DAVID & MARY ANDERSON FAMILY: Form 990PF, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- DAVID & MARY ANDERSON FAMILY (EIN 45-1844915)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-05
- IRS object ID
- 201741259349100714
- 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 Corp Stock Schedule
- Other Expenses Schedule
- Substantial Contributors Sch
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-05T09:49:02-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5946 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 537050946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 451844915 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID & MARY ANDERSON FAMILY | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DAVI | BusinessNameControlTxt |
| Phone | 6088365550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 MIDDLETON BEACH ROAD | AddressLine1Txt |
| City | MIDDLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53562 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID ANDERSON | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6088365550 | PhoneNum |
| Signature | 2017-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BEVERLY A KLUMPH | PreparerPersonNm |
| PTIN | P00024017 | PTIN |
| Phone | 6088332612 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.171.131.189 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-05-03 | IPDt |
| IP Tm | 10:06:00 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0C8AE9C15DE2A153F2B3F9FDE1C8FF8A67D788CC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F09455080562853F832900363057EFC36B366E94 | 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 | $709,815 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $20,568 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $20,568 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $13,470 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $238,618 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $13,470 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $34,038 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $34,038 | 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 | $2,375 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $594 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $594 | AccountingFeesChrtblPrpsAmt |
| Other Expenses Rev And Expnss | $5,031 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $5,031 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $7,406 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $5,625 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $594 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $302,066 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $348,226 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $309,472 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $5,625 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $348,820 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$275,434 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $28,413 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $31,271 | CashBOYAmt |
| Cash EOY | $13,981 | CashEOYAmt |
| Cash EOYFMV | $13,981 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $70,690 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $7,545 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $7,545 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $444,055 | CorporateStockBOYAmt |
| Corporate Stock EOY | $363,332 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $456,263 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $350,795 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $236,519 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $232,026 | CorporateBondsEOYFMVAmt |
| Total Assets BOY | $896,811 | TotalAssetsBOYAmt |
| Total Assets EOY | $621,377 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $709,815 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $896,811 | CapitalStockBOYAmt |
| Capital Stock EOY | $621,377 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $0 | RetainedEarningBOYAmt |
| Retained Earning EOY | $0 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $896,811 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $621,377 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $896,811 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $621,377 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $896,811 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$275,434 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $621,377 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $621,377 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (10 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| CAMBIAR INTL EQUITY FUND INS | P | 2016-03-15 | 2016-10-31 | $9,309 | $9,197 | $112 | $112 |
| DODGE & COX STOCK FUND | P | 2015-08-24 | 2016-08-26 | $28,820 | $28,685 | $135 | $135 |
| HARBOR CAPITAL APRCTION INST | P | 2014-10-15 | 2016-08-26 | $9,429 | $6,080 | $3,349 | $3,349 |
| MIDCAP SPDR TRUST SERIES I E T F | P | 2013-03-05 | 2016-05-23 | $39,601 | $28,556 | $11,045 | $11,045 |
| POWERSHARES QQQ ETF | P | 2015-12-08 | 2016-08-15 | $11,661 | $11,412 | $249 | $249 |
| T ROWE PRICE BLUE CHIP GROWTH FD | P | 2013-09-13 | 2016-08-26 | $11,365 | $8,891 | $2,474 | $2,474 |
| VANGUARD EQUITY INCOME ADM | P | 2014-06-30 | 2016-12-21 | $15,058 | $14,174 | $884 | $884 |
| DOUBLELINE TOTAL RET BD I | P | 2014-10-15 | 2016-10-31 | $62,340 | $63,127 | -$787 | -$787 |
| NUVEEN CORE PLUS BOND I | P | 2013-01-24 | 2016-12-21 | $47,311 | $51,149 | -$3,838 | -$3,838 |
| NUVEEN REAL ESTATE SECS I | P | 2014-10-15 | 2016-12-21 | $3,724 | $3,877 | -$153 | -$153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $13,470 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $215,895 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $1,101,908 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.195928 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $158,219 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $1,252,488 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.126324 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $86,711 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $1,251,806 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.069269 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $64,500 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $951,585 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.067782 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $266,750 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $345,669 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.771692 | DistributionYr5Rt |
| Total Distribution | 1.230995 | TotalDistributionRt |
| Average Distribution | 0.246199 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $834,123 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $205,360 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $284 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $205,644 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $348,820 | 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 | $284 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $284 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $284 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $2,064 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $2,064 | TotalPaymentsAndCreditsAmt |
| Overpayment | $1,780 | OverpaymentAmt |
| Applied To ES Tax | $1,780 | 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 | WI | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | Yes (1) | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID ANDERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6088365550 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 MIDDLETON BEACH ROAD | AddressLine1Txt |
| City | MIDDLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53562 | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|
| DAVID R ANDERSON | ||||||||
| 2525 MIDDLETON BEACH ROAD | MIDDLETON | WI | 53562 | PRESIDENT/TREASURER | 1.00 | $0 | $0 | $0 |
| SARAH CAFLISCH | ||||||||
| 2211 FOLWELL AVENUE | FALCON HEIGHTS | MN | 55108 | BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| KRISTINE MOSES | ||||||||
| 4918 SHERWOOD RD | MADISON | WI | 53711 | BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| DAVID K ANDERSON | ||||||||
| 4917 WOODBURN DRIVE | MADISON | WI | 53711 | VICE PRESIDENT/SECRETARY | 1.00 | $0 | $0 | $0 |
| MATTHEW ANDERSON | ||||||||
| 1601 DURHAM COURT | EDMOND | OK | 73013 | BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| JOSEPH ANDERSON | ||||||||
| 1814 SKYLINE CURVE | MINNEAPOLIS | MN | 55410 | BOARD MEMBER | 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 | $831,851 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $14,974 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $846,825 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $846,825 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $12,702 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $834,123 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $41,706 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $41,706 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $284 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $284 | TotalTaxAmt |
| Distributable Before Adj | $41,422 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $41,422 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $41,422 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $348,820 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $348,820 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $284 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $348,536 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $41,422 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $258,158 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $19,069 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $27,410 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $96,505 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $161,326 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $562,468 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $348,820 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $41,422 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $307,398 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $869,866 | 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 | $258,158 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $611,708 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $19,069 | ExcessFromYear4Amt |
| Excess From Year3 | $27,410 | ExcessFromYear3Amt |
| Excess From Year2 | $96,505 | ExcessFromYear2Amt |
| Excess From Year1 | $161,326 | ExcessFromYear1Amt |
| Excess From Current Year | $307,398 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (20 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| AGRACE | ||||||
| 5395 E CHERYL PARKWAY | MADISON | WI | 53711 | YES | CLINICAL CERTIFICATION | $60,362 |
| CATHOLIC CHARITIES | ||||||
| PO BOX 46550 | MADISON | WI | 53744 | YES | GENERAL PURPOSE | $450 |
| COFFEE HOUSE PRESS | ||||||
| 79 13TH AVENUE NE SUITE 110 | MINNEAPOLIS | MN | 55413 | YES | GENERAL PURPOSE | $12,500 |
| EDGEWOOD COLLEGE | ||||||
| 1000 EDGEWOOD COLLEGE DR | MADISON | WI | 53711 | YES | NURSING SCHOLARSHIP | $10,000 |
| FITZGERALD IN SAINT PAUL | ||||||
| 950 HOYT AVENUE WEST | SAINT PAUL | MN | 55117 | YES | GENERAL PURPOSE | $5,000 |
| NORTHSIDE PTO | ||||||
| 3620 HIGH RD | MIDDLETON | WI | 53562 | YES | GENERAL PURPOSE | $500 |
| ROSEVILLE AREA SCHOOLS FOUNDATION | ||||||
| 1910 W COUNTY RD B | ROSEVILLE | MN | 55113 | YES | GENERAL PURPOSE | $3,000 |
| SECOND HARVEST | ||||||
| 2802 DAIRY DRIVE | MADISON | WI | 53718 | YES | GENERAL PURPOSE | $63,353 |
| UNITED WAY OF DANE COUNTY | ||||||
| PO BOX 7548 | MADISON | WI | 53707 | YES | GENERAL PURPOSE | $18,005 |
| UW FOUNDATION | ||||||
| 1848 UNIVERSITY AVENUE | MADISON | WI | 53726 | YES | GENERAL PURPOSE | $137,356 |
| UNIVERSITY OF MN FOUNDATION | ||||||
| 200 OAK STREET SE SUITE 500 | MINNEAPOLIS | MN | 55455 | YES | NURSING SCHOLARSHIP | $5,000 |
| MADISON PARKS | ||||||
| 210 MARTIN LUTHER KING JR BLVD | MADISON | WI | 53703 | YES | GENERAL PURPOSE | $2,000 |
| OKLAHOMA WOMEN'S COALITION | ||||||
| 720 W WILSHIRE BLVD | OKLAHOMA CITY | OK | 73116 | YES | GENERAL PURPOSE | $5,000 |
| BADGER AIR COMMUNITY COUNCIL | ||||||
| 8814 ROYAL OAKS DRIVE | VERONA | WI | 53593 | YES | GENERAL PURPOSE | $1,500 |
| MWABA | ||||||
| 30 ASH ST | MADISON | WI | 53726 | YES | GENERAL PURPOSE | $10,000 |
| VAN HISE PTO | ||||||
| 246 S SEGOE RD | MADISON | WI | 53705 | YES | GENERAL PURPOSE | $5,000 |
| FMPS | ||||||
| 101 NOB HILL ROAD SUITE 300 | MADISON | WI | 53713 | YES | GENERAL PURPOSE | $5,000 |
| POTAWATOMI STATE PARK | ||||||
| 3740 PARK DR | STURGEON BAY | WI | 54235 | YES | GENERAL PURPOSE | $500 |
| CHISHOLM PTA | ||||||
| 2300 E 33RD STREET | EDMOND | OK | 73013 | YES | GENERAL PURPOSE | $3,000 |
| BRIMHALL PTA | ||||||
| 1744 WEST CTY RD B | ROSEVILLE | MN | 55113 | YES | GENERAL PURPOSE | $700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $348,226 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $20,568 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $13,470 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $34,038 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $34,038 | 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 | $2,375 | Amt |
| Net Investment Income | $594 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $594 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | US BANK | BondNm |
| EOY Book Value | $236,519 | EOYBookValueAmt |
| EOYFMV | $232,026 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | US BANK | StockNm |
| EOY Book Value | $363,332 | EOYBookValueAmt |
| EOYFMV | $456,263 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BANK AGENCY FEES | Desc |
| Revenue And Expenses Per Books | $5,031 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $5,031 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Substantial Contributors Sch SubstantialContributorsSch
Substantial Contributor Detail SubstantialContributorDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID ANDERSON | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 MIDDLETON BEACH ROAD | AddressLine1Txt |
| City | MIDDLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53562 | ZIPCd |