JEAN M NEWTON FBO CHENANGO MEMORIAL HOSPITAL: Form 990PF, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: JEAN M NEWTON FBO CHENANGO MEMORIAL HOSPITAL (EIN 16-6247584)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-05-04
IRS object ID: 201841249349100904
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 Bonds Schedule
Investments Govt Obligations Sch
Investments Other Schedule2
Other Decreases Schedule
Other Expenses Schedule
Other Increases Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-04T13:00:51-05:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	134008324	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PRICEWATERHOUSECOOPERS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1850 N CENTRAL AVE STE 700	AddressLine1Txt
City	PHOENIX	CityNm
State Abbreviation	AZ	StateAbbreviationCd
ZIP	85004	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	166247584	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEAN M NEWTON FBO CHENANGO MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	NEWT	BusinessNameControlTxt
Phone	6073376191	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	C/O NBT BANK NA 52 SOUTH BROAD ST	AddressLine1Txt
City	NORWICH	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13815	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TIMOTHY J HANDY	PersonNm
Person Title	SENIOR VP	PersonTitleTxt
Phone	6073376191	PhoneNum
Signature	2018-04-23	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JEFFREY E KUHLIN	PreparerPersonNm
PTIN	P00353001	PTIN
Phone	4123556000	PhoneNum
Preparation	2018-04-23	PreparationDt
Self Employed	Yes (X)	SelfEmployedInd

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	$2,681,466	FMVAssetsEOYAmt

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Schedule B Not Required	Yes (X)	ScheduleBNotRequiredInd
Dividends Rev And Expnss	$65,073	DividendsRevAndExpnssAmt
Dividends Net Invst Incm	$65,073	DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss	$32,969	NetGainSaleAstRevAndExpnssAmt
Gross Sales Price	$622,816	GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm	$32,969	CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm	$0	NetSTCapitalGainAdjNetIncmAmt
Total Rev And Expnss	$98,042	TotalRevAndExpnssAmt
Total Net Invst Incm	$98,042	TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss	$15,982	CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm	$14,384	CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl	$1,598	CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Net Invst Incm	$0	OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm	$0	OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl	$0	OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Net Invst Incm	$0	PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Adj Net Incm	$0	PensionEmplBnftAdjNetIncmAmt
Legal Fees Dsbrs Chrtbl	$0	LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss	$730	AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm	$0	AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm	$0	AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps	$730	AccountingFeesChrtblPrpsAmt
Other Prof Fees Dsbrs Chrtbl	$0	OtherProfFeesDsbrsChrtblAmt
Interest Dsbrs Chrtbl	$0	InterestDsbrsChrtblAmt
Taxes Rev And Expnss	$2,146	TaxesRevAndExpnssAmt
Taxes Net Invst Incm	$1,746	TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl	$0	TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss	$0	DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm	$0	DeprecAndDpltnNetInvstIncmAmt
Trav Conf Meeting Net Invst Incm	$0	TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm	$0	TravConfMeetingAdjNetIncmAmt
Printing And Pub Net Invst Incm	$0	PrintingAndPubNetInvstIncmAmt
Printing And Pub Adj Net Incm	$0	PrintingAndPubAdjNetIncmAmt
Other Expenses Rev And Expnss	$250	OtherExpensesRevAndExpnssAmt
Other Expenses Dsbrs Chrtbl	$250	OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss	$19,108	TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm	$16,130	TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm	$0	TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl	$2,578	TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss	$139,157	ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl	$139,157	ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss	$158,265	TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm	$16,130	TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm	$0	TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl	$141,735	TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses	-$60,223	ExcessRevenueOverExpensesAmt
Net Investment Income	$81,912	NetInvestmentIncomeAmt
Adjusted Net Income	$0	AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Field	Value	IRS element (for citing)
Cash EOY	$395	CashEOYAmt
Cash EOYFMV	$395	CashEOYFMVAmt
Sav And Temp Cash Invst BOY	$43,014	SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY	$64,514	SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV	$64,514	SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl EOY	$0	AcctRcvblEOYAmt
Acct Rcvbl EOYFMV	$0	AcctRcvblEOYFMVAmt
Other Rcvbl Allwnc Dbtfl Acct	$0	OtherRcvblAllwncDbtflAcctAmt
US Government Obligations BOY	$50,000	USGovernmentObligationsBOYAmt
Corporate Bonds BOY	$149,753	CorporateBondsBOYAmt
Other Investments BOY	$2,264,370	OtherInvestmentsBOYAmt
Other Investments EOY	$2,380,543	OtherInvestmentsEOYAmt
Other Investments EOYFMV	$2,616,557	OtherInvestmentsEOYFMVAmt
Total Assets BOY	$2,507,137	TotalAssetsBOYAmt
Total Assets EOY	$2,445,452	TotalAssetsEOYAmt
Total Assets EOYFMV	$2,681,466	TotalAssetsEOYFMVAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117	Yes (X)	OrgDoesNotFollowSFAS117Ind
Capital Stock BOY	$2,507,137	CapitalStockBOYAmt
Capital Stock EOY	$2,445,452	CapitalStockEOYAmt
Tot Net Ast Or Fund Balances BOY	$2,507,137	TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY	$2,445,452	TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY	$2,507,137	TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY	$2,445,452	TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Field	Value	IRS element (for citing)
Tot Net Ast Or Fund Balances BOY	$2,507,137	TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses	-$60,223	ExcessRevenueOverExpensesAmt
Other Increases	$1,157	OtherIncreasesAmt
Subtotal	$2,448,071	SubtotalAmt
Other Decreases	$2,619	OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY	$2,445,452	TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (81 entries)

PropertyPropertyDesc	AcquiredAcquiredDt	SoldSoldDt	Gross Sales PriceGrossSalesPriceAmt	Cost Or Other BasisCostOrOtherBasisAmt	Gain Or LossGainOrLossAmt	Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt	How AcquiredHowAcquiredCd
449.854 AMERICAN BEACON LARGE CAP VALUE FUND	2014-01-30	2017-01-23	$12,420	$12,546	-$126	-$126
824.091 CREDIT SUISSE COMMODITY RETURN STRATEGY FUND	2014-01-30	2017-01-23	$4,244	$5,909	-$1,665	-$1,665
134.365 DFA U.S. MICRO CAP PORTFOLIO	2014-01-30	2017-01-23	$2,737	$2,609	$128	$128
110.344 DFA U.S. SMALL CAP VALUE PORTFOLIO	2014-01-30	2017-01-23	$4,072	$3,749	$323	$323
333.749 DIAMOND HILL SMALL-MID CAP FUND	2013-07-19	2017-01-23	$7,166	$5,664	$1,502	$1,502
327.233 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND	2014-04-11	2017-01-23	$4,742	$4,499	$243	$243
88.417 PRIMECAP ODYSSEY GROWTH FUND	2014-01-30	2017-01-23	$2,592	$2,111	$481	$481
39.278 VANGUARD #94 INSTITUTIONAL INDEX	2014-01-30	2017-01-24	$8,161	$6,460	$1,701	$1,701
50000. IBM CORP 1.250% 2/06/17	2012-04-20	2017-02-06	$50,000	$49,998	$2	$2
10044.694 BLACKROCK HIGH YIELD BOND PORTFOLIO		2017-03-13	$76,942	$83,010	-$6,068	-$6,068
227.133 BLACKROCK HIGH YIELD BOND PORTFOLIO	2016-09-28	2017-03-13	$1,740	$1,722	$18	$18
887.889 AMERICAN BEACON LARGE CAP VALUE FUND		2017-05-16	$25,660	$27,494	-$1,834	-$1,834
9163.04 CREDIT SUISSE COMMODITY RETURN STRATEGY FUND		2017-05-16	$44,624	$62,803	-$18,179	-$18,179
671.248 CREDIT SUISSE COMMODITY RETURN STRATEGY FUND	2016-09-28	2017-05-16	$3,269	$3,303	-$34	-$34
590.931 DFA U.S. MICRO CAP PORTFOLIO	2014-01-30	2017-05-16	$12,315	$11,476	$839	$839
167.846 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO	2014-09-08	2017-05-16	$3,320	$3,281	$39	$39
270.649 DFA EMERGING MKTS PORTFOLIO		2017-05-16	$7,340	$7,273	$67	$67
314.582 DFA U.S. SMALL CAP VALUE PORTFOLIO	2014-01-30	2017-05-16	$11,520	$10,690	$830	$830
283.217 DODGE & COX INTL STOCK FUND		2017-05-16	$12,555	$12,346	$209	$209
20.357 FEDERATED INSTITUTIONAL HIGH YIELD BOND FUND	2017-03-13	2017-05-16	$205	$201	$4	$4
437.16 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND		2017-05-16	$7,235	$6,096	$1,139	$1,139
254.05 LAZARD EMERGING MARKETS PORTFOLIO	2011-10-26	2017-05-16	$4,705	$4,756	-$51	-$51
341.53 OPPENHEIMER INTERNATIONAL GROWTH FUND		2017-05-16	$13,750	$12,648	$1,102	$1,102
130.608 PRIMECAP ODYSSEY GROWTH FUND	2014-11-26	2017-05-16	$4,250	$3,539	$711	$711
449.275 TEMPLETON GLBL BD ADV	2014-09-08	2017-05-16	$5,580	$5,900	-$320	-$320
133.584 VANGUARD #94 INSTITUTIONAL INDEX		2017-05-16	$29,275	$23,859	$5,416	$5,416
18.023 AMERICAN BEACON LARGE CAP VALUE FUND	2014-12-29	2017-06-15	$525	$532	-$7	-$7
5.208 DFA U.S. MICRO CAP PORTFOLIO	2014-01-30	2017-06-15	$110	$101	$9	$9
38.83 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO	2014-09-08	2017-06-15	$770	$759	$11	$11
206.096 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO	2015-09-09	2017-06-15	$2,265	$1,981	$284	$284
29.002 DIAMOND HILL SMALL-MID CAP FUND	2015-09-09	2017-06-15	$645	$550	$95	$95
150.264 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND	2014-04-11	2017-06-15	$2,565	$2,066	$499	$499
2801.201 LOOMIS SAYLES BOND FUND	2014-01-30	2017-06-15	$39,665	$42,382	-$2,717	-$2,717
45.239 OPPENHEIMER INTERNATIONAL GROWTH FUND	2014-01-30	2017-06-15	$1,815	$1,641	$174	$174
17.22 PRIMECAP ODYSSEY GROWTH FUND	2014-11-26	2017-06-15	$565	$467	$98	$98
6.045 VANGUARD #94 INSTITUTIONAL INDEX	2014-01-30	2017-06-15	$1,345	$994	$351	$351
12.492 AMERICAN BEACON LARGE CAP VALUE FUND	2014-12-29	2017-09-18	$375	$369	$6	$6
78.14 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO	2014-09-08	2017-09-18	$1,655	$1,528	$127	$127
2413.591 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO		2017-09-18	$26,815	$21,752	$5,063	$5,063
157.934 DODGE & COX INTL STOCK FUND	2014-01-30	2017-09-18	$7,355	$6,531	$824	$824
225. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX	2017-05-16	2017-09-18	$6,984	$6,626	$358	$358
1398.92 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND	2014-04-11	2017-09-18	$23,320	$19,235	$4,085	$4,085
70.821 OPPENHEIMER INTERNATIONAL GROWTH FUND	2014-01-30	2017-09-18	$2,995	$2,569	$426	$426
3005.083 VANGUARD TOTAL BOND MARKET INDEX INSTL	2016-09-28	2017-09-18	$32,515	$33,326	-$811	-$811
3.098 VANGUARD #94 INSTITUTIONAL INDEX	2014-01-30	2017-09-18	$710	$510	$200	$200
198.799 AMERICAN BEACON LARGE CAP VALUE FUND		2017-10-02	$6,125	$5,549	$576	$576
73.587 DFA U.S. MICRO CAP PORTFOLIO	2014-01-30	2017-10-02	$1,680	$1,429	$251	$251
40.414 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO	2014-09-08	2017-10-02	$860	$790	$70	$70
39.806 DFA U.S. SMALL CAP VALUE PORTFOLIO	2014-01-30	2017-10-02	$1,560	$1,353	$207	$207
112.325 DIAMOND HILL SMALL-MID CAP FUND	2015-09-09	2017-10-02	$2,570	$2,131	$439	$439
57.935 DODGE & COX INTL STOCK FUND	2014-01-30	2017-10-02	$2,705	$2,396	$309	$309
91.896 DODGE & COX INCOME FUND	2017-09-18	2017-10-02	$1,270	$1,277	-$7	-$7
96.838 FEDERATED INSTITUTIONAL HIGH YIELD BOND FUND		2017-10-02	$980	$978	$2	$2
35. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX	2017-05-16	2017-10-02	$1,091	$1,031	$60	$60
29.588 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND	2014-04-11	2017-10-02	$495	$407	$88	$88
48.985 LOOMIS SAYLES BOND FUND	2017-09-18	2017-10-02	$700	$701	-$1	-$1
61.808 OPPENHEIMER INTERNATIONAL GROWTH FUND	2014-01-30	2017-10-02	$2,625	$2,242	$383	$383
94.224 PRIMECAP ODYSSEY GROWTH FUND	2014-11-26	2017-10-02	$3,295	$2,553	$742	$742
47.347 TEMPLETON GLBL BD ADV	2014-09-08	2017-10-02	$580	$622	-$42	-$42
192.95 VANGUARD TOTAL BOND MARKET INDEX INSTL	2017-06-15	2017-10-02	$2,080	$2,088	-$8	-$8
29.257 VANGUARD S/T INFL PROT-ADM	2017-09-18	2017-10-02	$725	$727	-$2	-$2
8.401 VANGUARD #94 INSTITUTIONAL INDEX	2014-01-30	2017-10-02	$1,935	$1,382	$553	$553
123.782 AMERICAN BEACON LARGE CAP VALUE FUND	2014-01-30	2017-11-30	$3,914	$3,452	$462	$462
184.109 DFA EMERGING MKTS PORTFOLIO	2017-09-18	2017-11-30	$5,457	$5,463	-$6	-$6
209.575 LAZARD EMERGING MARKETS PORTFOLIO	2017-09-18	2017-11-30	$4,093	$4,093
135.959 OPPENHEIMER INTERNATIONAL GROWTH FUND	2014-01-30	2017-11-30	$5,921	$4,931	$990	$990
252.868 PRIMECAP ODYSSEY GROWTH FUND		2017-11-30	$9,523	$6,846	$2,677	$2,677
31.145 VANGUARD #94 INSTITUTIONAL INDEX	2014-01-30	2017-11-30	$7,537	$5,123	$2,414	$2,414
101.849 AMERICAN BEACON LARGE CAP VALUE FUND	2014-01-30	2017-12-15	$3,250	$2,841	$409	$409
11.607 DFA U.S. MICRO CAP PORTFOLIO	2014-01-30	2017-12-15	$255	$225	$30	$30
47.55 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO	2014-09-08	2017-12-15	$980	$930	$50	$50
4.669 DFA U.S. SMALL CAP VALUE PORTFOLIO	2014-01-30	2017-12-15	$175	$159	$16	$16
177.331 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO	2014-01-30	2017-12-15	$1,940	$1,592	$348	$348
151.269 DODGE & COX INCOME FUND	2017-09-18	2017-12-15	$2,100	$2,103	-$3	-$3
16.959 DODGE & COX INCOME FUND	2014-11-26	2017-12-15	$235	$236	-$1	-$1
120. FLEXSHARES MSTAR GLBL UPSTRM NAT RES IDX	2017-05-16	2017-12-15	$3,833	$3,534	$299	$299
23.753 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND	2014-04-11	2017-12-15	$400	$327	$73	$73
57.05 VANGUARD TOTAL BOND MARKET INDEX INSTL	2017-06-15	2017-12-15	$615	$617	-$2	-$2
15.537 VANGUARD S/T INFL PROT-ADM	2017-09-18	2017-12-15	$385	$386	-$1	-$1
8.948 VANGUARD #94 INSTITUTIONAL INDEX	2014-01-30	2017-12-15	$2,190	$1,472	$718	$718
CAPITAL GAIN DIVIDENDS					$25,324		P

Field	Value	IRS element (for citing)
Capital Gain Net Income	$32,969	CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

Field	Value	IRS element (for citing)
Liable Section4942 Tax	false	LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1	$130,420	AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1	$2,461,612	NetVlNoncharitableAssetsYr1Amt
Distribution Yr1	0.052982	DistributionYr1Rt
Adjusted Qlfy Distri Yr2	$128,889	AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2	$2,592,041	NetVlNoncharitableAssetsYr2Amt
Distribution Yr2	0.049725	DistributionYr2Rt
Adjusted Qlfy Distri Yr3	$129,389	AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3	$2,720,612	NetVlNoncharitableAssetsYr3Amt
Distribution Yr3	0.047559	DistributionYr3Rt
Adjusted Qlfy Distri Yr4	$122,629	AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4	$2,589,466	NetVlNoncharitableAssetsYr4Amt
Distribution Yr4	0.047357	DistributionYr4Rt
Adjusted Qlfy Distri Yr5	$120,774	AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5	$2,422,228	NetVlNoncharitableAssetsYr5Amt
Distribution Yr5	0.049861	DistributionYr5Rt
Total Distribution	0.247484	TotalDistributionRt
Average Distribution	0.049497	AverageDistributionRt
Net Vl Noncharitable Assets	$2,599,579	NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets	$128,671	AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct	$819	NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct	$129,490	AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions	$141,735	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	$819	InvestmentIncomeExciseTaxAmt
Tax Under Section511	$0	TaxUnderSection511Amt
Subtotal	$819	SubtotalAmt
Subtitle A Tax	$0	SubtitleATaxAmt
Tax Based On Investment Income	$819	TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx	$800	EstimatedPlusOvpmtIncmTxAmt
Extsn Request Income Tax Paid	$0	ExtsnRequestIncomeTaxPaidAmt
Total Payments And Credits	$800	TotalPaymentsAndCreditsAmt
Es Penalty	$0	EsPenaltyAmt
Tax Due	$19	TaxDueAmt
Applied To ES Tax	$0	AppliedToESTaxAmt
Refund	$0	RefundAmt

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	NY	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	NBT BANK NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6073376191	PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

Field	Value	IRS element (for citing)
Address Line1	52 SOUTH BROAD STREET	AddressLine1Txt
City	NORWICH	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13815	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	false	FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn	Yes (true)	PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn	false	TransferAstDisqualifiedPrsnInd
Payment To Government Official	false	PaymentToGovernmentOfficialInd
Acts Fail To Qlfy As Exceptions	false	ActsFailToQlfyAsExceptionsInd
Uncorrected Prior Acts	false	UncorrectedPriorActsInd
Undistributed Income PY	false	UndistributedIncomePYInd
Undistr Incm Sect4942a2 Not App	false	UndistrIncmSect4942a2NotAppInd
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

Field	Value	IRS element (for citing)
Person	NBT BANK NA	PersonNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	52 SOUTH BROAD STREET	AddressLine1Txt
City	NORWICH	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13815	ZIPCd

Field	Value	IRS element (for citing)
Title	TRUSTEE	TitleTxt
Average Hrs Per Wk Devoted To Pos	1	AverageHrsPerWkDevotedToPosRt
Compensation	$15,982	CompensationAmt

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

Field	Value	IRS element (for citing)
Summary Of Direct Chrtbl Acty		SummaryOfDirectChrtblActyGrp
Sum Of Program Related Invst		SumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

Field	Value	IRS element (for citing)
Average Monthly FMV Of Sec	$2,594,483	AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances	$44,684	AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast	$0	FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets	$2,639,167	TotalFMVOfUnusedAssetsAmt
Reduction Claimed	$0	ReductionClaimedAmt
Acquisition Indebtedness	$0	AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast	$2,639,167	AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable	$39,588	CashDeemedCharitableAmt
Net Vl Noncharitable Assets	$2,599,579	NetVlNoncharitableAssetsAmt
Minimum Investment Return	$129,979	MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
Minimum Investment Return	$129,979	MinimumInvestmentReturnAmt
Tax Based On Investment Income	$819	TaxBasedOnInvestmentIncomeAmt
Total Tax	$819	TotalTaxAmt
Distributable Before Adj	$129,160	DistributableBeforeAdjAmt
Recoveries Qualfied Distri	$0	RecoveriesQualfiedDistriAmt
Distributable Before Ded	$129,160	DistributableBeforeDedAmt
Deduction From Distributable	$0	DeductionFromDistributableAmt
Distributable As Adjusted	$129,160	DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

Field	Value	IRS element (for citing)
Expenses And Contributions	$141,735	ExpensesAndContributionsAmt
Program Related Invst Total	$0	ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid	$0	CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test	$0	SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test	$0	SetAsideCashDistriTestAmt
Qualifying Distributions	$141,735	QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm	$819	PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri	$140,916	AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

Field	Value	IRS element (for citing)
Distributable As Adjusted	$129,160	DistributableAsAdjustedAmt
Undistributed Income PY	$38,395	UndistributedIncomePYAmt
Total For Prior Years	$0	TotalForPriorYearsAmt
Excess Distribution Cyov Yr5	$0	ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4	$0	ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3	$0	ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2	$0	ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1	$0	ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov	$0	TotalExcessDistributionCyovAmt
Qualifying Distributions	$141,735	QualifyingDistributionsAmt
Applied To Year1	$38,395	AppliedToYear1Amt
Applied To Prior Years	$0	AppliedToPriorYearsAmt
Treated As Distri From Corpus	$0	TreatedAsDistriFromCorpusAmt
Applied To Current Year	$103,340	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	$25,820	UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3	$0	CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5	$0	ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr	$0	ExcessDistriCyovToNextYrAmt
Excess From Year4	$0	ExcessFromYear4Amt
Excess From Year3	$0	ExcessFromYear3Amt
Excess From Year2	$0	ExcessFromYear2Amt
Excess From Year1	$0	ExcessFromYear1Amt
Excess From Current Year	$0	ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Field	Value	IRS element (for citing)
Only Contri To Preselected	Yes (X)	OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHENANGO MEMORIAL HOSPITAL	BusinessNameLine1Txt

Recipient US Address RecipientUSAddress

Field	Value	IRS element (for citing)
Address Line1	179 NORTH BROAD STREET	AddressLine1Txt
City	NORWICH	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13815	ZIPCd

Field	Value	IRS element (for citing)
Recipient Relationship	NONE	RecipientRelationshipTxt
Recipient Foundation Status	PC	RecipientFoundationStatusTxt
Grant Or Contribution Purpose	ICU/OPER ROOM, PCHSE	GrantOrContributionPurposeTxt
Amt	$139,157	Amt

Field	Value	IRS element (for citing)
Total Grant Or Contri Pd Dur Yr	$139,157	TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Field	Value	IRS element (for citing)
Fees Contracts From Govt Ag		FeesContractsFromGovtAgGrp
Membership Dues And Assmnt		MembershipDuesAndAssmntGrp
Int On Sav And Temp Cash Invst		IntOnSavAndTempCashInvstGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

Field	Value	IRS element (for citing)
Exclusion	14	ExclusionCd
Exclusion	$65,073	ExclusionAmt

Field	Value	IRS element (for citing)
Net Rntl Incm Re Debt Fincd Prop		NetRntlIncmReDebtFincdPropGrp
Net Rntl Incm Re Not Debt Fincd Prop		NetRntlIncmReNotDebtFincdProp
Net Rental Income Personal Prop		NetRentalIncomePersonalPropGrp
Other Investment Incm Part VII		OtherInvestmentIncmPartVIIGrp

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

Field	Value	IRS element (for citing)
Exclusion	18	ExclusionCd
Exclusion	$32,969	ExclusionAmt

Field	Value	IRS element (for citing)
Net Income Loss From Special Evt		NetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of Invntry		GrossProfitLossSlsOfInvntryGrp

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

Field	Value	IRS element (for citing)
Exclusion	$98,042	ExclusionAmt

Field	Value	IRS element (for citing)
Total Income Producing Acty	$98,042	TotalIncomeProducingActyAmt

Field	Value	IRS element (for citing)
Rln Of Acty To Accom Of Exmpt Prps		RlnOfActyToAccomOfExmptPrpsGrp

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Field	Value	IRS element (for citing)
Category	TAX PREPARATION FEE (NON-ALLOC	CategoryTxt
Amt	$730	Amt
Disbursements Charitable Prps	$730	DisbursementsCharitablePrpsAmt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (3 entries)

BondBondNm
PEPSICO INC 3% 8/25/2021
BANK OF AMERICA 6.4% 8/15/19
IBM CORP 1.25% 2/6/2017

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (25 entries)

Category Or ItemCategoryOrItemTxt	Listed At Cost Or FMVListedAtCostOrFMVCd	Book ValueBookValueAmt	EOYFMVEOYFMVAmt
OPPENHEIMER INTL GROWTH FD-Y	AT COST	$147,207	$177,593
DIAMOND HILL SMALL/MID CAP-I	AT COST	$65,002	$81,459
LAZARD EMERG MKTS	AT COST	$86,843	$96,151
DODGE & COX INTL STK FD	AT COST	$138,967	$175,470
VANGUARD TOTAL BD MKT FD	AT COST	$371,410	$368,864
TEMPLETON GLOBAL BD FD	AT COST	$56,557	$52,886
VANGUARD SHORT TERM INFLATION	AT COST	$107,184	$105,951
DODGE & COX INCOME FD	AT COST	$332,205	$337,444
LOOMIS SAYLES BOND FUND	AT COST	$105,870	$99,260
VANGUARD INSTITUIONAL INDEX	AT COST	$109,236	$161,688
AMERICAN BEACON L/C	AT COST	$161,341	$172,981
PRIMECAP ODYSSEY GROWTH	AT COST	$82,263	$107,109
DFA INTERNATIONAL SMALL	AT COST	$48,506	$52,773
DFA EMERGING MKTS POTFOLIO	AT COST	$77,979	$97,076
DFA GLOBAL REAL ESTATE SECS	AT COST	$43,950	$51,919
LAZARD GI LIST INFRASCTRUCTURE	AT COST	$44,075	$51,321
DFA U.S. MICRO CAP PORTFOLIO	AT COST	$24,236	$26,127
DFA US S/C VALUE PORTFOLIO	AT COST	$24,509	$26,233
FHLMC MTN	AT COST	$50,000	$49,550
BANK OF AMER CRP MTN BOND	AT COST	$50,000	$53,100
PEPSICO INC CORP BOND	AT COST	$49,755	$51,087
FEDERATED INSTITUTIONAL HIGH Y	AT COST	$79,676	$80,531
FLEXSHARES MSTAR GLBL UPSTRM N	AT COST	$123,772	$139,984
BLACKROCK
CREDIT SUISSE

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail (2 entries)

DescDesc	AmtAmt
MF TIMING DIFFERENCE SUBTRACTION	$1,208
TEMPLETON ASSET ADJ	$1,411

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

Field	Value	IRS element (for citing)
Desc	STATE FILING FEE	Desc
Revenue And Expenses Per Books	$250	RevenueAndExpensesPerBooksAmt
Net Investment Income	$0	NetInvestmentIncomeAmt
Disbursements Charitable Prps	$250	DisbursementsCharitablePrpsAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail (2 entries)

DescDesc	AmtAmt
MF TIMING DIFFERENCE ADDITION	$1,154
ROUNDING	$3

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxt	AmtAmt	Net Investment IncomeNetInvestmentIncomeAmt	Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FEDERAL ESTIMATES - PRINCIPAL	$400	$0	$0
FOREIGN TAXES ON QUALIFIED FOR	$1,402	$1,402	$0
FOREIGN TAXES ON NONQUALIFIED	$344	$344	$0