JACK PRIBAZ FOUNDATION: Form 990EZ, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- JACK PRIBAZ FOUNDATION (EIN 45-4104433)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-05-15
- IRS object ID
- 201901359349206410
- Schema version
- 2018v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-15T17:38:19-04:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 364240478 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Quality Back Office | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 S Washington St Ste 105 | AddressLine1Txt |
| City | Naperville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60540 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454104433 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE JACK PRIBAZ FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JACK | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 813 | AddressLine1Txt |
| City | Wheaton | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60187 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mike Pribaz | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 6302546909 | PhoneNum |
| Signature | 2019-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Gary Grottke CPA | PreparerPersonNm |
| PTIN | P01578334 | PTIN |
| Phone | 6304280640 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.170.40.100 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-15 | IPDt |
| IP Tm | 17:39:37 | IPTm |
| Federal Original Submission Id | 1558372019135a45u0gu | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-05-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 576EF44C97C7AE491A80B0E1F14B6AFD024C1F79 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 576EF44C97C7AE491A80B0E1F14B6AFD024C1F79 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $92,442 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $6,717 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $132 | InvestmentIncomeAmt |
| Fundraising Gross Income | $85,593 | FundraisingGrossIncomeAmt |
| Special Events Net Income Loss | $85,593 | SpecialEventsNetIncomeLossAmt |
| Total Revenue | $92,442 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $35,000 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $5,135 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $373 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $44,717 | OtherExpensesTotalAmt |
| Total Expenses | $85,225 | TotalExpensesAmt |
| Excess Or Deficit For Year | $7,217 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $125,917 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $133,134 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,667 | BOYAmt |
| EOY | $133,134 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,667 | BOYAmt |
| EOY | $133,134 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,750 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,917 | BOYAmt |
| EOY | $133,134 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | FUND RESEARCH & TREATMENT OF EPILEPSY | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | PROVIDE GRANTS FOR MEDICAL RESEARCH AND EDUCATION | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $15,000 | GrantsAndAllocationsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Mike Pribaz | ||||
| President | 10.00 | $0 | $0 | $0 |
| Brian Baird | ||||
| Director | 3.00 | $0 | $0 | $0 |
| Liz Pribaz | ||||
| VICE PRESIDENT | 5.00 | $0 | $0 | $0 |
| Gina Volenilek | ||||
| Director | 3.00 | $0 | $0 | $0 |
| Jim Thompson | ||||
| Director | 3.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Quality Back Office LLC | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 S Washington Ste 105 | AddressLine1Txt |
| City | Naperville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60540 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6304280640 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $138,669 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $80,833 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,574 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,560 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,221 | CurrentTaxYearAmt |
| Total | $294,857 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $94,205 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $88,230 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,400 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $77,089 | CurrentTaxYearAmt |
| Total | $295,924 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $138,669 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $175,038 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $99,804 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $84,960 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,310 | CurrentTaxYearAmt |
| Total | $590,781 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $590,781 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $191 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $95 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $135 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $135 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $132 | CurrentTaxYearAmt |
| Total | $688 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $191 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $95 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $135 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $135 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $132 | CurrentTaxYearAmt |
| Total | $688 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $138,860 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $175,133 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $99,939 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $85,095 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,442 | CurrentTaxYearAmt |
| Total | $591,469 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99880 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99900 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
| Licensed States | IL | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $77,089 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $77,089 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $19,279 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $3,986 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $4,854 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $77,089 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $77,089 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $19,279 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $3,986 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,854 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $28,119 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $48,970 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| List of grants and similar amounts paid Part I line 10 | Activity Medical Research Grantee BAYLOR COLLEGE OF MEDICINE Street ONE BAYLOR PLAZA City, State, Zip Houston, TX 77030Relationship NONE Amount 20,000Activity Medical Research Grantee Lurie Childrens Hospital Street 225 E Chicago Ave City, State, Zip Chicago, IL 60611Relationship none Amount 15,000 |
| Description of other expenses Part I line 16 | Description AmountSupplies 985Travel/Travel Meals 3,880Telephone 439Bank Fees 476Credit Card Fees 135Meals 360Registration Fees 281Donation 2,500Event Expense 28,118Promotional 7,485Other 58 |
| Description of total liabilities Part II line 26 | Category Beginning of Year End of YearGrant payable 42,750 0 |