MARY M PECKMAN TR FBO CHEN MEM HOSPITAL: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MARY M PECKMAN TR FBO CHEN MEM HOSPITAL (EIN 15-6017708)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2022-08-06
- IRS object ID
- 202222189349100202
- 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
- Form 990-PF
- Accounting Fees Schedule
- Investments Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-06T10:00:20-05:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 134008324 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRICEWATERHOUSECOOPERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1850 N CENTRAL AVE STE 700 | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 156017708 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY PECKHAM FBO CHENANGO MEM HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PECK | BusinessNameControlTxt |
| Phone | 6073376191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O NBT BANK NA 52 S BROAD ST | AddressLine1Txt |
| City | NORWICH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY J HANDY | PersonNm |
| Person Title | SENIOR VP | PersonTitleTxt |
| Phone | 6073376191 | PhoneNum |
| Signature | 2022-07-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY E KUHLIN | PreparerPersonNm |
| PTIN | P00353001 | PTIN |
| Phone | 4123556000 | PhoneNum |
| Preparation | 2022-07-11 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 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 | $3,623,525 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $83,886 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $83,886 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $172,136 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $684,553 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $172,136 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $256,022 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $256,022 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $33,417 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $30,075 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $3,342 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $0 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $0 | PensionEmplBnftAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $730 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $730 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $2,557 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $888 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $0 | TravConfMeetingAdjNetIncmAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $250 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $250 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $36,954 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $30,963 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $4,322 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $168,727 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $168,727 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $205,681 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $30,963 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $173,049 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $50,341 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $225,059 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $51,296 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $38,406 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $38,406 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| Other Investments BOY | $3,098,591 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $3,161,482 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,585,119 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $3,149,887 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,199,888 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,623,525 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $3,149,887 | CapitalStockBOYAmt |
| Capital Stock EOY | $3,199,888 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,149,887 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,199,888 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,149,887 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,199,888 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,149,887 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $50,341 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $3,200,228 | SubtotalAmt |
| Other Decreases | $340 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $3,199,888 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (122 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| 38.609 INVESCO OPPENHEIMER INTL GROWTH Y | 2020-06-15 | 2021-06-15 | $1,973 | $1,610 | $363 | $363 | |
| 67.968 INVESCO OPPENHEIMER INTL GROWTH Y | 2020-03-13 | 2021-06-15 | $3,472 | $2,434 | $1,038 | $1,038 | |
| 493.702 COLUMBIA DIVIDEND INCOME INST3 | 2020-06-04 | 2021-06-15 | $14,895 | $11,409 | $3,486 | $3,486 | |
| 159.949 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO | 2014-09-08 | 2021-06-15 | $3,730 | $3,127 | $603 | $603 | |
| 56.066 DFA EMERGING MKTS PORTFOLIO | 2020-06-04 | 2021-06-15 | $2,015 | $1,416 | $599 | $599 | |
| 515.516 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO | 2020-06-04 | 2021-06-15 | $6,645 | $5,191 | $1,454 | $1,454 | |
| 148.166 DODGE & COX INTL STOCK FUND | 2015-09-09 | 2021-06-15 | $7,515 | $5,738 | $1,777 | $1,777 | |
| 33.777 FIDELITY 500 INDEX FUND | 2020-06-15 | 2021-06-15 | $4,991 | $3,605 | $1,386 | $1,386 | |
| 67.807 FIDELITY 500 INDEX FUND | 2020-03-13 | 2021-06-15 | $10,019 | $6,400 | $3,619 | $3,619 | |
| 13.543 FIDELITY EMERGING MKTS INDEX FUND | 2019-09-17 | 2021-06-15 | $185 | $139 | $46 | $46 | |
| 26.316 FIDELITY INFLATION PROTECTED BOND INSTL PREM | 2020-06-04 | 2021-06-15 | $295 | $276 | $19 | $19 | |
| 45. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX | 2017-05-16 | 2021-06-15 | $1,788 | $1,325 | $463 | $463 | |
| 60. ISHARES MSCI EAFE GROWTH ETF | 2019-09-17 | 2021-06-15 | $6,559 | $4,851 | $1,708 | $1,708 | |
| 10.37 JPMORGAN LARGE CAP GROWTH I | 2020-06-15 | 2021-06-15 | $660 | $490 | $170 | $170 | |
| 44.557 JPMORGAN LARGE CAP GROWTH I | 2019-12-16 | 2021-06-15 | $2,835 | $1,785 | $1,050 | $1,050 | |
| 110.258 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND | 2020-06-15 | 2021-06-15 | $1,799 | $1,594 | $205 | $205 | |
| 104.816 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND | 2019-03-19 | 2021-06-15 | $1,711 | $1,557 | $154 | $154 | |
| 100000. PEPSICO INC 3.0000% 08/25/21 | 2013-10-17 | 2021-08-25 | $100,000 | $99,509 | $491 | $491 | |
| 361.932 INVESCO OPPENHEIMER INTL GROWTH Y | 2021-09-15 | $19,595 | $12,898 | $6,697 | $6,697 | ||
| 259.665 COLUMBIA DIVIDEND INCOME INST3 | 2021-08-26 | 2021-09-15 | $7,985 | $8,060 | -$75 | -$75 | |
| 334.316 COLUMBIA DIVIDEND INCOME INST3 | 2020-06-04 | 2021-09-15 | $10,280 | $7,726 | $2,554 | $2,554 | |
| 112.605 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO | 2014-09-08 | 2021-09-15 | $2,680 | $2,201 | $479 | $479 | |
| 253.027 DODGE & COX INTL STOCK FUND | 2015-09-09 | 2021-09-15 | $12,285 | $9,800 | $2,485 | $2,485 | |
| 19.823 DODGE & COX GLOBAL BOND FUND | 2020-06-04 | 2021-09-15 | $240 | $226 | $14 | $14 | |
| 56.022 DODGE & COX GLOBAL BOND FUND | 2021-09-15 | $680 | $670 | $10 | $10 | ||
| 408.637 FEDERATED INSTITUTIONAL HIGH YIELD BOND FUND | 2017-03-13 | 2021-09-15 | $4,115 | $4,041 | $74 | $74 | |
| 188.065 FIDELITY 500 INDEX FUND | 2021-09-15 | $29,325 | $17,230 | $12,095 | $12,095 | ||
| 233.82 FIDELITY INFLATION PROTECTED BOND INSTL PREM | 2020-09-15 | 2021-09-15 | $2,703 | $2,565 | $138 | $138 | |
| 10914.536 FIDELITY INFLATION PROTECTED BOND INSTL PREM | 2021-09-15 | $126,172 | $107,128 | $19,044 | $19,044 | ||
| 135. ISHARES MSCI EAFE GROWTH ETF | 2019-09-17 | 2021-09-15 | $15,210 | $10,914 | $4,296 | $4,296 | |
| 530.681 JPMORGAN LARGE CAP GROWTH I | 2020-09-15 | 2021-09-15 | $36,840 | $29,840 | $7,000 | $7,000 | |
| 32.049 JPMORGAN LARGE CAP GROWTH I | 2019-12-16 | 2021-09-15 | $2,225 | $1,284 | $941 | $941 | |
| 185.13 COLUMBIA DIVIDEND INCOME INST3 | 2020-09-16 | 2021-10-05 | $5,565 | $4,462 | $1,103 | $1,103 | |
| 30.507 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO | 2021-09-15 | 2021-10-05 | $385 | $402 | -$17 | -$17 | |
| 234.587 DIAMOND HILL SMALL-MID CAP FUND | 2021-10-05 | $6,735 | $4,137 | $2,598 | $2,598 | ||
| 95.378 DODGE & COX INTL STOCK FUND | 2021-08-26 | 2021-10-05 | $4,560 | $4,584 | -$24 | -$24 | |
| 75.21 DODGE & COX GLOBAL BOND FUND | 2021-10-05 | $895 | $906 | -$11 | -$11 | ||
| 1042.747 DODGE & COX INCOME FUND | 2020-12-15 | 2021-10-05 | $14,880 | $15,599 | -$719 | -$719 | |
| 632.766 FEDERATED INSTITUTIONAL HIGH YIELD BOND FUND | 2021-10-05 | $6,315 | $6,335 | -$20 | -$20 | ||
| 12.534 FIDELITY 500 INDEX FUND | 2021-08-26 | 2021-10-05 | $1,890 | $1,948 | -$58 | -$58 | |
| 151.183 FIDELITY SMALL CAP INDEX FUND | 2021-10-05 | $4,280 | $4,438 | -$158 | -$158 | ||
| 1499.586 FIDELITY US BOND INDEX INSTL PREMIUM | 2020-12-22 | 2021-10-05 | $18,100 | $18,640 | -$540 | -$540 | |
| 331.158 FIDELITY INFLATION PROTECTED BOND INSTL PREM | 2018-12-19 | 2021-10-05 | $3,805 | $3,206 | $599 | $599 | |
| 150. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX | 2017-05-16 | 2021-10-05 | $5,648 | $4,418 | $1,230 | $1,230 | |
| 73.446 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND | 2021-08-26 | 2021-10-05 | $1,170 | $1,199 | -$29 | -$29 | |
| 435.036 LOOMIS SAYLES BOND FUND | 2021-09-15 | 2021-10-05 | $5,960 | $6,025 | -$65 | -$65 | |
| 505.37 COLUMBIA DIVIDEND INCOME INST3 | 2020-09-16 | 2021-12-16 | $16,000 | $12,179 | $3,821 | $3,821 | |
| 66.461 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO | 2021-09-15 | 2021-12-16 | $860 | $875 | -$15 | -$15 | |
| 158.522 FIDELITY 500 INDEX FUND | 2018-12-19 | 2021-12-16 | $25,660 | $13,818 | $11,842 | $11,842 | |
| 75. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX | 2017-05-16 | 2021-12-16 | $2,930 | $2,209 | $721 | $721 | |
| 15. ISHARES MSCI EAFE GROWTH ETF | 2021-08-26 | 2021-12-16 | $1,634 | $1,655 | -$21 | -$21 | |
| 230.93 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND | 2021-12-16 | $3,875 | $3,302 | $573 | $573 | ||
| 120.428 COLUMBIA DIVIDEND INCOME INST3 | 2020-09-16 | 2022-03-15 | $3,655 | $2,902 | $753 | $753 | |
| 13.547 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO | 2021-09-15 | 2022-03-15 | $165 | $178 | -$13 | -$13 | |
| 40.301 DIAMOND HILL SMALL-MID CAP FUND | 2022-03-15 | $1,070 | $1,140 | -$70 | -$70 | ||
| 116.541 DODGE & COX INCOME FUND | 2021-09-15 | 2022-03-15 | $1,550 | $1,686 | -$136 | -$136 | |
| 43.337 FEDERATED INSTITUTIONAL HIGH YIELD BOND FUND | 2021-08-26 | 2022-03-15 | $400 | $433 | -$33 | -$33 | |
| 329.041 FIDELITY US BOND INDEX INSTL PREMIUM | 2021-09-15 | 2022-03-15 | $3,705 | $4,021 | -$316 | -$316 | |
| 253.874 FIDELITY INFLATION PROTECTED BOND INSTL PREM | 2022-03-15 | $2,785 | $2,912 | -$127 | -$127 | ||
| 755. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX | 2022-03-15 | $33,157 | $20,168 | $12,989 | $12,989 | ||
| 98.583 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND | 2022-03-15 | $1,600 | $1,601 | -$1 | -$1 | ||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P | |||||
| CAPITAL GAIN DIVIDENDS | $63,897 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $172,136 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $3,128 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $3,128 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $3,128 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,616 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Total Payments And Credits | $1,616 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $1,512 | TaxDueAmt |
| Applied To ES Tax | $0 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | NY | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NBT BANK NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6073376136 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 52 S BROAD STREET | AddressLine1Txt |
| City | NORWICH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NBT BANK NA | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 52 SOUTH BROAD STREET | AddressLine1Txt |
| City | NORWICH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | TRUSTEE | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $33,417 | CompensationAmt |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $3,724,912 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $75,841 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,800,753 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $3,800,753 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $57,011 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,743,742 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $187,187 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $187,187 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $3,128 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $3,128 | TotalTaxAmt |
| Distributable Before Adj | $184,059 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $184,059 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $184,059 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $173,049 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $173,049 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $184,059 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $0 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $0 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $9,379 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $7,145 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $981 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $17,505 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $173,049 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $173,049 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $11,010 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $11,010 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $6,495 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $6,495 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $5,514 | ExcessFromYear2Amt |
| Excess From Year1 | $981 | ExcessFromYear1Amt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chenango Memorial Hospital | BusinessNameLine1Txt |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 179 NORTH BROAD STREET | AddressLine1Txt |
| City | Norwich | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | NONE | RecipientRelationshipTxt |
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | GENERAL OPERATING | GrantOrContributionPurposeTxt |
| Amt | $168,727 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $168,727 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp | |
| Int On Sav And Temp Cash Invst | IntOnSavAndTempCashInvstGrp |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $83,886 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Income | OtherInvestmentIncomeGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $172,136 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $256,022 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $256,022 | TotalIncomeProducingActyAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Rln Of Acty To Accom Of Exmpt Prps | RlnOfActyToAccomOfExmptPrpsGrp |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAX PREPARATION FEE (NON-ALLOC | CategoryTxt |
| Amt | $730 | Amt |
| Disbursements Charitable Prps | $730 | DisbursementsCharitablePrpsAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (21 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| DFA INTERNATIONAL SMALL CO POR | AT COST | $66,827 | $73,546 |
| DFA GLOBAL REAL ESTATE SEC POR | AT COST | $58,562 | $74,819 |
| DIAMOND HILL SMALL-MID CAP FD | AT COST | $58,235 | $92,771 |
| DFA EMERGING MKTS PORT | AT COST | $93,681 | $113,212 |
| DODGE & COX INCOME FD | AT COST | $514,977 | $492,818 |
| DODGE & COX INTL STOCK FD | AT COST | $162,291 | $227,089 |
| LOOMIS SAYLES BD FD | AT COST | $195,706 | $178,914 |
| LAZARD GLOBAL LISTED INFRASTRU | AT COST | $62,710 | $72,960 |
| FEDERATED INSTITUTIONAL HIGH Y | AT COST | $187,438 | $179,466 |
| FLEXSHARES MSTAR GLBL UPSTRM N | AT COST | $103,989 | $149,388 |
| FIDELITY US BOND INDEX INSTL P | AT COST | $584,877 | $562,487 |
| PEPSICO INC | |||
| FIDELITY INFLATION PROECTED BO | AT COST | $95,445 | $103,619 |
| FIDELITY 500 INDEX FUND | AT COST | $177,495 | $306,255 |
| DODGE & COX GLOBAL BOND FUND | AT COST | $37,058 | $35,771 |
| JPMORGAN LARGE CAP GROWTH I | AT COST | $150,258 | $192,320 |
| INVESCO OPPENHEIMER INTL GROWT | AT COST | $114,519 | $112,975 |
| ISHARES MSCI EAFE GROWTH ETF | AT COST | $96,041 | $113,117 |
| FIDELITY EMERGING MKTS INDEX F | AT COST | $106,703 | $114,495 |
| COLUMBIA DIVIDEND INCOME INST3 | AT COST | $222,459 | $295,054 |
| FIDELITY SMALL CAP INDEX FUND | AT COST | $72,211 | $94,043 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ROUNDING | $11 |
| LAZARD GL LIST INFR FD COST BASIS ADJ | $329 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | STATE FILING FEE | Desc |
| Revenue And Expenses Per Books | $250 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $250 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (4 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FEDERAL TAX PAYMENT - PRIOR YE | $53 | $0 | $0 |
| FEDERAL ESTIMATES - PRINCIPAL | $1,616 | $0 | $0 |
| FOREIGN TAXES ON QUALIFIED FOR | $636 | $636 | $0 |
| FOREIGN TAXES ON NONQUALIFIED | $252 | $252 | $0 |