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THE JACK LEVIN FOUNDATION INC: Form 990PF, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
THE JACK LEVIN FOUNDATION INC (EIN 56-1116935)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-05-16
IRS object ID
201631379349101503
Schema version
2015v2.1
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)
Return2016-05-16T10:05:08-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN204759472PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LBA HAYNES STRAND PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 10949AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27404ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561116935EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE JACK LEVIN FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJACKBusinessNameControlTxt
Phone3365477005PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14253 WAYNE ROADAddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27407ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJACK LEVINPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3365477005PhoneNum
Signature2016-05-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHNNY C WOOD CPAPreparerPersonNm
PTINP00370070PTIN
Phone3362863204PhoneNum
Preparation2016-04-28PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,428,264FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$3InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$3InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$45,019DividendsRevAndExpnssAmt
Dividends Net Invst Incm$45,019DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss-$121,549NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$1,757,921GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$67,589CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss-$76,527TotalRevAndExpnssAmt
Total Net Invst Incm$112,611TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss$4,475AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$2,238AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$2,237AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$25,529OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$25,529OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$3,534TaxesRevAndExpnssAmt
Taxes Net Invst Incm$1,036TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$33,538TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$28,803TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$2,237TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$139,945ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$139,945ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$173,483TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$28,803TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$142,182TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$250,010ExcessRevenueOverExpensesAmt
Net Investment Income$83,808NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$12,302CashBOYAmt
Cash EOY$7,882CashEOYAmt
Cash EOYFMV$7,882CashEOYFMVAmt
Sav And Temp Cash Invst BOY$26,820SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$55,999SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$55,999SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl$894AcctRcvblAmt
Acct Rcvbl BOY$346AcctRcvblBOYAmt
Acct Rcvbl EOY$894AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$894AcctRcvblEOYFMVAmt
Prepaid Expenses BOY$19,405PrepaidExpensesBOYAmt
Prepaid Expenses EOY$16,907PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$16,907PrepaidExpensesEOYFMVAmt
Corporate Stock BOY$3,102,557CorporateStockBOYAmt
Corporate Stock EOY$2,829,738CorporateStockEOYAmt
Corporate Stock EOYFMV$3,346,582CorporateStockEOYFMVAmt
Total Assets BOY$3,161,430TotalAssetsBOYAmt
Total Assets EOY$2,911,420TotalAssetsEOYAmt
Total Assets EOYFMV$3,428,264TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$0CapitalStockBOYAmt
Capital Stock EOY$0CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$3,161,430RetainedEarningBOYAmt
Retained Earning EOY$2,911,420RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$3,161,430TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$2,911,420TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,161,430TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$2,911,420TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$3,161,430TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$250,010ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$2,911,420SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$2,911,420TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (4 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
PUBLICLY TRADED SECURITIESP$1,185,694$1,202,829-$17,135-$17,135
PUBLICLY TRADED SECURITIESP$218,562$475,003-$256,441-$256,441
PUBLICLY TRADED SECURITIESD$303,258$12,500$290,758$290,758
CAPITAL GAINS DIVIDENDSP$50,407$50,407$50,407
FieldValueIRS element (for citing)
Capital Gain Net Income$67,589CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$62,901AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$3,223,081NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.019516DistributionYr1Rt
Adjusted Qlfy Distri Yr2$30,656AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$1,161,094NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.026403DistributionYr2Rt
Adjusted Qlfy Distri Yr3$25,379AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$991,671NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.025592DistributionYr3Rt
Adjusted Qlfy Distri Yr4$10,060AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$978,637NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.010280DistributionYr4Rt
Adjusted Qlfy Distri Yr5$30,612AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$894,374NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.034227DistributionYr5Rt
Total Distribution0.116018TotalDistributionRt
Average Distribution0.023204AverageDistributionRt
Net Vl Noncharitable Assets$3,424,677NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$79,466AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$838NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$80,304AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$142,182QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$838InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$838SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$838TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$16,907EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$16,907TotalPaymentsAndCreditsAmt
Overpayment$16,069OverpaymentAmt
Applied To ES Tax$16,069AppliedToESTaxAmt
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 StateNCOrgReportOrRegisterStateCd
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 BooksJACK LEVINIndividualWithBooksNm
Phone3365477005PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line14253 WAYNE ROADAddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27407ZIPCd
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
JACK LEVIN
4253 WAYNE ROADGREENSBORONC27407PRESIDENT / DIR1.00$0$0$0
JANIS L FIELDS
1006 BRIDGEWATER DRIVEGREENSBORONC27410VICE PRES / DIR1.00$0$0$0
KAREN L ANSEL
1823 BEARHOLLOW ROADGREENSBORONC27410SECRETARY / DIR1.00$0$0$0
LINDA L HYSON
2705 ROSCREA COURTTALLAHASSEEFL32309TREASURER1.00$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$3,392,128AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$66,806AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$17,895FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$3,476,829TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$3,476,829AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$52,152CashDeemedCharitableAmt
Net Vl Noncharitable Assets$3,424,677NetVlNoncharitableAssetsAmt
Minimum Investment Return$171,234MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$171,234MinimumInvestmentReturnAmt
Tax Based On Investment Income$838TaxBasedOnInvestmentIncomeAmt
Total Tax$838TotalTaxAmt
Distributable Before Adj$170,396DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$170,396DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$170,396DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$142,182ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$142,182QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$838PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$141,344AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$170,396DistributableAsAdjustedAmt
Undistributed Income PY$136,844UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Total Excess Distribution Cyov$0TotalExcessDistributionCyovAmt
Qualifying Distributions$142,182QualifyingDistributionsAmt
Applied To Year1$136,844AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$5,338AppliedToCurrentYearAmt
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$165,058UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$0ExcessDistriCyovToNextYrAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerJACK LEVINContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (58 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
AMERICAN FRIENDS OF ALYN HOSPITAL
51 EAST 42ND STREET STE 308NEW YORKNY10017PCUNRESTRICTED$100
ALZHEIMER'S ASSOCIATION
PO BOX 42453CHARLOTTENC28215PCUNRESTRICTED$25
AMYOTROPHIC LATERAL SCLEROSIS (ALS) ASSOCIATION
PO BOX 8178PUEBLOCO81008PCUNRESTRICTED$35
AMERICAN CANCER SOCIETY
PO BOX 41912RALEIGHNC27629PCUNRESTRICTED$25
AMERICAN DIABETES ASSOCIATION
PO BOX 7023MERRIFIELDVA22116PCUNRESTRICTED$25
AMERICAN FARMLAND TRUST
1150 CONNECTICUT AVE NW STE 600WASHINGTONDC20036PCUNRESTRICTED$100
AMERICAN FRIENDS OF MAGEN DAVID
PO BOX 3098NEW YORKNY10117PCUNRESTRICTED$25
AMERICAN HEART ASSOCIATION INC
PO BOX 78851PHOENIXAZ85062PCUNRESTRICTED$50
AMERICAN KIDNEY FUND INC
PO BOX 1837MERRIFIELDVA22116PCUNRESTRICTED$25
AMERICAN PARKINSON DISEASE ASSOCIATION
135 PARKINSON AVENUESTATON ISLANDNY10305PCUNRESTRICTED$25
AMERICAN RED CROSS
PO BOX 14710GREENSBORONC27415PCUNRESTRICTED$25
ARTHRITIS FOUNDATION
PO BOX 96280WASHINGTONDC20077PCUNRESTRICTED$25
BETH DAVID SYNAGOGUE
804 WINVIEW DRIVEGREENSBORONC27410PCUNRESTRICTED$161
BOYS & GIRLS CLUBS OF AMERICA
1275 PEACHTREE STREET NEATLANTAGA30309PCUNRESTRICTED$500
B'NAI BRITH YOUTH ORGANIZATION (BBYO INC)
PO BOX 19006WASHINGTONDC20036PCUNRESTRICTED$200
CHILDRENS HOME SOCIETY
604 MEADOW STREETGREENSBORONC37405PCUNRESTRICTED$25
CIVITAS INSTITUTE
100 SOUTH HARRINGTON STREETRALEIGHNC27603PCUNRESTRICTED$25
CYSTIC FIBROSIS FOUNDATION
PO BOX 96305WASHINGTONDC20090PCUNRESTRICTED$25
EASTER SEAL SOCIETY
PO BOX 28239RALEIGHNC27611PCUNRESTRICTED$25
EPILEPSY FOUNDATION
PO BOX 96546WASHINGTONDC20077PCUNRESTRICTED$100
FREEDOM ALLIANCE
PO BOX 97242WASHINGTONDC20090PCUNRESTRICTED$125
FRIENDS OF THE SMITHSONIAN
PO BOX 9016PITTSFIELDMA01202PCUNRESTRICTED$75
GETTYSBURG FOUNDATION
PO BOX 3997GETTYSBURGPA17325PCUNRESTRICTED$50
GRAY'S HARBOR HISTORICAL SEAPORT AUTHORITY
712 HAGARA STREETABERDEENWA98520PCUNRESTRICTED$100
HERITAGE FOUNDATION
24 MASSACHUSETTS AVENUE NEWASHINGTONDC20002PCUNRESTRICTED$100
HONEST REPORTING INC
10024 SKOKIE BLVD STE 202SKOKIEIL60077PCUNRESTRICTED$100
HOSPICE & PALLIATIVE CARE OF GREENSBORO
2500 SUMMIT AVENUEGREENSBORONC27405PCUNRESTRICTED$100
JUDICIAL WATCH INC
425 THIRD STREET SW SUITE 800WASHINGTONDC20024PCUNRESTRICTED$50
LEE COUNTY EDUCATION FOUNDATION
PO BOX 98SANFORDNC27331PCUNRESTRICTED$500
LEUKEMIA & LYMPHOMA SOCIETY INC
PO BOX 9031PITTSFIELDMA01202PCUNRESTRICTED$25
LUPUS FOUNDATION OF AMERICA
PO BOX 630147BALTIMOREMD21263PCUNRESTRICTED$25
MACCABI USA SPORTS FOR ISRAEL
PO BOX 96462WASHINGTONDC20090PCUNRESTRICTED$25
MACULAR DEGENERATION RESEARCH
PO BOX 1952CLARKSBURGMD20871PCUNRESTRICTED$25
MARCH OF DIMES
PO BOX 2547DECATURIL62525PCUNRESTRICTED$25
MAZON
10495 SANTA MONICA BLVD STE 100LOS ANGELESCA90025PCUNRESTRICTED$25
METROPOLITAN MUSEUM OF MODERN ART
1000 FIFTH AVENUENEW YORKNY10130PCUNRESTRICTED$50
MUSCULAR DYSTROPHY ASSOCIATION
PO BOX 79069PHOENIXAZ85062PCUNRESTRICTED$25
NC HILLEL
201 WEST CAMERON AVENUECHAPEL HILLNC27516PCUNRESTRICTED$25
NC ZOO SOCIETY
4403 ZOO PARKWAYASHEBORONC27205PCUNRESTRICTED$50
NATIONAL OSTEOPOROSIS FOUNDATION
1150 17TH STREET NW SUITE 850WASHINGTONDC20036PCUNRESTRICTED$25
NATIONAL PARK FOUNDATION
PO BOX 17394BALTIMOREMD21298PCUNRESTRICTED$25
RAMAH DAROM
6400 POWERS FERRY ROAD STE 215ATLANTAGA30339PCUNRESTRICTED$100
SALVATION ARMY
PO BOX 5363GREENSBORONC27435PCUNRESTRICTED$25
SHRINERS HOSPITALS FOR CHILDREN
PO BOX 1510RANSONVA25438PCUNRESTRICTED$100
SIMON WIESENTHAL CENTER
1399 SOUTH ROXBURY DRIVE STE 100LOS ANGELESCA90035PCUNRESTRICTED$1,000
SPECIAL OLYMPICS NORTH CAROLINA INC
PO BOX 27728RALEIGHNC27611PCUNRESTRICTED$25
ST JUDE CHILDREN'S RESEARCH HOSPITAL
PO BOX 50MEMPHISTN38101PCUNRESTRICTED$100
THE CHILDREN'S MUSEUM
390 SOUT LIBERTY STREETWINSTONSALEMNC27101PCUNRESTRICTED$100
TORAH CENTER
111 LAUREL PLACEWESTFIELDNJ07090PCUNRESTRICTED$1,000
UNITED SERVICES ORGANIZATION
PO BOX 96860WASHINGTONDC20077PCUNRESTRICTED$25
UNITED STATES HOLOCAUST MEMORIAL MUSEUM
PO BOX 90988WASHINGTONDC20090PCUNRESTRICTED$25
UNITED STATES OLYMPIC COMMITTEE
PO BOX 7010ALBERT LEAMN56007PCUNRESTRICTED$25
VETERANS OF FOREIGN WARS OF THE UNITED STATES
PO BOX 8911TOPEKAKS66608PCUNRESTRICTED$50
WAKE FOREST FUND
1834 WAKE FOREST ROADWINSTONSALEMNC27106PCUNRESTRICTED$24,149
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER
MEDICAL CENTER DRIVEWINSTONSALEMNC27157PCUNRESTRICTED$100,000
WORLD JEWISH CONGRESS FOUNDATION
PO BOX 90400WASHINGTONDC20090PCUNRESTRICTED$25
WOUNDED WARRIORS PROJECT
4899 BELFORD ROAD SUITE 300JACLSONVILLEFL32256PCUNRESTRICTED$100
YALE SCHOOL OF MEDICINE
333 CEDAR STREETNEW HAVENCT06510PCUNRESTRICTED$10,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$139,945TotalGrantOrContriPdDurYrAmt
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$3ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$45,019ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion-$121,549ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion-$76,527ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty-$76,527TotalIncomeProducingActyAmt

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$4,475Amt
Net Investment Income$2,238NetInvestmentIncomeAmt
Disbursements Charitable Prps$2,237DisbursementsCharitablePrpsAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (20 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
HARBOR INTL FD INSTL CL$106,703$95,740
HOTCHKIS & WILEY DIVERSIFIED VALUE FD CL I$107,119$115,380
JANUS INVT FLEXIBLE BD FD CL I$123,958$120,003
LAZARD EMERGING MKTS PORT INSTL$178,782$128,983
MFS SER TR VALUE FD CL I$158,819$175,001
AMERICAN EUROPACIFIC GROWTH FD CL F2$64,296$58,303
OPPENHEIMER INTL GROWTH FD CL Y$52,991$59,531
RANIER MID CAP EQUITY FD INSTL CL$109,777$100,672
T ROWE PRICE REAL EST FD$29,818$40,619
TOUCHSTONE SANDS CAP INSTL GROWTH FD$76,753$77,943
VICTORY SMALL CO OPPORTUNITY FD CL I$126,894$115,301
VIRTUS EMERGING MKTS OPPORTUNITIES FD CL I$105,216$94,889
CONSTELLATION BRANDS INC CL A$802,038$1,419,415
DEUTSCHE SECS TR ENHANCED COMMODITY STRAT FD$54,455$54,647
DEUTSCHE SECS TR GLOBAL REAL ESTATE SECS FD$61,772$59,848
EATON VANCE SER II INCOME FD BOSTON$103,949$97,600
ADVISOR INNER CIRCLE EDGEWOOD GROWTH FD$151,969$157,872
RS INVT TR SMALL CAP GROWTH FD$128,567$115,336
AMERICAN WASHINGTON MUTUAL FD$170,966$159,847
RIDGEWORTH MID CAP VALUE EQUITY FD$114,896$99,652

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT MANAGEMENT FEESCategoryTxt
Amt$25,529Amt
Net Investment Income$25,529NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FEDERAL FORM 990-PF, 2014$2,498$0$0
FOREIGN TAX WITHHELD$1,036$1,036$0