
| CHEROKEE GARDEN CLUB COMMUNITY FUND INC | |||||||
| 250 WOODWARD WAY NW | ATLANTA | GA | 30305 | N/A | PUBLIC | GENERAL GIFTING DONATION | $1,000 |
| CHEROKEE GARDEN LIBRARY | |||||||
| 130 WEST PACES FERRY RD NW | ATLANTA | GA | 30305 | N/A | PUBLIC | ANNUAL FUND | $500 |
| EMORY ALZHEIMER'S RESERCH CENTER | |||||||
| 1762 CLIFTON RD | ATLANTA | GA | 30322 | N/A | PUBLIC | GENERAL GIFT - HONORAY | $1,600 |
| FAMILIES FIRST | |||||||
| 80 JOSEPH E LOWERY BLVD | ATLANTA | GA | 30314 | N/A | PUBLIC | FAMILY RESILIENCE AND RECOVERY FUND | $500 |
| GEORGIA AUDUBON | |||||||
| 4055 ROSWELL ROAD NE | ATLANTA | GA | 30342 | N/A | PUBLIC | GENERAL FUNDING DONATION | $500 |
| GEORGIA PUBLIC BROADCASTING | |||||||
| 260 14TH STREET NW | ATLANTA | GA | 30303 | N/A | PUBLIC | ANNUAL GIFT | $3,500 |
| NEW AMERICAN PATHWAYS | |||||||
| 2300 HENDERSON MILL RD | ATLANTA | GA | 30345 | N/A | PUBLIC | ANNUAL SUPPORT | $5,000 |
| GEORGIA WILDLIFE FEDERATION | |||||||
| 11600 HAZELBRAND RD | COVINGTON | GA | 30014 | N/A | PUBLIC | MEMBERSHIP SUPPORT | $250 |
| MCCALLIE SCHOOL | |||||||
| 500 DODDS AVE | CHATTANOOGA | TN | 37404 | N/A | PUBLIC | GENERAL FUNDING | $250 |
| GEORGE WASHINGTON'S MOUNT VERNON | |||||||
| PO BOX 110 | MOUNT VERNON | VA | 22121 | N/A | PUBLIC | PLEDGE PAYMENTS FOR CAMPAIGN FOR MOUNT VERNON | $40,000 |
| GEORGE WASHINGTON'S MOUNT VERNON | |||||||
| PO BOX 110 | MOUNT VERNON | VA | 22121 | N/A | PUBLIC | ANNUAL SUPPORT | $10,000 |
| OSSABAW ISLAND FOUNDATION | |||||||
| 13040 ABERCORN ST | SAVANNAH | GA | 31419 | N/A | PUBLIC | SUPPORT IN 2021 FOR GENERAL FUNDS | $500 |
| PUBLIC BROADCASTING ATLANTA | |||||||
| 740 BISMARK RD | ATLANTA | GA | 30324 | N/A | PUBLIC | GENERAL FUNDING | $2,000 |
| PARK PRIDE | |||||||
| POBOX 4936 | ATLANTA | GA | 30302 | N/A | PUBLIC | GENERAL FUNDS TO SUPPORT LOCAL GREEN SPACE | $1,000 |
| NEW SECTOR ALLIANCE | |||||||
| PO BOX 20001 | STANFORD | CA | 94309 | N/A | PUBLIC | GENERAL GIFTING | $250 |
| PATH | |||||||
| PO BOX 14327 | ATLANTA | GA | 30324 | N/A | PUBLIC | ANNUAL FUNDS | $1,000 |
| RESPITE CARE ATLANTA | |||||||
| 2715 PEACHTREE ROAD NE | ATLANTA | GA | 30305 | N/A | PUBLIC | SUPPORT FOR FURTHERING THE MISSION OF THE ORGANIZATION | $250 |
| SKYLAND TRAIL | |||||||
| 1961 NORTH DRUID HILLS RD | ATLANTA | GA | 30329 | N/A | PUBLIC | SUPPORT FOR 2021 BENEFITS OF LAUGHTER | $4,000 |
| SOUTHERN ENVIRONMENTAL LAW CENTER | |||||||
| 201 WEST MAIN STREET | CHARLOTTESVILLE | VA | 22902 | N/A | PUBLIC | UNRESTRICTED GIFT | $2,000 |
| STATE BOTANICAL GARDEN OF GEORGIA | |||||||
| 2450 SOUTH MILLEDGE AVE | ATHENS | GA | 30605 | N/A | PUBLIC | GENERAL GIFTING | $1,000 |
| THE TRUST FOR PUBLIC LAND | |||||||
| 101 MONTGOMERY ST SUITE 900 | SAN FRANCISCO | CA | 94104 | N/A | PUBLIC | GENERAL FUNDING TO SUPPORT THE MISSION OF THE ORGANIZATION | $2,000 |
| TREES ATLANTA | |||||||
| 225 CHESTER AVE SE | ATLANTA | GA | 30316 | N/A | PUBLIC | GENERAL FUNDING TO SUPPORT THE MISSION OF THE ORGANIZATION | $1,000 |
| AG RHODES | |||||||
| 2801 BUFORD HIGHWAY SUITE 500 | ATLANTA | GA | 30329 | N/A | PUBLIC | GENERAL GIFTING TO PROVIDE FOR THE NEEDS OF THE ELDERLY | $250 |
| ALL SAINTS' EPISCOPAL CHURCH | |||||||
| 634 W PEACHTREE ST NW | ATLANTA | GA | 30308 | N/A | PUBLIC | PLEDGE PAYMENT AND REFUGEE MINISTRY FUND | $21,000 |
| ATLANTA MEMORIAL PARK CONSERVANCY | |||||||
| PO BOX 11609 | ATLANTA | GA | 30355 | N/A | PUBLIC | WOODWARD WAY PRUNING PROJECT | $5,900 |
| CONCUSSION ALLIANCE | |||||||
| 3710 SW DONOVAN ST | SEATTLE | WA | 98126 | N/A | PUBLIC | GENERAL GIFT | $1,000 |
| CORNELL LAB OF ORNITHOLOGY | |||||||
| 159 SAPSUCKER WOODS RD | ITHACA | NY | 14850 | N/A | PUBLIC | GENERAL FUNDING | $60 |
| HISTORIC OAKLAND FOUNDATION | |||||||
| 248 OAKLAND AVE | ATLANTA | GA | 30312 | N/A | PUBLIC | PLEDGE PAYMENT FOR LIVING HISTORY CAPITAL CAMPAIGN | $10,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $121,060 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $52,191 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $122,789 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $174,980 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $174,980 | 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 |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | CategoryTxt |
| Amt | $5,500 | Amt |
| Net Investment Income | $4,125 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,375 | DisbursementsCharitablePrpsAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (3 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| EQUITIES-WELLS FARGO-MAIN | $1,467,048 | $2,122,730 |
| EQUITIES-WELLS FARGO-SUB ACCT. 4101 | $9,824 | $10,117 |
| EQUITIES-WELLS FARGO-SUB ACCT. 4102 | $97,594 | $179,925 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | FIXED INCOME-MUTUAL FUNDS-WELLS FARGO-MAIN | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $852,918 | BookValueAmt |
| EOYFMV | $842,977 | EOYFMVAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIVIDEND RECEIVABLE | Desc |
| EOY Book Value | $1,062 | EOYBookValueAmt |
| EOYFMV | $1,062 | EOYFMVAmt |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO EMH | Desc |
| BOY Book Value | $600 | BOYBookValueAmt |
| EOY Book Value | $600 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | MANAGEMENT FEES | CategoryTxt |
| Amt | $14,621 | Amt |
| Net Investment Income | $14,621 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| EXCISE TAX PAID | $19,000 | $0 | $0 |
| FOREIGN TAX PAID | $698 | $698 | $0 |