PEPIN FAMILY FOUNDATION INC: Form 990PF, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PEPIN FAMILY FOUNDATION INC (EIN 20-1250899)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-14
- IRS object ID
- 201843189349100104
- Schema version
- 2017v2.3
- 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 | 2018-11-14T07:51:35-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 590548468 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PURVIS GRAY & COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2347 SE 17TH STREET | AddressLine1Txt |
| City | OCALA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201250899 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEPIN FAMILY FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEPI | BusinessNameControlTxt |
| Phone | 8136266176 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4121 NORTH 50TH STREET | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33610 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT J AMMON | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 8136266176 | PhoneNum |
| Signature | 2018-11-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | STEVEN T LEE CPA | PreparerPersonNm |
| PTIN | P00367156 | PTIN |
| Phone | 3527323872 | PhoneNum |
| Preparation | 2018-11-05 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 68.110.130.24 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-14 | IPDt |
| IP Tm | 06:51:35 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9055BC76A8C3DDF55FD8A07F9833E33646F915C5 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AF056C27A3B52BF14F072D7B09A2E8EB433174DE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | 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 | $109,926 | 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 | $21,000 | ContriRcvdRevAndExpnssAmt |
| Total Rev And Expnss | $21,000 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $0 | TotalNetInvstIncmAmt |
| Other Prof Fees Rev And Expnss | $2,125 | OtherProfFeesRevAndExpnssAmt |
| Tot Opr Expenses Rev And Expnss | $2,125 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $50,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $50,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $52,125 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $50,000 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$31,125 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $141,051 | CashBOYAmt |
| Cash EOY | $109,926 | CashEOYAmt |
| Cash EOYFMV | $109,926 | CashEOYFMVAmt |
| Total Assets BOY | $141,051 | TotalAssetsBOYAmt |
| Total Assets EOY | $109,926 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $109,926 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Retained Earning BOY | $141,051 | RetainedEarningBOYAmt |
| Retained Earning EOY | $109,926 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $141,051 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $109,926 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $141,051 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $109,926 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $141,051 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$31,125 | ExcessRevenueOverExpensesAmt |
| Subtotal | $109,926 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $109,926 | TotNetAstOrFundBalancesEOYAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $3,500 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $129,777 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.026969 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $39,795 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $124,263 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.320248 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $163,936 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $143,953 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 1.138816 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $55,000 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $167,158 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.329030 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $29,745 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $193,183 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.153973 | DistributionYr5Rt |
| Total Distribution | 1.969036 | TotalDistributionRt |
| Average Distribution | 0.393807 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $129,691 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $51,073 | AdjNetVlNoncharitableAssetsAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $51,073 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $50,000 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
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 | FL | 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 | ROBERT J AMMON CPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8136266176 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4121 NORTH 50TH STREET | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33610 | 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 | Yes (true) | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| 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 |
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 |
|---|---|---|---|---|---|---|---|---|
| THOMAS A PEPIN | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | PRESIDENT | 2.00 | $0 | $0 | $0 |
| ROBERT J AMMON | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | TREASURER | 2.00 | $0 | $0 | $0 |
| RANDY GARCIA | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | SECRETARY | 2.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1Txt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $131,666 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $131,666 | TotalFMVOfUnusedAssetsAmt |
| Adjusted Total FMV Of Unused Ast | $131,666 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $1,975 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $129,691 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $6,485 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $6,485 | MinimumInvestmentReturnAmt |
| Distributable Before Adj | $6,485 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $6,485 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $6,485 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $50,000 | ExpensesAndContributionsAmt |
| Qualifying Distributions | $50,000 | QualifyingDistributionsAmt |
| Adjusted Qualifying Distri | $50,000 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $6,485 | DistributableAsAdjustedAmt |
| Excess Distribution Cyov Yr5 | $17,097 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $46,642 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $156,738 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $33,582 | ExcessDistributionCyovYr2Amt |
| Total Excess Distribution Cyov | $254,059 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $50,000 | QualifyingDistributionsAmt |
| Applied To Current Year | $6,485 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $43,515 | RemainingDistriFromCorpusAmt |
| Total Corpus | $297,574 | TotalCorpusAmt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Excess Distri Cyov From Yr5 | $17,097 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $280,477 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $46,642 | ExcessFromYear4Amt |
| Excess From Year3 | $156,738 | ExcessFromYear3Amt |
| Excess From Year2 | $33,582 | ExcessFromYear2Amt |
| Excess From Current Year | $43,515 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (2 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| FLORIDA HOSP TAMPA FOUNDATION | ||||||
| 3100 E FLETCHER AVENUE | TAMPA | FL | 33613 | PC | CARDIOVASCULAR RESEARCH & TREATMENT | $40,000 |
| PEPIN ACADEMIES FOUNDATION | ||||||
| 3916 E HILLSBOROUGH AVE | TAMPA | FL | 34610 | PC | SCHOOL FOR LEARNING DISABLED CHILDRE | $10,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $50,000 | TotalGrantOrContriPdDurYrAmt |
Grant Or Contri Apprv For Fut GrantOrContriApprvForFutGrp
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA HOSP TAMPA FOUNDATION | BusinessNameLine1Txt |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 E FLETCHER AVENUE | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33613 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | CARDIOVASCULAR RESEARCH & TREATMENT | GrantOrContributionPurposeTxt |
| Amt | $25,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Apprv Fut | $25,000 | TotalGrantOrContriApprvFutAmt |
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 |
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 Person | THOMAS DENISE BRADLEY | ContributorPersonNm |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5012 W CYPRESS ST | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $15,000 | TotalContributionsAmt |
| Person Contribution | Yes (X) | PersonContributionInd |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt |
|---|---|
| WEBSITE | $1,125 |
| VIDEO PRODUCTION | $1,000 |