MARY M PECKMAN TR FBO CHEN MEM HOSPITAL: Form 990PF, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MARY M PECKMAN TR FBO CHEN MEM HOSPITAL (EIN 15-6017708)
- Tax period
- 2016-04-01 to 2017-03-31
- Filed
- 2017-08-09
- IRS object ID
- 201702219349100210
- Schema version
- 2016v3.0
- 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 | 2017-08-09T09:00:16-05:00 | ReturnTs |
| Tax Period End | 2017-03-31 | 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 | 2016-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 156017708 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY PECKHAM FBO CHENANGO MEM HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PECK | BusinessNameControlTxt |
| Phone | 6073376191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O NBT BANK NA 52 S 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 | 2017-07-07 | 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 | 2017-07-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 155.201.188.13 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C7734AB4F163F79B4BD05B5D8599C405E5817D79 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CE7540483F52A3F009DB2CFCE2D2FF87C0C2E812 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $3,467,455 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $77,769 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $76,465 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $48,463 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $472,345 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $48,463 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $126,232 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $124,928 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $30,420 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $27,378 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $3,042 | 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 | $1,000 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $1,000 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $1,637 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $1,637 | 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 | $253 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $253 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $33,310 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $29,015 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $4,295 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $160,897 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $160,897 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $194,207 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $29,015 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $165,192 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$67,975 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $95,913 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $749 | CashBOYAmt |
| Sav And Temp Cash Invst BOY | $67,503 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $23,447 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $23,447 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| US Government Obligations BOY | $48,467 | USGovernmentObligationsBOYAmt |
| Corporate Bonds BOY | $200,948 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $200,948 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $208,020 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $3,079,951 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $3,104,588 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,235,988 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $3,397,618 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,328,983 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,467,455 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $3,397,618 | CapitalStockBOYAmt |
| Capital Stock EOY | $3,328,983 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,397,618 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,328,983 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,397,618 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,328,983 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,397,618 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$67,975 | ExcessRevenueOverExpensesAmt |
| Other Increases | $1,240 | OtherIncreasesAmt |
| Subtotal | $3,330,883 | SubtotalAmt |
| Other Decreases | $1,900 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $3,328,983 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (24 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| 50000. FFCB 5.050% 9/06/16 | 2007-07-16 | 2016-09-06 | $50,000 | $50,000 | |||
| 30.948 DFA U.S. MICRO CAP PORTFOLIO | 2014-01-30 | 2016-09-28 | $596 | $601 | -$5 | -$5 | |
| 160.19 DFA INTERNATIONAL SMALL COMPANY PORTFOLIO | 2014-09-08 | 2016-09-28 | $2,941 | $3,132 | -$191 | -$191 | |
| 28.627 DFA U.S. SMALL CAP VALUE PORTFOLIO | 2014-01-30 | 2016-09-28 | $963 | $973 | -$10 | -$10 | |
| 1579.284 DFA GLOBAL REAL ESTATE SECURITIES PORTFOLIO | 2014-01-30 | 2016-09-28 | $18,525 | $14,182 | $4,343 | $4,343 | |
| 2027.337 DIAMOND HILL SMALL-MID CAP FUND | 2013-07-19 | 2016-09-28 | $41,337 | $34,404 | $6,933 | $6,933 | |
| 840.708 DODGE & COX INTL STOCK FUND | 2011-10-26 | 2016-09-28 | $32,418 | $26,701 | $5,717 | $5,717 | |
| 461.295 OPPENHEIMER INTERNATIONAL GROWTH FUND | 2014-01-30 | 2016-09-28 | $17,192 | $16,731 | $461 | $461 | |
| 2572.731 PRIMECAP ODYSSEY GROWTH FUND | 2014-01-30 | 2016-09-28 | $75,252 | $61,411 | $13,841 | $13,841 | |
| 42.662 VANGUARD #94 INSTITUTIONAL INDEX | 2014-01-30 | 2016-09-28 | $8,463 | $7,017 | $1,446 | $1,446 | |
| 360.639 DODGE & COX INTL STOCK FUND | 2011-10-26 | 2016-11-08 | $14,000 | $11,454 | $2,546 | $2,546 | |
| 578.452 DODGE & COX INCOME FUND | 2011-10-20 | 2016-11-08 | $8,000 | $7,682 | $318 | $318 | |
| 180.288 LAZARD EMERGING MARKETS PORTFOLIO | 2011-10-26 | 2016-11-08 | $3,000 | $3,375 | -$375 | -$375 | |
| 360.231 LOOMIS SAYLES BOND FUND | 2014-01-30 | 2016-11-08 | $5,000 | $5,450 | -$450 | -$450 | |
| 302.055 VANGUARD S/T INFL PROT-ADM | 2014-01-30 | 2016-11-09 | $7,500 | $7,482 | $18 | $18 | |
| 829.56 AMERICAN BEACON LARGE CAP VALUE FUND | 2014-01-30 | 2017-01-23 | $22,904 | $23,136 | -$232 | -$232 | |
| 797.584 CREDIT SUISSE COMMODITY RETURN STRATEGY FUND | 2014-01-30 | 2017-01-23 | $4,108 | $5,719 | -$1,611 | -$1,611 | |
| 133.02 DFA U.S. MICRO CAP PORTFOLIO | 2014-01-30 | 2017-01-23 | $2,710 | $2,583 | $127 | $127 | |
| 121.686 DFA U.S. SMALL CAP VALUE PORTFOLIO | 2014-01-30 | 2017-01-23 | $4,490 | $4,135 | $355 | $355 | |
| 460.021 DIAMOND HILL SMALL-MID CAP FUND | 2013-07-19 | 2017-01-23 | $9,877 | $7,807 | $2,070 | $2,070 | |
| 338.406 LAZARD GLOBAL LISTED INFRASTRUCTURE FUND | 2014-04-11 | 2017-01-23 | $4,904 | $4,653 | $251 | $251 | |
| 72.529 VANGUARD #94 INSTITUTIONAL INDEX | 2014-01-30 | 2017-01-24 | $15,070 | $11,930 | $3,140 | $3,140 | |
| 13695.706 BLACKROCK HIGH YIELD BOND PORTFOLIO | 2017-03-13 | $104,909 | $113,324 | -$8,415 | -$8,415 | ||
| CAPITAL GAIN DIVIDENDS | $18,186 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $48,463 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $180,937 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $3,231,894 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.055985 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $168,661 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $3,627,624 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.046494 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $164,822 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $3,536,834 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.046602 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $161,012 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $3,291,618 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.048916 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $159,469 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $3,238,521 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.049241 | DistributionYr5Rt |
| Total Distribution | 0.247238 | TotalDistributionRt |
| Average Distribution | 0.049448 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $3,362,598 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $166,274 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $959 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $167,233 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $165,192 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $1,918 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $1,918 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $1,918 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $3,137 | EstimatedPlusOvpmtIncmTxAmt |
| Applied To Es Tax | $0 | AppliedToEsTaxAmt |
| Total Payments And Credits | $3,137 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $1,219 | OverpaymentAmt |
| Applied To ES Tax | $1,219 | 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 | 6073376193 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 52 S 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 | $30,420 | 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 | $3,413,805 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $0 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,413,805 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $3,413,805 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $51,207 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,362,598 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $168,130 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $168,130 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $1,918 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $1,918 | TotalTaxAmt |
| Distributable Before Adj | $166,212 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $166,212 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $166,212 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $165,192 | 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 | $165,192 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $165,192 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $166,212 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Prior Year1 | 2014 | PriorYear1Yr |
| 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 | $14,690 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $14,690 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $165,192 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $165,192 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $1,020 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $1,020 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $13,670 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $13,670 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $0 | ExcessFromYear2Amt |
| Excess From Year1 | $13,670 | ExcessFromYear1Amt |
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 | GENERAL OPERATING SUPPORT - | GrantOrContributionPurposeTxt |
| Amt | $160,897 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $160,897 | 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 | $77,769 | 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 | $48,463 | 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 | $126,232 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $126,232 | 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 | $1,000 | Amt |
| Disbursements Charitable Prps | $1,000 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (3 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| BANK OF AMERICA 6.4% 8-15-19 | $50,000 | $54,623 |
| COLGATE- PALM 2.45% 11/15/2021 | $51,439 | $50,652 |
| PEPSICO INC 3.0% 8/25/21 | $99,509 | $102,745 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (21 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| DFA INTERNATIONAL SMALL CO | AT COST | $74,273 | $71,120 |
| OPPENHEIMER INTL GROWTH FD-Y | AT COST | $223,604 | $231,574 |
| CREDIT SUISSE COMM RET | AT COST | $90,241 | $66,666 |
| DFA US S/C VALUE PORT | AT COST | $31,205 | $34,183 |
| DFA GLOBAL REAL ESTATE SEC | AT COST | $89,977 | $104,395 |
| AMERICAN BEACON L/C VALUE | AT COST | $271,965 | $284,036 |
| DIAMOND HILL SMALL MIDCAP-1 | AT COST | $84,068 | $105,250 |
| DFA EMERGING MKTS PORT | AT COST | $103,786 | $109,876 |
| DODGE & COX INCOME FD | AT COST | $434,396 | $434,460 |
| PRIMECAP ODYSSEY GROWTH | AT COST | $93,721 | $111,317 |
| VANGUARD INSTITUTIONAL INDEX | AT COST | $194,801 | $251,602 |
| LAZARD EMERGING MKTS | AT COST | $112,493 | $110,684 |
| DODGE & COX INTL STOCK FD | AT COST | $208,089 | $231,971 |
| DFA U S MICRO CAP PORT | AT COST | $32,579 | $34,895 |
| TEMPLETON GLOBAL BD FD | AT COST | $78,704 | $77,830 |
| LOOMIS SAYLES BD FD | AT COST | $164,084 | $152,373 |
| BLACKROCK HIGH YIELD BD PORT | |||
| VANGUARD SHORT-TERM INFLAT | AT COST | $132,734 | $132,906 |
| VANGUARD TOTAL BD MKT INDEX FD | AT COST | $480,750 | $473,362 |
| LAZARD GI LIST INFRASTRUCTURE | AT COST | $98,118 | $111,426 |
| FEDERATED INSTITUTIONAL HIGH Y | AT COST | $105,000 | $106,062 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (2 entries)
| DescDesc | AmtAmt |
|---|---|
| TEMPLETON ASSET BASIS ADJ | $1,898 |
| ROUNDING | $2 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| PUBLIC NOTICE FEE | $3 | $0 | $3 |
| STATE FILING FEE | $250 | $0 | $250 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCOME PD IN 2016 TAXED IN 2015 | Desc |
| Amt | $1,240 | Amt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FOREIGN TAXES ON QUALIFIED FOR | $1,396 | $1,396 | $0 |
| FOREIGN TAXES ON NONQUALIFIED | $241 | $241 | $0 |