CLOVERFIELDS FOUNDATION: Form 990PF, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CLOVERFIELDS FOUNDATION (EIN 20-1919362)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-08-27
- IRS object ID
- 201822399349100102
- 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
- Form 990-PF
- Schedule B
- Accounting Fees Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Other Receivables Officers Sch
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-27T07:37:52-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | 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 | 2017-01-01 | 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 | 2018-07-27 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | 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 | $32,340,112 | 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 | $5,069,200 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $250 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $250 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $311,518 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $311,518 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | -$78,695 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $706,169 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $128 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $128 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $5,302,401 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $311,896 | 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 | $11,420 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Taxes Rev And Expnss | $54,173 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $3,632 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $69,225 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $2,554,314 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $2,554,314 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $2,623,539 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $2,554,314 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $2,678,862 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $311,896 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $5,428,472 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $3,821,998 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $3,821,998 | SavAndTempCashInvstEOYFMVAmt |
| Rcvbl From Officers EOY | $1,000 | RcvblFromOfficersEOYAmt |
| Rcvbl From Officers EOYFMV | $1,000 | RcvblFromOfficersEOYFMVAmt |
| Corporate Stock BOY | $12,116,610 | CorporateStockBOYAmt |
| Corporate Stock EOY | $16,400,946 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $24,570,114 | 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 | $22,402,223 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,081,085 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $32,340,112 | 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 | $22,402,223 | RetainedEarningBOYAmt |
| Retained Earning EOY | $25,081,085 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $22,402,223 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $25,081,085 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $22,402,223 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $25,081,085 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $22,402,223 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $2,678,862 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $25,081,085 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $25,081,085 | 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 | $706,169 | GrossSalesPriceAmt |
| Cost Or Other Basis | $784,864 | CostOrOtherBasisAmt |
| Gain Or Loss | -$78,695 | GainOrLossAmt |
| Gains Minus Excess Or Losses | -$78,695 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | -$78,695 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $2,327,802 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $22,317,203 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.104305 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $2,300,568 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $24,416,202 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.094223 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $1,742,188 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $24,724,198 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.070465 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $758,833 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $21,421,018 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.035425 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $2,619,806 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $19,918,409 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.131527 | DistributionYr5Rt |
| Total Distribution | 0.435945 | TotalDistributionRt |
| Average Distribution | 0.087189 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $23,324,321 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $2,033,624 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $3,119 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $2,036,743 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $2,554,314 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | Yes (X) | DomesticOrgMeetingSect4940eInd |
| Investment Income Excise Tax | $3,119 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $3,119 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $3,119 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $15,655 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $15,655 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $12,536 | OverpaymentAmt |
| Applied To ES Tax | $12,536 | 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 |
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 MOORELAND 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 | $18,939,768 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $4,739,746 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $23,679,514 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $23,679,514 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $355,193 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $23,324,321 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $1,166,216 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $1,166,216 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $3,119 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $3,119 | TotalTaxAmt |
| Distributable Before Adj | $1,163,097 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $1,163,097 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $1,163,097 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $2,554,314 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $2,554,314 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $3,119 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $2,551,195 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $1,163,097 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $1,673,624 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr3 | $512,813 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $1,080,646 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $1,225,578 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $4,492,661 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $2,554,314 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $1,163,097 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $1,391,217 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $5,883,878 | 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 | $1,673,624 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $4,210,254 | ExcessDistriCyovToNextYrAmt |
| Excess From Year3 | $512,813 | ExcessFromYear3Amt |
| Excess From Year2 | $1,080,646 | ExcessFromYear2Amt |
| Excess From Year1 | $1,225,578 | ExcessFromYear1Amt |
| Excess From Current Year | $1,391,217 | 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 (38 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| AMERICAN DIABETES ASSOCIATION | |||||||
| 1245 E BRICKYARD ROAD SUITE 30 | SALT LAKE CITY | UT | 84106 | N/A | PUBLIC CHARITY | TOUR DE CURE | $25,000 |
| AMERICAN HEART ASSOCIATION | |||||||
| 7272 GREENVILLE AVE | DALLAS | TX | 75231 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| BASILICA OF ST MARY'S | |||||||
| BOX 50010 | MINNEAPOLIS | MN | 554050010 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $56,788 |
| BRECK SCHOOL | |||||||
| 123 OTTAWA AVENUE NORTH | MINNEAPOLIS | MN | 55422 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| CHILDREN'S HEARTLINK | |||||||
| 5075 ARCADIA AVENUE | MINNEAPOLIS | MN | 554362306 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| CHURCH OF THE ASCENSION | |||||||
| 1726 DUPONT AVE N | MINNEAPOLIS | MN | 55411 | N/A | PUBLIC CHARITY | FUNDING FOR THE ASCENSION CATHOLIC SCHOOL | $50,000 |
| COMPASS REGIONAL HOSPICE | |||||||
| 160 COURSEVALL DRIVE | CENTREVILLE | MD | 21617 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| 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 |
| FIGHTING CHANCE INC | |||||||
| 1704 NORTH 33RD AVE | MINNEAPOLIS | MN | 554122440 | N/A | PRIVATE FOUNDATION | GENERAL OPERATING FUND | $25,000 |
| FORDAM UNIVERSITY | |||||||
| 888 7TH AVE | NEW YORK | NY | 10019 | N/A | PUBLIC CHARITY | FOOTBALL OFFICE RENOVATIONS AND FORDHAM FUND SCHOLARSHIPS | $125,000 |
| FRIENDS OF WYE MILL INC | |||||||
| PO BOX 277 | WYE MILLS | MD | 21679 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $2,500 |
| GEORGETOWN UNIVERSITY | |||||||
| 2115 WISCONSIN AVE NW STE 500 | WASHINGTON | DC | 20007 | N/A | PUBLIC CHARITY | CLASS OF 1964 ENDOWED FUND | $600,000 |
| GUTHRIE THEATRE | |||||||
| 818 SOUTH 2ND STREET | MINNEAPOLIS | MN | 55415 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| INNER CITY TENNIS | |||||||
| 4005 NICOLLET AVE S | MINNEAPOLIS | MN | 55409 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $25,000 |
| INTERFAITH OUTREACH & COMMUNITY PARTNERS | |||||||
| 1605 COUNTY ROAD 101 | PLYMOUTH | MN | 554472708 | N/A | PUBLIC CHARITY | STABILIZE STRENGTHEN AND THRIVE CAMPAIGN | $350,000 |
| INTERFAITH OUTREACH & COMMUNITY PARTNERS | |||||||
| 1605 COUNTY ROAD 101 | PLYMOUTH | MN | 554472708 | N/A | PUBLIC CHARITY | 2017 SLEEP OUT | $150,000 |
| LIFE TIME FOUNDATION | |||||||
| 2902 CORPORATE PLACE | CHANHASSEN | MN | 55317 | N/A | PUBLIC CHARITY | BAHRAM AKRADI'S CHEQUAMEGON RACE FOR A PURPOSE | $1,000 |
| LIFE TIME FOUNDATION | |||||||
| 2902 CORPORATE PLACE | CHANHASSEN | MN | 55317 | N/A | PUBLIC CHARITY | FUND-A-NEED DONATION | $5,000 |
| MARYWOOD UNIVERSITY | |||||||
| 2300 ADAMS AVENUE | SCRANTON | PA | 18509 | N/A | PUBLIC CHARITY | MARYWOOD SCHOLARSHIP FUND | $10,000 |
| MINNEAPOLIS INSTITUTE OF ARTS | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 55404 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $30,000 |
| NATIONAL ALOPECIA AREATA FOUNDATION | |||||||
| 65 MITCHELL BLVD STE 200-B | SAN RAFAEL | CA | 94903 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $2,500 |
| PATHWAYS TO CHILDREN | |||||||
| 100 2ND ST SE 1201 | MINNEAPOLIS | MN | 55410 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $3,500 |
| PROJECT HOPE | |||||||
| 255 CARTER HALL LANE PO BOX 250 | MILLWOOD | VA | 22646 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $10,000 |
| ST OLAF CHURCH | |||||||
| 215 S 8TH STREET | MINNEAPOLIS | MN | 55402 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $10,000 |
| STANFORD UNIVERSITY | |||||||
| 326 GALVEZ STREET | STANFORD | CA | 943056105 | N/A | PUBLIC CHARITY | FUNDING FOR SCHOOL OF BUSINESS | $37,500 |
| TEENAGER'S INC | |||||||
| 105 BETHLEHEM PIKE | PHILADELPHIA | PA | 19118 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| THE CHILDREN'S THEATRE | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 554043597 | N/A | PUBLIC CHARITY | FUNDING FOR THE SYNERGY SERIES | $7,000 |
| THE CHILDREN'S THEATRE | |||||||
| 2400 THIRD AVE S | MINNEAPOLIS | MN | 554043597 | N/A | PUBLIC CHARITY | FUNDING FOR CURTAIN CALL BALL | $20,946 |
| THE GOOD ACRE | |||||||
| 1790 LARPENTEUR AVE W | FALCON HEIGHTS | MN | 55113 | N/A | PUBLIC CHARITY | FUNDING FOR INNOVATION FUND | $5,000 |
| THE SAINT PAUL SEMINARY | |||||||
| 2260 SUMMIT AVENUE | ST PAUL | MN | 551051094 | N/A | PUBLIC CHARITY | I WILL GIVE YOU SHEPHERDS CAMPAIGN | $200,000 |
| UNIVERSITY OF MINNESOTA FOUNDATION | |||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 554552010 | N/A | PUBLIC CHARITY | CHILDREN'S HEALTH WINEFEST | $12,580 |
| UNIVERSITY OF MINNESOTA FOUNDATION | |||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 554552010 | N/A | PUBLIC CHARITY | UROLOGIC CANCER TREATMENT OUTCOMES RESEARCH | $100,000 |
| UNIVERSITY OF MINNESOTA FOUNDATION | |||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 554552010 | N/A | PUBLIC CHARITY | CHILDREN'S HEALTH FASHION-FEST EVENT FUND | $5,000 |
| 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 | $25,000 |
| UNIVERSITY OF ST THOMAS | |||||||
| 2115 SUMMIT AVENUE | ST PAUL | MN | 551051096 | N/A | PUBLIC CHARITY | HEMSLEY ENDOWED SCHOLARSHIP FOR DOUGHERTY FAMILY COLLEGE | $500,000 |
| WASHINGTON JESUIT ACADEMY | |||||||
| 900 VARNUM STREET NE | WASHINGTON | DC | 20017 | N/A | PUBLIC CHARITY | GENERAL OPERATING FUND | $5,000 |
| YMCA OF THE GREATER TWIN CITIES | |||||||
| 30 S 9TH ST | MINNEAPOLIS | MN | 554023198 | N/A | PUBLIC CHARITY | YMCA CAMPAIGN FOR A GREATER TWIN CITIES | $25,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $2,554,314 | 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 | $250 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $311,518 | ExclusionAmt |
Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $128 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | -$78,695 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $233,201 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $233,201 | 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 | $5,069,200 | TotalContributionsAmt |
| Noncash Contribution | Yes (X) | NoncashContributionInd |
Non Cash Property Contribution NonCashPropertyContributionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
| Noncash Property | 23,000 SHARES UNITEDHEALTH GROUP INC. | NoncashPropertyDesc |
| Fair Market Value | $5,069,200 | FairMarketValueAmt |
| Received | 2017-12-22 | ReceivedDt |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | DORSEY & WHITNEY | CategoryTxt |
| Amt | $11,420 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (29 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| 1069 SHS ADIENT PLC | $49,799 | $84,130 |
| 651 SHS ALPHABET INC (CLASS C) | $283,180 | $681,207 |
| 175 SHS ALPHABET INC (CLASS A) | $41,166 | $184,345 |
| 19,100 SHS AMERICAN INTERNATIONAL GROUP INC | $973,650 | $1,137,978 |
| 2310 SHS APPLE INC | $198,107 | $390,921 |
| 12,400 SHS BALL CORP | $439,671 | $469,340 |
| 2200 SHS CELGENE CORP | $123,185 | $229,592 |
| 1500 SHS CHEVRON | $115,815 | $187,785 |
| 5909 SHS CHUBB LTD | $465,117 | $863,482 |
| 18,000 SHS CIT GROUP INC | $827,732 | $886,140 |
| 9800 SHS CITIGROUP INC | $492,328 | $729,218 |
| 4600 SHS COMCAST CORP | $41,829 | $184,230 |
| 9500 SHS DANAHER CORP | $533,951 | $881,790 |
| 3333 SHS DELPHI TECHNOLOGIES PLC | $83,242 | $174,883 |
| 12,900 SHS DELTA AIR LINES INC | $407,763 | $722,400 |
| 4750 SHS FORTIVE CORPORATION | $166,124 | $343,663 |
| 28,900 SHS GENERAL ELECTRIC COMPANY | $748,918 | $504,305 |
| 4300 SHS GILEAD SCIENCES INC | $334,880 | $308,052 |
| 10,696 SHS JOHNSON CONTROLS | $488,700 | $407,625 |
| 8300 SHS JPMORGAN CHASE & CO | $483,321 | $887,602 |
| 4000 SHS METLIFE INC | $122,085 | $202,240 |
| 2300 SHS MICROSOFT CORP | $64,083 | $196,742 |
| 18,800 SHS ORACLE CORP | $605,748 | $888,864 |
| 5800 SHS THERMO FISHER SCIENTIFIC INC | $485,185 | $1,101,304 |
| 5800 SHS UNITED PARCEL SVC INC | $517,128 | $691,070 |
| 24,000 SHS UNITEDHEALTH GROUP | $1,802,064 | $5,070,580 |
| 2200 SHS BRIGHTHOUSE FINANCIAL INC | $14,090 | $21,286 |
| 10,000 SHS APTIV PLC | $422,885 | $848,300 |
| 23,000 SHS UNITEDHEALTH GROUP | $5,069,200 | $5,291,040 |
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 Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER | Desc |
| Revenue And Expenses Per Books | $3,632 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SECURITIES LITIGATION SETTLEMENT | Desc |
| Revenue And Expenses Per Books | $128 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $128 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $128 | AdjustedNetIncomeAmt |
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 | $1,000 | 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 | $1,000 | ConsiderationFMVAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| REAL ESTATE TAXES | $51,173 | $0 | $0 |
| EXCISE TAXES | $3,000 | $0 | $0 |