STRATEGY STUDIO / PUBLIC DATA EXPLORER

MAX KAGAN FAMILY FOUNDATION: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
MAX KAGAN FAMILY FOUNDATION (EIN 01-6019033)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-08-30
IRS object ID
201732429349100713
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-08-30T10:48:49-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN043097400PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KEVIN P MARTIN ASSOCIATES PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110 FORBES WESTAddressLine1Txt
CityBRAINTREECityNm
State AbbreviationMAStateAbbreviationCd
ZIP02184ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN016019033EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAX KAGAN FAMILY FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMAXKBusinessNameControlTxt
Phone9785157415PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line142 MUSSEL POINT ROADAddressLine1Txt
CityGLOUCESTERCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01930ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLEAHGRACE BRIENNA KAYLERPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone9785157415PhoneNum
Signature2017-08-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOLANTA TUCK CPAPreparerPersonNm
PTINP01340068PTIN
Phone7813803520PhoneNum
Preparation2017-08-28PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address72.93.210.10IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-08-28IPDt
IP Tm14:53:38IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id0008D4A23B6D6EC2EF50B674881025AF20BAB983AtSubmissionCreationDeviceId
At Submission Filing Device Id2BEFDC6BDC96FAE587A5D8EE1472B3DB0E40ACA5AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,654,925FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$36,880ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$13,533InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$13,533InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$72,205DividendsRevAndExpnssAmt
Dividends Net Invst Incm$72,205DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$22,712NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$1,878,954GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$22,712CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$145,330TotalRevAndExpnssAmt
Total Net Invst Incm$108,450TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$4,250OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$4,250OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$0OthEmplSlrsWgsDsbrsChrtblAmt
Accounting Fees Rev And Expnss$4,500AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$4,500AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$0AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$32,380OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$32,380OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$7,409TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$48,539TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$41,130TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$234,211ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$234,211ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$282,750TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$41,130TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$234,211TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$137,420ExcessRevenueOverExpensesAmt
Net Investment Income$67,320NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$179,991SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$839,878SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$839,990SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl$6,582AcctRcvblAmt
Acct Rcvbl BOY$3,893AcctRcvblBOYAmt
Acct Rcvbl EOY$6,582AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$6,582AcctRcvblEOYFMVAmt
US Government Obligations BOY$174,738USGovernmentObligationsBOYAmt
US Government Obligations EOY$174,730USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$225,611USGovtObligationsEOYFMVAmt
Corporate Stock BOY$2,486,750CorporateStockBOYAmt
Corporate Stock EOY$2,338,620CorporateStockEOYAmt
Corporate Stock EOYFMV$2,582,742CorporateStockEOYFMVAmt
Other Investments BOY$651,858OtherInvestmentsBOYAmt
Total Assets BOY$3,497,230TotalAssetsBOYAmt
Total Assets EOY$3,359,810TotalAssetsEOYAmt
Total Assets EOYFMV$3,654,925TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$1,545,996CapitalStockBOYAmt
Capital Stock EOY$1,545,996CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$1,951,234RetainedEarningBOYAmt
Retained Earning EOY$1,813,814RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$3,497,230TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$3,359,810TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,497,230TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$3,359,810TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$3,497,230TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$137,420ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$3,359,810SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$3,359,810TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (13 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
UBS FINANCIAL 33224P$59,591$60,749-$1,158-$1,158
UBS FINANCIAL 33224P$48,798$54,375-$5,577-$5,577
UBS FINANCIAL 62595P$2,146$2,062$84$84
UBS FINANCIAL 62595P$566,914$646,190-$79,276-$79,276
UBS FINANCIAL 62596P$443,770$458,648-$14,878-$14,878
UBS FINANCIAL 62596P$227,348$194,745$32,603$32,603
UBS FINANCIAL 62597P$60,034$56,320$3,714$3,714
UBS FINANCIAL 62597P$273,135$217,183$55,952$55,952
UBS FINANCIAL 62597P$201$201$201
UBS FINANCIAL 62599P$11,006$9,758$1,248$1,248
UBS FINANCIAL 62599P$84,964$58,435$26,529$26,529
UBS FINANCIAL 62600P$5,691$4,996$695$695
UBS FINANCIAL 62600P$95,356$92,781$2,575$2,575
FieldValueIRS element (for citing)
Capital Gain Net Income$22,712CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$113,735AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$3,747,558NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.030349DistributionYr1Rt
Adjusted Qlfy Distri Yr2$178,545AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$3,822,735NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.046706DistributionYr2Rt
Adjusted Qlfy Distri Yr3$188,408AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$3,513,546NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.053623DistributionYr3Rt
Adjusted Qlfy Distri Yr4$152,110AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$3,212,175NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.047354DistributionYr4Rt
Adjusted Qlfy Distri Yr5$180,442AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$3,296,354NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.054740DistributionYr5Rt
Total Distribution0.232772TotalDistributionRt
Average Distribution0.046554AverageDistributionRt
Net Vl Noncharitable Assets$3,620,696NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$168,558AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$673NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$169,231AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$234,211QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$673InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$673SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$673TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$1,300EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$1,300TotalPaymentsAndCreditsAmt
Es Penalty$9EsPenaltyAmt
Overpayment$618OverpaymentAmt
Applied To ES Tax$618AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateMEOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksLEAHGRACE BRIENNA KAYLERIndividualWithBooksNm
Phone9785157415PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line142 MUSSEL POINT ROADAddressLine1Txt
CityGLOUCESTERCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01930ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
LEAHGRACE BRIENNA KAYLER
42 MUSSEL POINT RDGLOUCESTERMA01930TRUSTEE1.00$0$0$0
RONALD STRIAR
42 MUSSEL POINT RDGLOUCESTERMA01930TRUSTEE1.00$0$0$0
RICHARD GROSSMAN
42 MUSSEL POINT RDGLOUCESTERMA01930TRUSTEE1.00$0$0$0
CANDACE PLATZ
42 MUSSEL POINT RDGLOUCESTERMA01930TRUSTEE1.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$3,332,045AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$343,789AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$3,675,834TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$3,675,834AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$55,138CashDeemedCharitableAmt
Net Vl Noncharitable Assets$3,620,696NetVlNoncharitableAssetsAmt
Minimum Investment Return$181,035MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$181,035MinimumInvestmentReturnAmt
Tax Based On Investment Income$673TaxBasedOnInvestmentIncomeAmt
Total Tax$673TotalTaxAmt
Distributable Before Adj$180,362DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$180,362DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$180,362DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$234,211ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$234,211QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$673PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$233,538AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$180,362DistributableAsAdjustedAmt
Undistributed Income PY$54,338UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Total Excess Distribution Cyov$0TotalExcessDistributionCyovAmt
Qualifying Distributions$234,211QualifyingDistributionsAmt
Applied To Year1$54,338AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$179,873AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$0TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$489UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$0ExcessDistriCyovToNextYrAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonLEAHGRACE BRIENNA KAYLERRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1102 FOREST AVENUEAddressLine1Txt
CityORONOCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04473ZIPCd
FieldValueIRS element (for citing)
Recipient Phone9785157415RecipientPhoneNum
Recipient Email AddressLEAHGRACEKAYLER@GMAILCOMRecipientEmailAddressTxt
Form And Info And MaterialsN/AFormAndInfoAndMaterialsTxt
Submission DeadlinesN/ASubmissionDeadlinesTxt
Restrictions On AwardsN/ARestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (85 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtAddress Line2RecipientUSAddress/AddressLine2TxtAddress Line1RecipientForeignAddress/AddressLine1TxtCityRecipientForeignAddress/CityNmCountryRecipientForeignAddress/CountryCdForeign PostalRecipientForeignAddress/ForeignPostalCd
ACTION INC
180 MAIN STGLOUCESTERMA01930NONEPCOPERATIONAL SUPPORT$4,350
AMERICAN JEWISH WORLD SERVICE
45 WEST 36TH STREETNEW YORKNY10018NONEPCOPERATIONAL SUPPORT$8,250
AMERICAN REFUGEE COMMITTEE
615 FIRST AVENUE NE SUITE 500MINNEAPOLISMN55413NONEPCOPERATIONAL SUPPORT$2,250
ANIMAL REFUGE LEAGUE
PO BOX 336WESTBROOKME040980336NONEPCOPERATIONAL SUPPORT$150
APPALACHIAN MOUNTAIN CLUB
5 JOY STREETBOSTONMA02108NONEPCOPERATIONAL SUPPORT$500
APPALACHIAN TRAIL CONSERVATION
KELLOGG CONSERVATION CENTER PO BOXSOUTH EGREMONTMA01258NONEPCOPERATIONAL SUPPORT$500264
ARK FOUNDATION
NONEPCOPERATIONAL SUPPORT$2,25035 SYDNEY STREETLONDONUKSW3 6PU
ARTIS NAPLES
5833 PELICAN BAY BLVDNAPLESFL34108NONEPCOPERATIONAL SUPPORT$1,600
ASPCA
PO BOX 96929WASHINGTONDC20077NONEPCOPERATIONAL SUPPORT$1,000
BOSTON UNIVERITY SCHOOL OF GENERAL STUDIES
595 COMMONWEALTH AVENUEBOSTONMA02215NONEPCOPERATIONAL SUPPORT$1,000
BOSTON UNIVERITY SCHOOL OF MANAGEMENT
595 COMMONWEALTH AVENUEBOSTONMA02215NONEPCOPERATIONAL SUPPORT$1,500
BROOKFIELD INSTITUTE
PO BOX 388BROOKFIELDMA01506NONEPCOPERATIONAL SUPPORT$4,500
CAMP SUNSHINE
35 ACADIA RDCASCOME04015NONEPCOPERATIONAL SUPPORT$1,000
CAMP SUSAN CURTIS FOUNDATION
1321 WASHINGTON AVE 104PORTLANDME04103NONEPCOPERATIONAL SUPPORT$300
CAPE ANN ANIMAL AID
4 PAWS LANEGLOUCESTERMA01930NONEPCOPERATIONAL SUPPORT$2,250
CAPE ANN FOOD PANTRY
28 EMERSON AVEGLOUCESTERMA01930NONEPCOPERATIONAL SUPPORT$2,100
CENTER FOR REPRODUCTIVE RIGHTS
199 WATER STREETNEW YORKNY10038NONEPCOPERATIONAL SUPPORT$1,700
CHAPLAINCY INSTITUTE
302 STEVENS AVEPORTLANDME04103NONEPCOPERATIONAL SUPPORT$6,000
CLOUD FOUNDATION
107 SOUTH 7TH STCOLORADO SPRINGSCO80905NONEPCOPERATIONAL SUPPORT$1,000
COMBINED JEWISH PHILANTHROPIES
126 HIGH STBOSTONMA02110NONEPCOPERATIONAL SUPPORT$1,800
COMMUNITY CONCEPTS INC
240 BATES STREETLEWISTONME04240NONEPCOPERATIONAL SUPPORT$2,500
CONGREGATION BETH ISRAEL
PO BOX 1726BANGORME04402NONEPCOPERATIONAL SUPPORT$165
CORNELL LAB OF ORINITHOLOGY
PO BOX 11ITHACANY14851NONEPCOPERATIONAL SUPPORT$3,000
CURE ALZHEIMER'S FUND
34 WASHINGTON STWELLESLEY HILLSMA02481NONEPCOPERATIONAL SUPPORT$3,150
DANA FARBER CANCER INSTITUTE
10 BROOKLINE PLACE WESTBROOKLINEMA02445NONEPCOPERATIONAL SUPPORT$5,000
DEERFIELD ACADEMY
PO BOX 306DEERFIELDMA01342NONEPCOPERATIONAL SUPPORT$1,000
EMPOWERMENT HEALTH
42 MUSSEL POINT ROADGLOUCESTERMA01930NONEPCOPERATIONAL SUPPORT$300
ESSEX COUNTY GREENBELT
82 EASTERN AVEESSEXMA01929NONEPCOPERATIONAL SUPPORT$750
FAMILY PLANNING ASSOCIATION OF MAINE
PO BOX 587AUGUSTAME04332NONEPCOPERATIONAL SUPPORT$1,300
FREEPORT COMMUNITY SERVICES
53 DEPOT STFREEPORTME04032NONEPCOPERATIONAL SUPPORT$1,000
FREEPORT GRIDIRON CLUB
106 TENPENNY STFREEPORTME04032NONEPCOPERATIONAL SUPPORT$1,000
FREEPORT PUBLIC LIBRARY
10 LIBRARY DRFREEPORTME04032NONEPCOPERATIONAL SUPPORT$500
FRIENDS OF HARVARD SKIING
65 WORTH HARVARD STBOSTONMA02163NONEPCOPERATIONAL SUPPORT$1,000
FRIENDS OF ISRAEL DEFENSE FORCE
PO BOX 4224NEW YORKNY10163NONEPCOPERATIONAL SUPPORT$4,000
FRIENDS OF ISRAELS ENVIRONMENT
4182 BECK AVENUESTUDIO CITYCA91604NONEPCOPERATIONAL SUPPORT$1,500
GLOBAL WILDLIFE CONSERVATION
PO BOX 129AUSTINTX78767NONEPCOPERATIONAL SUPPORT$13,150
GOOD SHEPPARD FOOD BANK
3121 HOTEL RDAUBURNME04210NONEPCOPERATIONAL SUPPORT$1,000
GREATER ANDROSCOGGIN HUMANE SOCIETY
55 STRAWBERRY AVELEWISTONME04240NONEPCOPERATIONAL SUPPORT$2,041
GREATER MIAMI JEWISH FEDERATION
4200 BISCAYNE BLVDMIAMIFL33137NONEPCOPERATIONAL SUPPORT$6,000
GROWTH THROUGH LEARNING
86 SHERMAN STREETCAMBRIDGEMA02140NONEPCOPERATIONAL SUPPORT$2,750
HARVARD COLLEGE FUND
CAMBRIDGECAMBRIDGEMA02138NONEPCOPERATIONAL SUPPORT$1,000
HIAS
1300 SPRING STREET SUITE 500SILVER SPRINGMD20910NONEPCOPERATIONAL SUPPORT$4,000
HILLEL AT UNIVERSITY OF MIAMI
1100 STANFORD DRIVECORAL GABLESFL33146NONEPCOPERATIONAL SUPPORT$500
HOLOCAUST & HUMAN RIGHTS EDUCATION CENTER
4 W RED OAK LN 330WEST HARRISONNY10604NONEPCOPERATIONAL SUPPORT$500
IMMIGRANT LEGAL ADVOCACY
309 CUMBERLAND AVE 201PORTLANDME04101NONEPCOPERATIONAL SUPPORT$3,000
JEWISH COMMUNITY ALLIANCE
57 ASHMONT STPORTLANDME04103NONEPCOPERATIONAL SUPPORT$10,000
JEWISH FAMILY SERVICES OF METROWEST
475 FRANKLIN ST 101FRAMINGHAMMA01702NONEPCOPERATIONAL SUPPORT$9,000
JEWISH FEDERATION LEWISTON
74 BRADMAN STAUBURNME04210NONEPCOPERATIONAL SUPPORT$1,000
JEWISH FEDERATION NAPLES
2500 VANDERBILT BEACH RDNAPLESFL34109NONEPCOPERATIONAL SUPPORT$2,500
LANGERMAN FOUNDATION
4506 NORTH 12TH STPHOENIXAZ85014NONEPCOPERATIONAL SUPPORT$3,000
LIGHTS ON THE MOUNTAIN
PO BOX 2366ROBBINSVILLENC28771NONEPCOPERATIONAL SUPPORT$11,000
LOWN CARDIOVASCULAR GROUP
830 BOYLSTON ST 205CHESTNUT HILLMA02467NONEPCOPERATIONAL SUPPORT$1,000
MAINE CENTER FOR GRIEVING CHILDREN
555 FOREST AVEPORTLANDME04101NONEPCOPERATIONAL SUPPORT$2,000
MAINE CHAPTER APPALACHIAN MOUNTAIN CLUB
5 JOY STREETBOSTONMA02108NONEPCOPERATIONAL SUPPORT$1,000
MAINE EQUAL JUSTICE PARTNERS
126 SEWALL STAUGUSTAME04330NONEPCOPERATIONAL SUPPORT$1,000
MAINE EQUINE WELFARE ALLIANCE
29 WILTSHIRE PLACECAMDENME04843NONEPCOPERATIONAL SUPPORT$500
MAINE JEWISH MUSEUM
267 CONGRESS STPORTLANDME04101NONEPCOPERATIONAL SUPPORT$1,000
MIDDLEBURY COLLEGE
14 OLD CHAPEL RDMIDDLEBURYVT05753NONEPCOPERATIONAL SUPPORT$10,900
NATURAL RESOURCES COUNCIL OF MAINE
3 WADE STAUGUSTAME04330NONEPCOPERATIONAL SUPPORT$500
NEVE MICHAEL CHILDREN'S VILLAGE
NONEPCOPERATIONAL SUPPORT$4,7501 HAZFIRA STREETPARDES HANAIS37000
PARTNERS IN HEALTH
888 COMMONWEALTH AVEBOSTONMA02215NONEPCOPERATIONAL SUPPORT$3,000
PATHWAYS FOR CHILDREN
29 EMERSON AVEGLOUCESTERMA01930NONEPCOPERATIONAL SUPPORT$7,500
PATIENT AIRLIFT SERVICES
120 ADAMS BLVDFARMINGDALENY11735NONEPCOPERATIONAL SUPPORT$5,000
PINE TREE LEGAL ASSISTANCE
88 FEDERAL STREET PO BOX 547PORTLANDME04112NONEPCOPERATIONAL SUPPORT$1,000
PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND
784 HERCULES DRCOLCHESTERVT05446NONEPCOPERATIONAL SUPPORT$100
PREBLE STREET RESOURCE CENTER
5 PORTLAND STPORTLANDME04101NONEPCOPERATIONAL SUPPORT$1,300
RIDING TO THE TOP
PO BOX 1928WINDHAMME04062NONEPCOPERATIONAL SUPPORT$2,130
ROCKPORT CHAMBER MUSIC
PO BOX 312ROCKPORTMA01966NONEPCOPERATIONAL SUPPORT$750
ROCKPORT POLICE
168 MAIN STROCKPORTMA01966NONEPCOPERATIONAL SUPPORT$1,200
SUGARLOAF REGIONAL SKI EDUCATION FOUNDATION
PO BOX 546STRATTONME04982NONEPCOPERATIONAL SUPPORT$2,000
TEMPLE BETH SHALOM
193 EAST PLEASANT AVELIVINGSTONNJ07039NONEPCKEVIN - 07/24/17 03:43PM WORKSHEET PRIVATE FOUNDATION$4,000
TEMPLE SHALOM SYNAGOGUE CENTER
74 BRADMAN STAUBURNME04210NONEPCOPERATIONAL SUPPORT$8,000
THE BROOKE
NONEPCOPERATIONAL SUPPORT$5,2005TH FLOOR FRIARS BRIDGE COURTLONDONUKSE1 8NZ
THE FRESH AIR FUND
633 3RD AVENEW YORKNY10017NONEPCOPERATIONAL SUPPORT$100
THE PUBLIC THEATER
425 LAFAYETTE STREETNEW YORKNY10003NONEPCOPERATIONAL SUPPORT$1,000
TILTON SCHOOL
30 SCHOOL STLEWISTONME04240NONEPCOPERATIONAL SUPPORT$500
TREE STREET YOUTH
144 HOWE STLEWISTONME04240NONEPCOPERATIONAL SUPPORT$1,500
TRINITY JUBILEE CENTER
247 BATES STLEWISTONME04240NONEPCOPERATIONAL SUPPORT$2,000
UNITED JEWISH APPEAL - NJ
130 E 59TH STNEW YORKNY10022NONEPCOPERATIONAL SUPPORT$1,500
UNIVERISTY OF MIAMI
1320 S DIXIE HWYCORAL GABLESFL33146NONEPCOPERATIONAL SUPPORT$2,500
UNIVERSITY OF VERMONT
UNOVERSITY OF VERMONTBURLINGTONVT05405NONEPCOPERATIONAL SUPPORT$5,000
WABAN PROJECT
5 DUNAWAY DRSANFORDME04073NONEPCOPERATIONAL SUPPORT$10,000
WELLSPRING HOUSE
302 ESSEX AVEGLOUCESTERMA01930NONEPCOPERATIONAL SUPPORT$2,025
WESTBROOK ANIMAL RESCUE LEAGUE
449 STROUDWATER STREETWESTBROOKME04092NONEPCOPERATIONAL SUPPORT$150
WORLD JEWISH CONGRESS
501 MADISON AVENUENEW YORKNY10022NONEPCOPERATIONAL SUPPORT$3,500
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$234,211TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$13,533ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$72,205ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$22,712ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$108,450ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$108,450TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp (3 entries)

ContributorContributorNumAddress Line1ContributorUSAddress/AddressLine1TxtCityContributorUSAddress/CityNmState AbbreviationContributorUSAddress/StateAbbreviationCdZIPContributorUSAddress/ZIPCdTotal ContributionsTotalContributionsAmtPerson ContributionPersonContributionInd
LEAHGRACE BRIENNA KAYLER
142 MUSSEL POINT ROADGLOUCESTERMA01930$10,000Yes (X)
JAMES A PLATZ
22 GREAT FALLS PLAZAAUBURNME04210$15,000Yes (X)
DANIEL G KAGAN
32 ROLAND KIMBALL ROADFREEPORTME04032$10,730Yes (X)

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING & TAX PREPCategoryTxt
Amt$4,500Amt
Net Investment Income$4,500NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockCORPORATE STOCKStockNm
EOY Book Value$2,338,620EOYBookValueAmt
EOYFMV$2,582,742EOYFMVAmt

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$174,730USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$225,611USGovtObligationsEOYFMVAmt
State Local Sec Book Vl EOY$0StateLocalSecBookVlEOYAmt
State Local Sec EOYFMV$0StateLocalSecEOYFMVAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT ADVISORY FEESCategoryTxt
Amt$32,380Amt
Net Investment Income$32,380NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (4 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
STATE TAXES$393$0$0
FEDERAL TAXES$1,648$0$0
FOREIGN TAXES PAID$2,145$0$0
PAYROLL TAXES$3,223$0$0