THE JACK LEVIN FOUNDATION INC: Form 990PF, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- THE JACK LEVIN FOUNDATION INC (EIN 56-1116935)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-05-14
- IRS object ID
- 201831349349101748
- Schema version
- 2017v2.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Stock Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-14T11:09:52-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 204759472 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LBA HAYNES STRAND PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 10949 | AddressLine1Txt |
| City | GREENSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27404 | 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 | 561116935 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE JACK LEVIN FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JACK | BusinessNameControlTxt |
| Phone | 3365477005 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4253 WAYNE ROAD | AddressLine1Txt |
| City | GREENSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27407 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JACK LEVIN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3365477005 | PhoneNum |
| Signature | 2018-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHNNY C WOOD CPA | PreparerPersonNm |
| PTIN | P00370070 | PTIN |
| Phone | 3362863204 | PhoneNum |
| Preparation | 2018-05-14 | PreparationDt |
| 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 | $4,369,042 | 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 | $4,215 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $228 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $228 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $57,451 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $57,451 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $625,105 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $3,058,538 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $889,898 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $686,999 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $947,577 | 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 | $4,215 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $2,108 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $2,107 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $27,905 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $27,774 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $131 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $1,583 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $480 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $33,703 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $30,362 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $2,238 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $176,676 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $176,676 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $210,379 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $30,362 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $178,914 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $476,620 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $917,215 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $8,031 | CashBOYAmt |
| Cash EOY | $6,224 | CashEOYAmt |
| Cash EOYFMV | $6,224 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $115,811 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $159,907 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $159,907 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl | $2,851 | AcctRcvblAmt |
| Acct Rcvbl BOY | $960 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $2,851 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $2,851 | AcctRcvblEOYFMVAmt |
| Prepaid Expenses BOY | $16,069 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $14,966 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $14,966 | PrepaidExpensesEOYFMVAmt |
| Corporate Stock BOY | $2,712,537 | CorporateStockBOYAmt |
| Corporate Stock EOY | $3,146,080 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $4,185,094 | CorporateStockEOYFMVAmt |
| Total Assets BOY | $2,853,408 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,330,028 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,369,042 | 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 | $2,853,408 | RetainedEarningBOYAmt |
| Retained Earning EOY | $3,330,028 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $2,853,408 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,330,028 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $2,853,408 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,330,028 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $2,853,408 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $476,620 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $3,330,028 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $3,330,028 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (5 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|
| PUBLICLY TRADED SECURITIES | P | $2,213,561 | $2,003,494 | $210,067 | $210,067 |
| PUBLICLY TRADED SECURITIES | P | $106,415 | $147,646 | -$41,231 | -$41,231 |
| PUBLICLY TRADED SECURITIES | D | $704,287 | $17,500 | $686,787 | $686,787 |
| PUBLICLY TRADED SECURITIES | P | $3,832 | $3,832 | $3,832 | |
| CAPITAL GAINS DIVIDENDS | P | $30,443 | $30,443 | $30,443 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $889,898 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $166,410 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $3,572,245 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.046584 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $141,344 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $3,424,677 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.041272 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $62,901 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $3,223,081 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.019516 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $30,656 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $1,161,094 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.026403 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $25,379 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $991,671 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.025592 | DistributionYr5Rt |
| Total Distribution | 0.159367 | TotalDistributionRt |
| Average Distribution | 0.031873 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $3,974,145 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $126,668 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $9,172 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $135,840 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $178,914 | 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 | $9,172 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $9,172 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $9,172 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $14,966 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $14,966 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $5,794 | OverpaymentAmt |
| Applied To ES Tax | $5,794 | 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 | NC | 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 | JACK LEVIN | IndividualWithBooksNm |
| Phone | 3365477005 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4253 WAYNE ROAD | AddressLine1Txt |
| City | GREENSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27407 | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|
| JACK LEVIN | ||||||||
| 4253 WAYNE ROAD | GREENSBORO | NC | 27407 | PRESIDENT / DIR | 1.00 | $0 | $0 | $0 |
| JANIS L FIELDS | ||||||||
| 1006 BRIDGEWATER DRIVE | GREENSBORO | NC | 27410 | VICE PRES / DIR | 1.00 | $0 | $0 | $0 |
| KAREN L BAUERSFELD | ||||||||
| 5838 FRED LINEBERRY ROAD | RANDLEMAN | NC | 27317 | SECRETARY / DIR | 1.00 | $0 | $0 | $0 |
| LINDA L HYSON | ||||||||
| 510 NORTH MERIDIAN STREET | TALLAHASSEE | FL | 32301 | TREASURER / DIR | 1.00 | $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 | $3,860,186 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $158,941 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $15,538 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $4,034,665 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $4,034,665 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $60,520 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,974,145 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $198,707 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $198,707 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $9,172 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $9,172 | TotalTaxAmt |
| Distributable Before Adj | $189,535 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $189,535 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $189,535 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $178,914 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $178,914 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $9,172 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $169,742 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $189,535 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $175,054 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $178,914 | QualifyingDistributionsAmt |
| Applied To Year1 | $175,054 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $3,860 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $185,675 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | JACK LEVIN | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (65 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| AMERICAN FRIENDS OF ALYN HOSPITAL | ||||||
| 51 EAST 42ND STREET STE 308 | NEW YORK | NY | 10017 | PC | UNRESTRICTED | $100 |
| ALZHEIMER'S ASSOCIATION | ||||||
| PO BOX 42453 | CHARLOTTE | NC | 28215 | PC | UNRESTRICTED | $25 |
| AMYOTROPHIC LATERAL SCLEROSIS (ALS) ASSOCIATION | ||||||
| PO BOX 8178 | PUEBLO | CO | 81008 | PC | UNRESTRICTED | $35 |
| AMERICAN CANCER SOCIETY | ||||||
| PO BOX 41912 | RALEIGH | NC | 27629 | PC | UNRESTRICTED | $25 |
| AMERICAN DIABETES ASSOCIATION | ||||||
| PO BOX 7023 | MERRIFIELD | VA | 22116 | PC | UNRESTRICTED | $25 |
| AMERICAN FARMLAND TRUST | ||||||
| 1150 CONNECTICUT AVE NW STE 600 | WASHINGTON | DC | 20036 | PC | UNRESTRICTED | $100 |
| AMERICAN FRIENDS OF MAGEN DAVID | ||||||
| PO BOX 3098 | NEW YORK | NY | 10117 | PC | UNRESTRICTED | $25 |
| AMERICAN HEART ASSOCIATION INC | ||||||
| PO BOX 78851 | PHOENIX | AZ | 85062 | PC | UNRESTRICTED | $25 |
| AMERICAN KIDNEY FUND INC | ||||||
| PO BOX 1837 | MERRIFIELD | VA | 22116 | PC | UNRESTRICTED | $25 |
| AMERICAN LUNG ASSOCIATION | ||||||
| 1301 PENNSYLVANIA AVENUE NW STE 800 | WASHINGTON | DC | 20004 | PC | UNRESTRICTED | $25 |
| AMERICAN PARKINSON DISEASE ASSOCIATION | ||||||
| 135 PARKINSON AVENUE | STATON ISLAND | NY | 10305 | PC | UNRESTRICTED | $25 |
| AMERICAN RED CROSS | ||||||
| PO BOX 14710 | GREENSBORO | NC | 27415 | PC | UNRESTRICTED | $25 |
| ARTHRITIS FOUNDATION | ||||||
| PO BOX 96280 | WASHINGTON | DC | 20077 | PC | UNRESTRICTED | $25 |
| BETH DAVID SYNAGOGUE | ||||||
| 804 WINVIEW DRIVE | GREENSBORO | NC | 27410 | PC | UNRESTRICTED | $1,256 |
| BOYS & GIRLS CLUBS OF AMERICA | ||||||
| 1275 PEACHTREE STREET NE | ATLANTA | GA | 30309 | PC | UNRESTRICTED | $500 |
| B'NAI BRITH INTERNATIONAL | ||||||
| PO BOX 96729 | WASHINGTON | DC | 20090 | PC | UNRESTRICTED | $25 |
| CENTRAL CAROLINA COMMUNITY COLLEGE (CCCC) FOUNDATION | ||||||
| 1105 KELLY DRIVE | SANFORD | NC | 27330 | PC | UNRESTRICTED | $500 |
| CIVITAS INSTITUTE | ||||||
| 100 SOUTH HARRINGTON STREET | RALEIGH | NC | 27603 | PC | UNRESTRICTED | $2,000 |
| CONSUMER REPORTS FOUNDATION | ||||||
| PO BOX 96552 | WASHINGTON | DC | 20090 | PC | UNRESTRICTED | $30 |
| CROHN'S & COLITIS FOUNDATION | ||||||
| 386 PARK AVENUE SOUTH 17TH FLOOR | NEW YORK | NY | 10016 | PC | UNRESTRICTED | $100 |
| CYSTIC FIBROSIS FOUNDATION | ||||||
| PO BOX 96305 | WASHINGTON | DC | 20090 | PC | UNRESTRICTED | $25 |
| EASTER SEAL SOCIETY | ||||||
| PO BOX 28239 | RALEIGH | NC | 27611 | PC | UNRESTRICTED | $25 |
| EPILEPSY FOUNDATION | ||||||
| PO BOX 96546 | WASHINGTON | DC | 20077 | PC | UNRESTRICTED | $100 |
| FREEDOM ALLIANCE | ||||||
| PO BOX 97242 | WASHINGTON | DC | 20090 | PC | UNRESTRICTED | $125 |
| FRIENDS OF THE IDF | ||||||
| 350 5TH AVENUE STE 2011 | NEW YORK | NY | 10117 | PC | UNRESTRICTED | $250 |
| FRIENDS OF THE SMITHSONIAN | ||||||
| PO BOX 9016 | PITTSFIELD | MA | 01202 | PC | UNRESTRICTED | $75 |
| GEORGIA TECH FOUNDATION | ||||||
| 190 NORTH AVENUE NW | ATLANTA | GA | 303139806 | PC | UNRESTRICTED | $11,000 |
| GETTYSBURG FOUNDATION | ||||||
| PO BOX 3997 | GETTYSBURG | PA | 17325 | PC | UNRESTRICTED | $50 |
| GRAY'S HARBOR HISTORICAL SEAPORT AUTHORITY | ||||||
| 712 HAGARA STREET | ABERDEEN | WA | 98520 | PC | UNRESTRICTED | $1,000 |
| GREENSBORO JEWISH FEDERATION | ||||||
| 5509-C WEST FRIENDLY AVENUE | GREENSBORO | NC | 274104211 | PC | UNRESTRICTED | $7,000 |
| GREENSBORO URBAN MINISTRIES | ||||||
| 305 WEST LEE STREET | GREENSBORO | NC | 27406 | PC | UNRESTRICTED | $1,000 |
| HERITAGE FOUNDATION | ||||||
| 24 MASSACHUSETTS AVENUE NE | WASHINGTON | DC | 20002 | PC | UNRESTRICTED | $100 |
| HOSPICE & PALLIATIVE CARE OF GREENSBORO | ||||||
| 2500 SUMMIT AVENUE | GREENSBORO | NC | 27405 | PC | UNRESTRICTED | $500 |
| INTELLECTUAL TAKEOUT | ||||||
| 8011 34TH AVENUE SUITE C-11 | BLOOMINGTON | MN | 55425 | PC | UNRESTRICTED | $100 |
| JUDICIAL WATCH INC | ||||||
| 425 THIRD STREET SW SUITE 800 | WASHINGTON | DC | 20024 | PC | UNRESTRICTED | $100 |
| LEE COUNTY EDUCATION FOUNDATION | ||||||
| PO BOX 98 | SANFORD | NC | 27331 | PC | UNRESTRICTED | $500 |
| LEUKEMIA & LYMPHOMA SOCIETY INC | ||||||
| PO BOX 9031 | PITTSFIELD | MA | 01202 | PC | UNRESTRICTED | $25 |
| LUPUS FOUNDATION OF AMERICA | ||||||
| PO BOX 630147 | BALTIMORE | MD | 21263 | PC | UNRESTRICTED | $25 |
| MACCABI USA SPORTS FOR ISRAEL | ||||||
| PO BOX 96462 | WASHINGTON | DC | 20090 | PC | UNRESTRICTED | $25 |
| MACULAR DEGENERATION RESEARCH | ||||||
| PO BOX 1952 | CLARKSBURG | MD | 20871 | PC | UNRESTRICTED | $25 |
| MAZON | ||||||
| 10495 SANTA MONICA BLVD STE 100 | LOS ANGELES | CA | 90025 | PC | UNRESTRICTED | $25 |
| METROPOLITAN MUSEUM OF MODERN ART | ||||||
| 1000 FIFTH AVENUE | NEW YORK | NY | 10130 | PC | UNRESTRICTED | $50 |
| MUSCULAR DYSTROPHY ASSOCIATION | ||||||
| PO BOX 79069 | PHOENIX | AZ | 85062 | PC | UNRESTRICTED | $25 |
| NC HILLEL | ||||||
| 201 WEST CAMERON AVENUE | CHAPEL HILL | NC | 27516 | PC | UNRESTRICTED | $30 |
| NC ZOO SOCIETY | ||||||
| 4403 ZOO PARKWAY | ASHEBORO | NC | 27205 | PC | UNRESTRICTED | $50 |
| NATIONAL MULTIPLE SCLEROSIS SOCIETY | ||||||
| PO BOX 958 | GREENSBORO | NC | 27402 | PC | UNRESTRICTED | $25 |
| NATIONAL OSTEOPOROSIS FOUNDATION | ||||||
| 1150 17TH STREET NW SUITE 850 | WASHINGTON | DC | 20036 | PC | UNRESTRICTED | $25 |
| NATIONAL PARK FOUNDATION | ||||||
| PO BOX 17394 | BALTIMORE | MD | 21298 | PC | UNRESTRICTED | $25 |
| PROSTATE CANCER FOUNDATION | ||||||
| PO BOX 7015 | ALBERT LEA | MN | 56007 | PC | UNRESTRICTED | $50 |
| SALVATION ARMY | ||||||
| PO BOX 5363 | GREENSBORO | NC | 27435 | PC | UNRESTRICTED | $200 |
| SENIOR SERVICES INC | ||||||
| 2895 SHOREFAIR DRIVE | WINSTONSALEM | NC | 27199 | PC | UNRESTRICTED | $100 |
| SHRINERS HOSPITALS FOR CHILDREN | ||||||
| PO BOX 1510 | RANSON | VA | 25438 | PC | UNRESTRICTED | $100 |
| SIMON WIESENTHAL CENTER | ||||||
| 1399 SOUTH ROXBURY DRIVE STE 100 | LOS ANGELES | CA | 90035 | PC | UNRESTRICTED | $1,000 |
| ST JUDE CHILDREN'S RESEARCH HOSPITAL | ||||||
| PO BOX 50 | MEMPHIS | TN | 38101 | PC | UNRESTRICTED | $100 |
| STONY CREEK PRESBYTERIAN CHURCH | ||||||
| 2140 STONY CREEK CHURCH ROAD | BURLINGTON | NC | 27217 | PC | UNRESTRICTED | $100 |
| TORAH CENTER | ||||||
| 111 LAUREL PLACE | WESTFIELD | NJ | 07090 | PC | UNRESTRICTED | $1,000 |
| UNITED SERVICES ORGANIZATION | ||||||
| PO BOX 96860 | WASHINGTON | DC | 20077 | PC | UNRESTRICTED | $25 |
| UNITED STATES HOLOCAUST MEMORIAL MUSEUM | ||||||
| PO BOX 90988 | WASHINGTON | DC | 20090 | PC | UNRESTRICTED | $25 |
| UNITED STATES OLYMPIC COMMITTEE | ||||||
| PO BOX 7010 | ALBERT LEA | MN | 56007 | PC | UNRESTRICTED | $25 |
| VETERANS OF FOREIGN WARS OF THE UNITED STATES | ||||||
| PO BOX 8911 | TOPEKA | KS | 66608 | PC | UNRESTRICTED | $50 |
| WAKE FOREST FUND | ||||||
| 1834 WAKE FOREST ROAD | WINSTONSALEM | NC | 27106 | PC | UNRESTRICTED | $1,000 |
| WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | ||||||
| MEDICAL CENTER DRIVE | WINSTONSALEM | NC | 27157 | PC | UNRESTRICTED | $134,500 |
| WEST MARKET UNITED METHODIST CHURCH | ||||||
| 332 WEST MARKET STREET | GREENSBORO | NC | 27401 | PC | UNRESTRICTED | $100 |
| WILSON DISEASE ASSOCIATION | ||||||
| 5572 NORTH DIVERSEY BLVD | MILWAUKEE | WI | 53217 | PC | UNRESTRICTED | $11,000 |
| WOUNDED WARRIORS PROJECT | ||||||
| 4899 BELFORD ROAD SUITE 300 | JACLSONVILLE | FL | 32256 | PC | UNRESTRICTED | $100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $176,676 | 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 | $228 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $57,451 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $625,105 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $682,784 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $682,784 | 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 |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | CategoryTxt |
| Amt | $4,215 | Amt |
| Net Investment Income | $2,108 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $2,107 | DisbursementsCharitablePrpsAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (14 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| CONSTELLATION BRANDS INC CL A | $508,069 | $1,456,055 |
| AMERICAN NEW WORLD FD | $61,015 | $63,776 |
| BLACKROCK II STRAT INCOME FD | $163,166 | $163,415 |
| CLEARBRIDGE LRG CAP GRWTH FD | $183,111 | $190,081 |
| DEUTSCHE REAL ASSETS FD | $163,109 | $167,736 |
| EV GRWTH ATL SMALL CAP FD | $139,761 | $151,012 |
| ISHARES CORE MSCI FD | $189,536 | $198,006 |
| JOHN HANCOCK INT'L GRWTH FD | $189,876 | $199,631 |
| MFS VALUE FD | $164,973 | $188,334 |
| PIMCO INCOME FD | $300,520 | $300,033 |
| VANGUARD S&P 500 INDEX FD | $378,202 | $406,446 |
| VANGUARD STRATEGIC EQ FD | $107,837 | $108,454 |
| VANGUARD TOTAL BOND INDEX FD | $188,538 | $186,958 |
| WESTERN ASSET CORE BD FD | $408,367 | $405,157 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| INVESTMENT MANAGEMENT FEES | $27,774 | $27,774 | $0 |
| OFFICE EXPENSE | $131 | $0 | $131 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FEDERAL FORM 990-PF, 2016 | $1,103 | $0 | $0 |
| FOREIGN TAX WITHHELD | $480 | $480 | $0 |