CLOVERFIELDS FOUNDATION: Form 990PF, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CLOVERFIELDS FOUNDATION (EIN 20-1919362)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-06-13
- IRS object ID
- 201911649349100716
- 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
- Form 990-PF
- Schedule B
- Accounting Fees Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Other Receivables Officers Sch
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-06-13T17:46:05-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410223337 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DORSEY & WHITNEY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 S 6TH ST STE 1500 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201919362 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLOVERFIELDS FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLOV | BusinessNameControlTxt |
| Phone | 6124926440 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O DEAN BARR 50 S 6TH ST NO 1500 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554021498 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN J HEMSLEY | PersonNm |
| Person Title | DIR, PRESIDENT & TREAS | PersonTitleTxt |
| Phone | 6124926440 | PhoneNum |
| Signature | 2019-06-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEAN D BARR | PreparerPersonNm |
| PTIN | P00005626 | PTIN |
| Phone | 6123402600 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 170.112.1.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-06-03 | IPDt |
| IP Tm | 10:39:30 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AFD1374F89352E82E27ED5861037FD12B89EFF54 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $45,605,978 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $16,757,385 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $17,251 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $17,251 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $439,235 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $439,235 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $2,174,350 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $8,483,761 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $2,174,350 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $19,388,221 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $2,630,836 | 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 | $6,600 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Taxes Rev And Expnss | $79,639 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $8,797 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $5 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $95,036 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $5 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $2,519,333 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $2,519,333 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $2,614,369 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $5 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $2,519,333 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $16,773,852 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $2,630,831 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $3,821,998 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $10,147,876 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $10,147,876 | SavAndTempCashInvstEOYFMVAmt |
| Rcvbl From Officers BOY | $1,000 | RcvblFromOfficersBOYAmt |
| Rcvbl From Officers EOY | $1,000 | RcvblFromOfficersEOYAmt |
| Rcvbl From Officers EOYFMV | $1,000 | RcvblFromOfficersEOYFMVAmt |
| Corporate Stock BOY | $16,400,946 | CorporateStockBOYAmt |
| Corporate Stock EOY | $26,797,641 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $31,510,102 | CorporateStockEOYFMVAmt |
| Invst Land Cost Or Other Basis | $4,607,141 | InvstLandCostOrOtherBasisAmt |
| Land Bldg Investments BOY | $4,607,141 | LandBldgInvestmentsBOYAmt |
| Land Bldg Investments EOY | $4,607,141 | LandBldgInvestmentsEOYAmt |
| Land Bldg Investments EOYFMV | $3,697,000 | LandBldgInvestmentsEOYFMVAmt |
| Other Investments BOY | $250,000 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $250,000 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $250,000 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $25,081,085 | TotalAssetsBOYAmt |
| Total Assets EOY | $41,803,658 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $45,605,978 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $0 | CapitalStockBOYAmt |
| Capital Stock EOY | $0 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $25,081,085 | RetainedEarningBOYAmt |
| Retained Earning EOY | $41,803,658 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $25,081,085 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $41,803,658 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $25,081,085 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $41,803,658 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $25,081,085 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $16,773,852 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $41,854,937 | SubtotalAmt |
| Other Decreases | $51,279 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $41,803,658 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | PUBLICLY TRADED SECURITIES | PropertyDesc |
| Gross Sales Price | $8,483,761 | GrossSalesPriceAmt |
| Cost Or Other Basis | $6,309,411 | CostOrOtherBasisAmt |
| Gain Or Loss | $2,174,350 | GainOrLossAmt |
| Gains Minus Excess Or Losses | $2,174,350 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $2,174,350 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $2,551,195 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $23,324,321 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.109379 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $2,327,802 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $22,317,203 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.104305 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $2,300,568 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $24,416,202 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.094223 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $1,742,188 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $24,724,198 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.070465 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $758,833 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $21,421,018 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.035425 | DistributionYr5Rt |
| Total Distribution | 0.413797 | TotalDistributionRt |
| Average Distribution | 0.082759 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $34,424,159 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $2,848,909 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $26,308 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $2,875,217 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $2,519,333 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $52,617 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $52,617 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $52,617 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $36,536 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $33,000 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $69,536 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $16,919 | OverpaymentAmt |
| Applied To ES Tax | $16,919 | 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 | MN | 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 | DEAN D BARR DORSEY WHITNEY LLP | IndividualWithBooksNm |
| Phone | 6124926440 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH 6TH STREET SUITE 1500 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554021498 | 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 (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| STEPHEN J HEMSLEY | ||||||||
| 622 FERNDALE ROAD WEST | WAYZATA | MN | 55391 | DIR, PRESIDENT & TREAS | 1.00 | $0 | $0 | $0 |
| BARBARA K HEMSLEY | ||||||||
| 622 FERNDALE ROAD WEST | WAYZATA | MN | 55391 | DIRECTOR, SECRETARY | 0.50 | $0 | $0 | $0 |
| MATTHEW S HEMSLEY | ||||||||
| 4620 MOORLAND AVENUE | EDINA | MN | 55424 | DIRECTOR | 0.50 | $0 | $0 | $0 |
| 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 | $26,541,542 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $4,459,843 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $3,947,000 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $34,948,385 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $34,948,385 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $524,226 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $34,424,159 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $1,721,208 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $1,721,208 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $52,617 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $52,617 | TotalTaxAmt |
| Distributable Before Adj | $1,668,591 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $1,668,591 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $1,668,591 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $2,519,333 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $2,519,333 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $2,519,333 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $1,668,591 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr4 | $512,813 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $1,080,646 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $1,225,578 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $1,391,217 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $4,210,254 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $2,519,333 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $1,668,591 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $850,742 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $5,060,996 | 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 | $5,060,996 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $512,813 | ExcessFromYear4Amt |
| Excess From Year3 | $1,080,646 | ExcessFromYear3Amt |
| Excess From Year2 | $1,225,578 | ExcessFromYear2Amt |
| Excess From Year1 | $1,391,217 | ExcessFromYear1Amt |
| Excess From Current Year | $850,742 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | STEPHEN J HEMSLEY | ContributingManagerNm |
| Contributing Manager | BARBARA K HEMSLEY | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (43 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ALZHEIMER'S ASSOCIATION | |||||||
| 7900 W 78TH ST STE 100 | MINNEAPOLIS | MN | 55439 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| AMERICAN CANCER SOCIETY | |||||||
| PO BOX 22718 | OKLAHOMA CITY | OK | 73123 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| ASCENSION CATHOLIC SCHOOL | |||||||
| 1723 BRYANT AVE N | MINNEAPOLIS | MN | 55411 | N/A | PUBLIC CHARITY | THE ASCENSION CAMPAIGN | $50,000 |
| BRECK SCHOOL | |||||||
| 123 OTTAWA AVENUE NORTH | MINNEAPOLIS | MN | 55422 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $6,050 |
| BRECK SCHOOL | |||||||
| 123 OTTAWA AVENUE NORTH | MINNEAPOLIS | MN | 55422 | N/A | PUBLIC CHARITY | ANNUAL FUND | $5,000 |
| CHAMPIONS FOR CHILDREN | |||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 554552030 | N/A | PUBLIC CHARITY | UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL | $1,560 |
| CHILDREN'S HEARTLINK | |||||||
| 5075 ARCADIA AVENUE | MINNEAPOLIS | MN | 554362306 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $4,250 |
| CHILDREN'S THEATRE COMPANY | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | IGNITE THE IMAGINATION CAMPAIGN | $100,000 |
| CHILDREN'S THEATRE COMPANY | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $10,000 |
| CHILDREN'S THEATRE COMPANY | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | CURTAIN CALL BALL | $13,800 |
| CHILDREN'S THEATRE COMPANY | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | 2018 CURTAIN CALL BALL | $25,255 |
| COLLEGE POSSIBLE | |||||||
| 755 PRIOR AVE N STE 210 | ST PAUL | MN | 55104 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $2,500 |
| COMPASS REGIONAL HOSPICE | |||||||
| 160 COURSEVALL DRIVE | CENTREVILLE | MD | 21617 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| CONSTELLATION FUND | |||||||
| 323 N WASHINGTON AVE 2ND FL | MINNEAPOLIS | MN | 55401 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $100,000 |
| COURAGE KENNY FOUNDATION | |||||||
| 3915 GOLDEN VALLEY RD | MINNEAPOLIS | MN | 55422 | N/A | PUBLIC CHARITY | ARTHUR ANDERSEN MINNEAPOLIS ALUMNI FUND TO SUPPORT THE COURAGE KENNY FITNESS PROGRAMS EXPANSION PROJECT | $50,000 |
| CRISTO REY JESUIT HIGH SCHOOL | |||||||
| 2924 4TH AVE S | MINNEAPOLIS | MN | 554084194 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $50,000 |
| FORDAM UNIVERSITY | |||||||
| 888 7TH AVE | NEW YORK | NY | 10019 | N/A | PUBLIC CHARITY | 3RD ANNUAL FOOTBALL TRAINING CAMP | $300 |
| FRACTURED ATLAS | |||||||
| 248 WEST 35TH 10TH FL | NEW YORK | NY | 10001 | N/A | PUBLIC CHARITY | TOGETHER IN HOPE PROJECT | $25,000 |
| GEORGETOWN UNIVERSITY | |||||||
| 2115 WISCONSIN AVE NW STE 500 | WASHINGTON | DC | 20007 | N/A | PUBLIC CHARITY | CLASS OF 1964 ENDOWED FUND | $600,000 |
| GRAYWOLF PRESS | |||||||
| 250 3RD AVE N STE 600 | MINNEAPOLIS | MN | 55401 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $15,000 |
| INTERFAITH OUTREACH & COMMUNITY PARTNERS | |||||||
| 1605 COUNTY ROAD 101 | PLYMOUTH | MN | 55447 | N/A | PUBLIC CHARITY | 2018 SLEEP OUT | $150,000 |
| INTERFAITH OUTREACH & COMMUNITY PARTNERS | |||||||
| 1605 COUNTY ROAD 101 | PLYMOUTH | MN | 55447 | N/A | PUBLIC CHARITY | STABILIZE STRENGTHEN AND THRIVE CAMPAIGN | $200,000 |
| INTERFAITH OUTREACH & COMMUNITY PARTNERS | |||||||
| 1605 COUNTY ROAD 101 | PLYMOUTH | MN | 55447 | N/A | PUBLIC CHARITY | NEIGHBORHOOD PROGRAM YOUTH PROGRAMS | $5,000 |
| LAZARUS HOUSE MINISTRIES | |||||||
| PO BOX 408 | LAWRENCE | MA | 01842 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $2,500 |
| MACPHAIL CENTER FOR MUSIC | |||||||
| 501 SOUTH SECOND STREET | MINNEAPOLIS | MN | 55401 | N/A | PUBLIC CHARITY | 2018 MUSIC MATTERS | $1,000 |
| MARYWOOD UNIVERSITY | |||||||
| 2300 ADAMS AVENUE | SCRANTON | PA | 18509 | N/A | PUBLIC CHARITY | MARYWOOD SCHOLARSHIP FUND | $200,000 |
| MINNEAPOLIS FOUNDATION | |||||||
| 800 IDS CENTER 80 S 8TH STREET | MINNEAPOLIS | MN | 55402 | N/A | PUBLIC CHARITY | GREAT MN SCHOOLS FUND | $250,000 |
| MINNEAPOLIS INSTITUTE OF ARTS | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $25,000 |
| MON LUIS ISLAND SCHOOLHOUSE RENOVATION PROJECT | |||||||
| 12470 OLD CEDAR POINT ROAD | CODEN | AL | 36523 | N/A | PUBLIC CHARITY | RESTORE AND PRESERVE THE HISTORIC CREOLE SCHOOLHOUSE | $5,000 |
| NATIONAL ALOPECIA AREATA FOUNDATION | |||||||
| 65 MITCHELL BLVD STE 200-B | SAN RAFAEL | CA | 94903 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $2,500 |
| OUR LADY OF GRACE CATHOLIC CHURCH | |||||||
| 5071 EDEN AVENUE | EDINA | MN | 55436 | N/A | PUBLIC CHARITY | GHANA HIGH SCHOOL SCHOLARSHIP FUND | $500 |
| PATHWAYS TO CHILDREN | |||||||
| 100 2ND ST SE 1201 | MINNEAPOLIS | MN | 55410 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $1,000 |
| QUEENSTOWN VOLUNTEER FIRE DEPARTMENT INC | |||||||
| PO BOX 118 | QUEENSTOWN | MD | 21658 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $250 |
| RALLY FOUNDATION FOR CHILDHOOD CANCER RESEARCH | |||||||
| 5775 GLENRIDGE DRIVE BLDG B STE 370 | ATLANTA | GA | 30328 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| ST DAVID'S CENTER | |||||||
| 3395 PLYMOUTH RD | MINNETONKA | MN | 55305 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| ST OLAF CHURCH | |||||||
| 215 S 8TH STREET | MINNEAPOLIS | MN | 55402 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $15,000 |
| SUMMIT ACADEMY | |||||||
| 935 OLSEN MEMORIAL HWY | MINNEAPOLIS | MN | 55405 | N/A | PUBLIC CHARITY | 2018-2019 ANNUAL FUND | $5,000 |
| TEENS INC | |||||||
| 105 BETHLEHEM PIKE | PHILADELPHIA | PA | 19118 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| THE BASILICA OF SAINT MARY | |||||||
| PO BOX 50010 | MINNEAPOLIS | MN | 554050010 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $6,788 |
| THE SAINT PAUL SEMINARY | |||||||
| 2260 SUMMIT AVENUE | ST PAUL | MN | 551051094 | N/A | PUBLIC CHARITY | ONGOING CLERGY FORMATION | $4,000 |
| UNIVERSITY OF MINNESOTA FOUNDATION | |||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 554552010 | N/A | PUBLIC CHARITY | UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL FUND | $50,000 |
| UNIVERSITY OF MINNESOTA FOUNDATION | |||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 554552010 | N/A | PUBLIC CHARITY | CHILDREN'S HEALTH WINEFEST | $7,080 |
| UNIVERSITY OF ST THOMAS | |||||||
| 2115 SUMMIT AVENUE | ST PAUL | MN | 551051096 | N/A | PUBLIC CHARITY | ATHLETIC FACILITY AND AQUATIC CENTER | $500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $2,519,333 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $17,251 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $439,235 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $2,174,350 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $2,630,836 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $2,630,836 | 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 |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHEN J AND BARBARA K HEMSLEY | BusinessNameLine1Txt |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 622 FERNDALE ROAD WEST | AddressLine1Txt |
| City | WAYZATA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55391 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $16,757,385 | TotalContributionsAmt |
| Noncash Contribution | Yes (X) | NoncashContributionInd |
Non Cash Property Contribution NonCashPropertyContributionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
| Noncash Property | 59,560 SHARES UNITEDHEALTH GROUP INC. | NoncashPropertyDesc |
| Fair Market Value | $16,757,385 | FairMarketValueAmt |
| Received | 2018-11-30 | ReceivedDt |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | DORSEY & WHITNEY | CategoryTxt |
| Amt | $6,600 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (27 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| APTIV PLC | $65,110 | $153,925 |
| JOHNSON CONTROLS | $122,175 | $79,284 |
| ADIENT PLC | $12,438 | $4,021 |
| BALL CORP | $109,877 | $142,538 |
| DELTA AIR LINES INC | $101,474 | $160,928 |
| CHEVRON | $28,954 | $40,796 |
| ALPHABET INC (CLASS A) | $41,166 | $182,868 |
| CIT GROUP INC | $187,487 | $172,215 |
| ORACLE CORP | $116,412 | $212,205 |
| AMERICAN INTERNATIONAL GROUP INC | $480,700 | $376,366 |
| CELGENE CORP | $29,586 | $35,249 |
| MICROSOFT CORP | $64,083 | $233,611 |
| APPLE INC | $198,107 | $364,379 |
| UNITEDHEALTH GROUP | $23,628,648 | $26,546,227 |
| GENERAL ELECTRIC COMPANY | $187,229 | $54,693 |
| DELPHI TECHNOLOGIES PLC | $13,252 | $11,943 |
| METLIFE INC | $30,521 | $41,060 |
| GILEAD SCIENCES INC | $75,394 | $67,241 |
| COMCAST CORP | $10,457 | $39,158 |
| FORTIVE CORPORATION | $41,470 | $80,380 |
| THERMO FISHER SCIENTIFIC INC | $70,557 | $324,496 |
| UNITED PARCEL SVC INC | $104,102 | $141,419 |
| CHUBB LTD | $62,697 | $188,215 |
| ALPHABET INC (CLASS C) | $283,180 | $674,182 |
| JPMORGAN CHASE & CO | $483,321 | $810,246 |
| DANAHER CORP | $133,234 | $244,910 |
| CITIGROUP INC | $116,010 | $127,547 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | GATHER INC | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $250,000 | BookValueAmt |
| EOYFMV | $250,000 | EOYFMVAmt |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | STOCK BASIS ADJ (DONOR BASIS VS FMV) | Desc |
| Amt | $51,279 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| OTHER | $8,767 | $0 | $0 |
| STATE OF MINNESOTA REREGISTRATION FEE | $25 | $0 | $0 |
| INVESTMENT EXPENSE FROM 1099-DIV | $5 | $5 | $0 |
Other Receivables Officers Sch OtherReceivablesOfficersSch
Officer Other Rcvbl OfficerOtherRcvblGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Borrower Person | STEPHEN J HEMSLEY DIR PRESIDENT TRE | BorrowerPersonNm |
| Borrower Title | DIR, PRESIDENT & TREAS | BorrowerTitleTxt |
| Loan Original | $1,000 | LoanOriginalAmt |
| Balance Due | $0 | BalanceDueAmt |
| Note | 2017-05 | NoteDt |
| Loan Maturity | 2018-12 | LoanMaturityDt |
| Repayment Terms | IN FULL BY 12/31/2018 | RepaymentTermsTxt |
| Interest | 0.000000000000 | InterestRt |
| Security Provided Borrower | NONE | SecurityProvidedBorrowerTxt |
| Lender Consideration | INADVERTENT CONTRIBUTION TO A 501C4 - WILL BE REIMBURSED BY STEPHEN HEMSLEY. | LenderConsiderationDesc |
| Consideration FMV | $0 | ConsiderationFMVAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| REAL ESTATE TAXES | $55,639 | $0 | $0 |
| EXCISE TAXES | $24,000 | $0 | $0 |