JEAN M NEWTON FBO CHENANGO MEMORIAL HOSPITAL: Form 990PF, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- JEAN M NEWTON FBO CHENANGO MEMORIAL HOSPITAL (EIN 16-6247584)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-05-10
- IRS object ID
- 201611329349100801
- Schema version
- 2015v2.0
- 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 | 2016-05-10T23:00:18-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 WOOD AVE SOUTH | AddressLine1Txt |
| City | ISELIN | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 08830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | 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 | 2016-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DIEGO RESTREPO | PreparerPersonNm |
| PTIN | P00670890 | PTIN |
| Phone | 7327679100 | PhoneNum |
| Preparation | 2016-05-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $2,461,890 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $67,395 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $67,395 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $7,486 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $580,101 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $7,486 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $74,881 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $74,881 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $14,876 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $13,388 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $1,488 | 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 | $555 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $555 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $17,929 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $1,646 | 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 Rev And Expnss | $1 | PrintingAndPubRevAndExpnssAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Printing And Pub Dsbrs Chrtbl | $1 | PrintingAndPubDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $250 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $250 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $33,611 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $15,034 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $2,294 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $127,193 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $127,193 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $160,804 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $15,034 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $129,487 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$85,923 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $59,847 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $279 | CashBOYAmt |
| Cash EOY | $337 | CashEOYAmt |
| Cash EOYFMV | $337 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $68,605 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $58,422 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $58,422 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| US Government Obligations BOY | $74,455 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $50,000 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $49,479 | USGovtObligationsEOYFMVAmt |
| Corporate Bonds BOY | $244,787 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $200,078 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $207,270 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $2,247,752 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $2,241,316 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $2,146,382 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $2,635,878 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,550,153 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $2,461,890 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $2,635,878 | CapitalStockBOYAmt |
| Capital Stock EOY | $2,550,153 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $2,635,878 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $2,550,153 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $2,635,878 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $2,550,153 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $2,635,878 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$85,923 | ExcessRevenueOverExpensesAmt |
| Other Increases | $1,103 | OtherIncreasesAmt |
| Subtotal | $2,551,058 | SubtotalAmt |
| Other Decreases | $905 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $2,550,153 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (22 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| 25000. GEN ELEC CAP CRP MTN 6.100% 4/15/15 | 2009-04-13 | 2015-04-15 | $25,000 | $25,000 | |||
| 834.001 AMERICAN BEACON L/C VALU-IS | 2014-01-30 | 2015-04-27 | $25,087 | $23,260 | $1,827 | $1,827 | |
| 177.053 DFA GLOBAL REAL ESTATE SECURITIES | 2014-01-30 | 2015-04-27 | $1,921 | $1,590 | $331 | $331 | |
| 344.408 DIAMOND HILL SMALL/MID CAP-I | 2013-07-19 | 2015-04-27 | $6,754 | $5,845 | $909 | $909 | |
| 500.027 LAZARD GL LIST INFRASTRUCTURE-INST | 2014-04-11 | 2015-04-27 | $7,640 | $6,875 | $765 | $765 | |
| 749.876 PRIMECAP ODYSSEY GROWTH | 2014-01-30 | 2015-04-27 | $20,329 | $17,900 | $2,429 | $2,429 | |
| 150.263 VANGUARD #94 INSTITUTIONAL INDEX | 2014-01-30 | 2015-04-27 | $28,963 | $24,715 | $4,248 | $4,248 | |
| 7476.864 LOOMIS SAYLES BOND FUND-INS | 2015-06-01 | $109,013 | $113,142 | -$4,129 | -$4,129 | ||
| 7162.288 BLACKROCK HIGH YIELD BD-INST | 2014-01-30 | 2015-09-09 | $55,150 | $59,017 | -$3,867 | -$3,867 | |
| 38.834 DFA U.S. MICRO CAP PORTFOLIO | 2014-01-30 | 2015-09-09 | $720 | $754 | -$34 | -$34 | |
| 2905.288 DFA INTERNATIONAL SMALL CO | 2015-09-09 | $50,174 | $55,311 | -$5,137 | -$5,137 | ||
| 1286.915 PRIMECAP ODYSSEY GROWTH | 2014-01-30 | 2015-09-09 | $33,666 | $30,719 | $2,947 | $2,947 | |
| 7456.559 TEMPLETON GLOBAL BOND FUND-AD | 2015-09-09 | $85,676 | $99,116 | -$13,440 | -$13,440 | ||
| 16.789 VANGUARD #94 INSTITUTIONAL INDEX | 2014-01-30 | 2015-09-09 | $2,991 | $2,761 | $230 | $230 | |
| 25000. FHLB 4.750% 9/11/15 | 2007-02-13 | 2015-09-11 | $25,000 | $25,000 | |||
| 20000. HEWLETT-PACK CO 2.600% 9/15/17 | 2012-05-23 | 2015-11-08 | $20,546 | $20,546 | |||
| 559.695 DFA EMERGING MKTS PORTFOLIO | 2014-01-30 | 2015-12-21 | $11,575 | $13,556 | -$1,981 | -$1,981 | |
| 289.915 DODGE & COX INTL STOCK FUND | 2015-12-21 | $10,466 | $9,907 | $559 | $559 | ||
| 915.578 LAZARD EMERGING MKTS PORT-IN | 2011-10-26 | 2015-12-21 | $12,397 | $17,140 | -$4,743 | -$4,743 | |
| 473.705 OPPENHEIMER INTL GROWTH FD-Y | 2014-01-30 | 2015-12-21 | $16,831 | $17,181 | -$350 | -$350 | |
| 19.941 VANGUARD #94 INSTITUTIONAL INDEX | 2014-01-30 | 2015-12-22 | $3,711 | $3,280 | $431 | $431 | |
| CAPITAL GAIN DIVIDENDS | $26,491 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $7,486 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $129,389 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $2,720,612 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.047559 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $122,629 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $2,589,466 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.047357 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $120,774 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $2,422,228 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.049861 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $114,927 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $2,398,599 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.047914 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $103,765 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $2,296,431 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.045185 | DistributionYr5Rt |
| Total Distribution | 0.237876 | TotalDistributionRt |
| Average Distribution | 0.047575 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $2,592,041 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $123,316 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $598 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $123,914 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $129,487 | 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 | $598 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $598 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $598 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $8,840 | EstimatedPlusOvpmtIncmTxAmt |
| Applied To Es Tax | $0 | AppliedToEsTaxAmt |
| Total Payments And Credits | $8,840 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $8,242 | OverpaymentAmt |
| Applied To ES Tax | $600 | AppliedToESTaxAmt |
| Refund | $7,642 | 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 | $14,876 | 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 | $2,566,351 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $65,163 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $2,631,514 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $2,631,514 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $39,473 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $2,592,041 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $129,602 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $129,602 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $598 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $598 | TotalTaxAmt |
| Distributable Before Adj | $129,004 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $129,004 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $129,004 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $129,487 | 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 | $129,487 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $598 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $128,889 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $129,004 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $47,817 | 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 | $129,487 | QualifyingDistributionsAmt |
| Applied To Year1 | $47,817 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $81,670 | 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 | $47,334 | 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 | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
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 | N/A | RecipientRelationshipTxt |
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | ICU/OPER ROOM, PCHSE | GrantOrContributionPurposeTxt |
| Amt | $127,193 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $127,193 | 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 | $67,395 | 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 | $7,486 | 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 | $74,881 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $74,881 | 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 | CategoryTxt |
| Amt | $555 | Amt |
| Disbursements Charitable Prps | $555 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (6 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| PEPSICO INC 3% 8/25/2021 | $49,755 | $51,526 |
| BANK OF AMERICA 6.4% 8/15/19 | $50,000 | $55,555 |
| GOLDMAN SACHS 3.625% 2/7/2016 | $50,325 | $50,127 |
| IBM CORP 1.25% 2/6/2017 | $49,998 | $50,062 |
| GE CAPITAL 6.1% 4/15/15 | ||
| HEWLETT PACKARD 2.6% 9/15/2017 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $50,000 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $49,479 | USGovtObligationsEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (20 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| OPPENHEIMER INTL GROWTH FD-Y | AT COST | $179,888 | $178,664 |
| DIAMOND HILL SMALL/MID CAP-I | AT COST | $95,449 | $101,177 |
| LAZARD EMERG MKTS | AT COST | $82,870 | $61,769 |
| DODGE & COX INTL STK FD | AT COST | $173,363 | $173,867 |
| VANGUARD TOTAL BD MKT FD | AT COST | $255,276 | $252,843 |
| TEMPLETON GLOBAL BD FD | AT COST | $59,600 | $52,422 |
| BLACK ROCK HIGH YIELD BOND FD | AT COST | $83,010 | $71,619 |
| VANGUARD SHORT TERM INFLATION | AT COST | $111,250 | $108,607 |
| DODGE & COX INCOME FD | AT COST | $211,481 | $208,196 |
| LOOMIS SAYLES BOND FUND | AT COST | $112,352 | $95,644 |
| VANGUARD INSTITUIONAL INDEX | AT COST | $162,933 | $182,724 |
| AMERICAN BEACON L/C | AT COST | $188,478 | $163,174 |
| PRIMECAP ODYSSEY GROWTH | AT COST | $120,358 | $129,612 |
| DFA INTERNATIONAL SMALL | AT COST | $57,340 | $50,477 |
| DFA EMERGING MKTS POTFOLIO | AT COST | $74,795 | $63,661 |
| DFA GLOBAL REAL ESTATE SECS | AT COST | $71,223 | $81,217 |
| LAZARD GI LIST INFRASCTRUCTURE | AT COST | $77,250 | $75,342 |
| CREDIT SUISSE COMM RIET | AT COST | $68,712 | $45,042 |
| DFA U.S. MICRO CAP PORTFOLIO | AT COST | $27,722 | $25,095 |
| DFA US S/C VALUE PORTFOLIO | AT COST | $27,966 | $25,230 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INCOME PD IN 2016 TAXED IN 2015 | $901 |
| ROUNDING | $4 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NYS EPTL 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCOME PD IN 2015 TAXED IN 2014 | Desc |
| Amt | $1,103 | Amt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (4 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| PRIOR YEAR EXCISE TAX | $7,443 | $0 | $0 |
| ESTIMATED EXCISE TAX | $8,840 | $0 | $0 |
| FOREIGN TAXES ON QUALIFIED | $1,222 | $1,222 | $0 |
| FOREIGN TAXES ON NONQUALIFED | $424 | $424 | $0 |