STRATEGY STUDIO / PUBLIC DATA EXPLORER

HARRY AND THELMA SURRENA MEMORIAL FUND: Form 990PF, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
HARRY AND THELMA SURRENA MEMORIAL FUND (EIN 23-7435554)
Tax period
2014-11-01 to 2015-10-31
Filed
2016-03-14
IRS object ID
201640749349100724
Schema version
2014v6.0
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)
Return2016-03-14T18:13:10-05:00ReturnTs
Tax Period End2015-10-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN830232295PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MOHATT RINALDO JOHNSON & GODWIN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 603AddressLine1Txt
CitySHERIDANCityNm
State AbbreviationWYStateAbbreviationCd
ZIP828010603ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2014-11-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237435554EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HARRY & THELMA SURRENA MEMORIALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHARRBusinessNameControlTxt
Phone3076726494PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 603AddressLine1Txt
CitySHERIDANCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82801ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN M PRADEREPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone3076726494PhoneNum
Signature2015-03-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL B JOHNSONPreparerPersonNm
PTINP00912386PTIN
Phone3076726494PhoneNum
Preparation2016-03-14PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$5,753,112FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$1,500ContriRcvdRevAndExpnssAmt
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$17,491InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$17,229InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$139,187DividendsRevAndExpnssAmt
Dividends Net Invst Incm$139,187DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$197,967NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$944,844GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$197,967CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$356,145TotalRevAndExpnssAmt
Total Net Invst Incm$354,383TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$38,982CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$19,491CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$19,491CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss$2,500AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$1,875AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$625AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$31,995OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$31,995OtherProfFeesNetInvstIncmAmt
Taxes Rev And Expnss$6,396TaxesRevAndExpnssAmt
Taxes Net Invst Incm$1,914TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$1,491TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$79,873TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$55,275TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$21,607TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$290,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$290,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$369,873TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$55,275TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$311,607TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$13,728ExcessRevenueOverExpensesAmt
Net Investment Income$299,108NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$313,095SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$136,087SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$136,087SavAndTempCashInvstEOYFMVAmt
US Government Obligations BOY$126,246USGovernmentObligationsBOYAmt
US Government Obligations EOY$150,000USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$169,076USGovtObligationsEOYFMVAmt
Corporate Stock BOY$2,903,285CorporateStockBOYAmt
Corporate Stock EOY$2,639,322CorporateStockEOYAmt
Corporate Stock EOYFMV$3,741,720CorporateStockEOYFMVAmt
Corporate Bonds BOY$1,251,091CorporateBondsBOYAmt
Corporate Bonds EOY$1,653,248CorporateBondsEOYAmt
Corporate Bonds EOYFMV$1,621,104CorporateBondsEOYFMVAmt
Other Assets BOY$22,982OtherAssetsBOYAmt
Other Assets EOY$22,982OtherAssetsEOYAmt
Other Assets EOYFMV$85,125OtherAssetsEOYFMVAmt
Total Assets BOY$4,616,699TotalAssetsBOYAmt
Total Assets EOY$4,601,639TotalAssetsEOYAmt
Total Assets EOYFMV$5,753,112TotalAssetsEOYFMVAmt
Other Liabilities BOY$1,723OtherLiabilitiesBOYAmt
Other Liabilities EOY$391OtherLiabilitiesEOYAmt
Total Liabilities BOY$1,723TotalLiabilitiesBOYAmt
Total Liabilities EOY$391TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$2,443,594CapitalStockBOYAmt
Capital Stock EOY$2,443,594CapitalStockEOYAmt
Retained Earning BOY$2,171,382RetainedEarningBOYAmt
Retained Earning EOY$2,157,654RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$4,614,976TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$4,601,248TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$4,616,699TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$4,601,639TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$4,614,976TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$13,728ExcessRevenueOverExpensesAmt
Subtotal$4,601,248SubtotalAmt
Tot Net Ast Or Fund Balances EOY$4,601,248TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (73 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
1457.72-VANGUARD EMERGING MARKETS STP2015-04-012015-10-15$43,819$50,000-$6,181-$6,181
53-APPLE COMPUTER INCP2009-10-052015-03-30$6,659$1,414$5,245$5,245
374-CITIGROUP INCP2013-11-262015-03-30$19,382$19,859-$477-$477
297-JP MORGAN CHASE & COMPANYP2000-03-032015-03-30$18,188$15,907$2,281$2,281
0.4-SOUTH32 LTDP2009-09-172015-06-29$3$3$3
1441.75-VANGUARD EMERGING MARKETS STP2014-11-192015-10-15$43,339$50,000-$6,661-$6,661
272-APPLE COMPUTER INCP2009-10-052015-03-05$34,360$7,259$27,101$27,101
38-COSTCO WHOLESALE CORPORATIONP2009-10-222015-03-30$5,782$2,209$3,573$3,573
40-MCKESSON CORPORATIONP2012-09-132015-03-30$9,144$3,517$5,627$5,627
20.4-SOUTH32 LTDP2009-09-172015-07-09$130$130$130
7396.45-DFA COMMODITY STRATEGY PORTFP2015-04-012015-10-14$45,266$50,000-$4,734-$4,734
104-APPLE COMPUTER INCP2011-01-062015-03-30$13,066$4,957$8,109$8,109
4-COSTCO WHOLESALE CORPORATIONP2010-05-142015-03-30$609$231$378$378
220-MICROSOFT CORPORATIONP2012-10-172015-03-30$9,018$6,513$2,505$2,505
60-SOUTH32 LTDP2010-03-122015-07-09$383$383$383
142-FIREEYE INCP2014-12-122015-03-30$5,669$4,216$1,453$1,453
225-BAKER HUGHES INCP2012-03-052015-03-30$14,303$10,812$3,491$3,491
88-DEERE & COMPANYP2011-07-112015-03-30$7,815$7,359$456$456
50000-MINNESOTA STATE GO UNLTD 3P2009-10-232014-11-01$50,000$50,000
60-SOUTH32 LTDP2010-06-022015-07-09$383$383$383
50000-HP INC 2.65% 01/06/2016P2013-12-092015-10-16$49,206$51,225-$2,019-$2,019
169-BB&T CORPORATIONP2012-04-122015-03-30$6,616$5,257$1,359$1,359
121-DISNEY WALT CO HOLDINGSP2009-01-152015-03-30$12,842$2,432$10,410$10,410
193-MONDELEZ INTERNATIONAL INCP2010-06-022015-03-30$7,031$3,662$3,369$3,369
141.6-SOUTH32 LTDP2013-01-222015-07-09$905$905$905
50000-HEWLETT-PACKARD CO 2.125% 13 SP2013-11-212015-09-14$50,000$50,999-$999-$999
45-BERKSHIRE HATHAWAY INC - CL BP2010-02-172015-03-30$6,557$3,430$3,127$3,127
97-DU PONT E I DE NEMOURS & COMPANYP2010-10-262015-03-30$7,053$4,561$2,492$2,492
66-NATIONAL OILWELL VARCO INCP2013-01-292015-03-30$3,290$4,381-$1,091-$1,091
153-TARGET CORPORATIONP2004-04-192015-03-30$12,624$6,701$5,923$5,923
45000-AT&T INC .9% 12/02/2016P2013-11-212015-09-14$45,102$44,992$110$110
92-BHP BILLITON LIMITED ADRP2009-09-172015-03-30$4,345$6,346-$2,001-$2,001
388-EMC CORPORATIONP2010-02-242015-03-30$9,884$6,789$3,095$3,095
126-NORDSTROM INCP2014-01-212015-03-30$10,096$7,498$2,598$2,598
140-TERADATA CORPP2013-08-232015-03-30$6,071$8,540-$2,469-$2,469
515-NATIONAL OILWELL VARCO INCP2013-01-292015-09-14$19,920$34,184-$14,264-$14,264
122-BRISTOL MYERS SQUIBB COMPANYP2013-02-052015-03-30$8,021$4,509$3,512$3,512
123-EMERSON ELECTRIC COMPANYP2001-02-052015-03-30$6,992$4,545$2,447$2,447
712.86-OPPENHEIMER DEVELOPING MARKETP2012-12-032015-04-01$25,000$24,202$798$798
193-U S BANCORP DELP2013-11-262015-03-30$8,467$7,598$869$869
15-CHEMOURS CO/THEP2011-03-032015-08-12$148$200-$52-$52
19-CATERPILLAR INCP2010-05-142015-03-31$1,526$1,227$299$299
70-EXXON MOBIL CORPORATIONP1983-06-242015-03-30$5,996$303$5,693$5,693
95-PEPSICO INCP1996-05-292015-03-30$9,149$2,928$6,221$6,221
98-UNION PACIFIC CORPORATIONP2013-11-202015-03-30$10,773$7,787$2,986$2,986
118-CHEMOURS CO/THEP2010-10-262015-08-12$1,163$1,350-$187-$187
150-CATERPILLAR INCP2011-10-252015-03-31$12,051$13,599-$1,548-$1,548
668-FORD MOTOR COMPANYP2012-07-052015-03-30$10,805$6,419$4,386$4,386
77-PHILIP MORRIS INTERNATIONALP2011-09-262015-03-30$5,911$4,954$957$957
130-UNITEDHEALTH GROUP INCP2011-05-192015-03-30$15,711$6,585$9,126$9,126
45-CHEMOURS CO/THEP2011-10-252015-08-12$444$499-$55-$55
162-CATERPILLAR INCP2012-08-032015-03-31$13,015$13,918-$903-$903
465-GENERAL ELECTRIC COMPANYP2008-12-022015-03-30$11,677$8,005$3,672$3,672
128-PROCTER & GAMBLE COMPANYP2003-06-162015-03-30$10,575$5,920$4,655$4,655
182.861-VANGUARD INFLATION-PROTECTEDP2011-04-062015-04-01$4,826$4,728$98$98
10-AMAZON.COM INCP2014-02-052015-03-30$3,741$3,455$286$286
104-CELGENE CORPP2012-12-112015-03-30$12,385$4,305$8,080$8,080
0.889-GENERAL MOTORS COP2013-11-272014-11-28$27$27$27
108-QUALCOMM INCP2000-03-032015-03-30$7,423$6,946$477$477
754.893-VANGUARD INFLATION-PROTECTEDP2011-10-252015-04-01$19,922$21,000-$1,078-$1,078
38-AMAZON.COM INCP2014-02-052015-07-27$20,233$13,129$7,104$7,104
0.8-CHEMOURS COP2010-10-262015-07-21$10$9$1$1
0.808-GENERAL MOTORS CO WARRANTS EXPP2013-11-302014-12-01$10$10$10
317-ROCHE HOLDINGS LTD SPONS ADRP2012-12-112015-03-30$10,844$8,046$2,798$2,798
LITIGATION PROCEEDSP2013-10-302015-10-31$790$790$790
116-AMERICAN EXPRESS COMPANYP2013-08-292015-03-30$9,080$8,407$673$673
55-CHEVRON CORPP2003-06-162015-03-30$5,875$2,067$3,808$3,808
0.808-GENERAL MOTORS CO WARRANTS EXPP2013-11-302014-12-01$4$4$4
78-SCHLUMBERGER LIMITEDP2011-11-232015-03-30$6,593$5,202$1,391$1,391
51-APACHE CORPORATIONP2012-08-202015-03-30$3,102$4,559-$1,457-$1,457
366-CISCO SYSTEMS INCP2004-02-252015-03-30$10,087$8,575$1,512$1,512
123-GILEAD SCIENCES INC.P2012-05-042015-03-30$12,303$3,120$9,183$9,183
538-SKYWORKS SOLUTIONS INC.P2013-08-232015-03-31$53,018$13,531$39,487$39,487
FieldValueIRS element (for citing)
Capital Gain Net Income$197,967CapitalGainNetIncomeAmt
Net Short Term Capital Gain Loss-$16,123NetShortTermCapitalGainLossAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$303,292AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$5,560,400NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.054545DistributionYr1Rt
Adjusted Qlfy Distri Yr2$258,436AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$5,125,398NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.050423DistributionYr2Rt
Adjusted Qlfy Distri Yr3$244,959AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$4,807,448NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.050954DistributionYr3Rt
Adjusted Qlfy Distri Yr4$234,756AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$4,609,464NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.050929DistributionYr4Rt
Adjusted Qlfy Distri Yr5$207,821AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$4,402,615NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.047204DistributionYr5Rt
Total Distribution0.254055TotalDistributionRt
Average Distribution0.050811AverageDistributionRt
Net Vl Noncharitable Assets$5,532,056NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$281,089AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$2,991NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$284,080AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$311,607QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$2,991InvestmentIncomeExciseTaxAmt
Subtotal$2,991SubtotalAmt
Tax Based On Investment Income$2,991TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$2,600EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$2,600TotalPaymentsAndCreditsAmt
Tax Due$391TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateWYOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsfalseNewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1MOHATT RINALDO JOHNSON & GODWINBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3076726494PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 603AddressLine1Txt
CitySHERIDANCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82801ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnfalseSaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnfalseBrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnfalseFurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnYes (true)PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Acts Fail To Qlfy As ExceptionsfalseActsFailToQlfyAsExceptionsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
RALPH C ROBINSON
PO BOX 27BUFFALOWY82834TRUSTEE4.00$12,994$0$0
JOHN PRADERE
PO BOX 603SHERIDANWY82801TRUSTEE4.00$12,994$0$0
ROBERT WYATT
PO BOX 603SHERIDANWY82081TRUSTEE4.00$12,994$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1N/ADescription1Txt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$5,409,363AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$121,813AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$85,125FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$5,616,301TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$5,616,301AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$84,245CashDeemedCharitableAmt
Net Vl Noncharitable Assets$5,532,056NetVlNoncharitableAssetsAmt
Minimum Investment Return$276,603MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$276,603MinimumInvestmentReturnAmt
Tax Based On Investment Income$2,991TaxBasedOnInvestmentIncomeAmt
Total Tax$2,991TotalTaxAmt
Distributable Before Adj$273,612DistributableBeforeAdjAmt
Distributable Before Ded$273,612DistributableBeforeDedAmt
Distributable As Adjusted$273,612DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$311,607ExpensesAndContributionsAmt
Qualifying Distributions$311,607QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$2,991PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$308,616AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$273,612DistributableAsAdjustedAmt
Undistributed Income PY$20,092UndistributedIncomePYAmt
Qualifying Distributions$311,607QualifyingDistributionsAmt
Applied To Year1$20,092AppliedToYear1Amt
Applied To Current Year$273,612AppliedToCurrentYearAmt
Remaining Distri From Corpus$17,903RemainingDistriFromCorpusAmt
Total Corpus$17,903TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov To Next Yr$17,903ExcessDistriCyovToNextYrAmt
Excess From Current Year$17,903ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonSURRENA MEMORIAL FUNDRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1BOX 27AddressLine1Txt
CityBUFFALOCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82834ZIPCd
FieldValueIRS element (for citing)
Recipient Phone3076845574RecipientPhoneNum
Form And Info And MaterialsWRITTEN APPLICATIONFormAndInfoAndMaterialsTxt
Submission DeadlinesNONESubmissionDeadlinesTxt
Restrictions On AwardsCHARITABLE, RELIGIOUS, SCIENTIFIC, & EDUCATIONAL PURPOSES IN THE U.S.RestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (25 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtBusiness Name Line2RecipientBusinessName/BusinessNameLine2Txt
BREAD OF LIFE
PO BOX 909BUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$10,000
BUFFALO SENIOR CENTER
671 W FETTERMANBUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$10,000
CHILDREN'S CENTER - BUFFA
151 KLONDIKEBUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$50,000
JOHNSON COUNTY LIBRARY
171 N ADAMSBUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$10,000FOUNDATION
JOHNSON COUNTY YMCA
101 SOUTH KLONDIKEBUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$20,000
METHODIST CHURCH
132 N ADAMS AVEBUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$5,000OF BUFFALO WYOMING
MOUNTAIN PLAINS HERITAGE
PO BOX 27BUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$3,000
CLEARMONT COMMUNITY LIBRA
PO BOX 26CLEARMONTWY82835NONEEXEMPT ORG.GENERAL OPERATIONS$5,000
TONGUE RIVER BRANCH
PO BOX 909RANCHESTERWY82839NONEEXEMPT ORG.GENERAL OPERATIONS$5,000LIBRARY
TONGUE RIVER CHILD'S
84 DAYTON STREETRANCHESTERWY82839NONEEXEMPT ORG.GENERAL OPERATIONS$10,000PLACE
CHILDREN'S CENTER
863 HIGHLAND AVESHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$30,000
GENESIS FOUNDATION
444 CRESCENT DRSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$35,000
HABITAT FOR HUMANITY - BUFFALO
615 BURRITT AVEBUFFALOWY82834NONEEXEMPT ORG.GENERAL OPERATIONS$10,000
LUNCH TOGETHER SOUP KITCHEN
102 S CONNER STSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$10,000
METHODIST CHURCH
215 W WORKSSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$5,000OF SHERIDAN WYOMING
SCOTTISH RITE CHILDHOOD
8 RIVERBEND COURTSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$5,000LANGUAGE CLINIC C/O TOM NEIGHBORS
SENIOR CITIZENS COUNCIL
211 SMITH STREETSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$10,000
SHERIDAN COLLEGE
3059 COFFEEN AVESHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$10,000FOUNDATION
SHERIDAN COUNTY LIBRARY
335 W ALGERSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$5,000FOUNDATION INC
SHERIDAN COUNTY YMCA
417 NORTH JEFFERSONSHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$20,000
VOLUNTEERS OF AMERICA OF
PO BOX 6291SHERIDANWY82801NONEEXEMPT ORG.HOMELESS SHELTER$5,000WYOMING AND MONTANA
STORY BRANCH LIBRARY
PO BOX 188STORYWY82842NONEEXEMPT ORG.GENERAL OPERATIONS$5,000
STORY COMMUNITY CHURCH
PO BOX 415STORYWY82842NONEEXEMPT ORG.GENERAL OPERATIONS$5,000
THE FOOD GROUP
PO BOX 1500SHERIDANWY82801NONEEXEMPT ORG.GENERAL OPERATIONS$2,000
CHILD ADVOCACY CENTER
40 E WORKS STSHERIDANWY82801NONEEXEMPT ORGGENERAL OPERATIONS$5,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$290,000TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$17,491ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$139,187ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$197,967ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$354,645ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$354,645TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EOfalseTrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EOfalseTrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EOfalsePurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth AssetsfalseRentalOfFacilitiesOthAssetsInd
Reimbursement ArrangementsfalseReimbursementArrangementsInd
Loans Or Loan GuaranteesfalseLoansOrLoanGuaranteesInd
Performance Of Services EtcfalsePerformanceOfServicesEtcInd
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOfalseRelationshipsNonchrtblEOInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$2,500Amt
Net Investment Income$1,875NetInvestmentIncomeAmt
Disbursements Charitable Prps$625DisbursementsCharitablePrpsAmt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (23 entries)

BondBondNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
BLACKROCK INC$50,000$56,745
CSX CORP 6.25%$50,884$55,676
DODGE & COX INCOME FUND$150,000$149,739
HEWLETT PACKARD 2.125
HEWLWTT PACKARD 2.650
MCKESSON CORP$50,114$50,189
AT&T .900
GENERAL ELECTRIC CAP 5.1%$100,000$109,418
LILLY ELI & CO$26,815$26,622
EATON CORP$50,137$50,421
OPPENHEIMER INTERNATIONAL BOND FUND$200,000$179,100
WELLPOINT 2.3
TEMPLETON GLOBAL BOND FUND$200,000$175,152
US BANCORP
VANGUARD HIGH YIELD CORPORATE PORT$300,000$300,970
VANGUARD INTERMEDIATE-TERM INVEST$50,000$49,683
VANGUARD SHORT TERM CORP FUND$50,000$49,069
EASTON VANCE FLOATING RATE FUND$150,000$142,352
ANTHEM INC$50,318$50,587
ERGENAL MTRS CORP$750
PUBLIC STORAGE$25,000$25,590
TENNESSEE VALLEY AUTHORITY$49,980$49,510
VANGUARD SHORT-TERM INVESTMENT GRADE$100,000$99,531

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (71 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
AMAZON$13,129$23,784
AMERICAN EXPRESS$59,864$60,752
APACHE CORPORATION$56,313$42,784
APPLE COMPUTER INC$72,615$143,161
BAKER HUGHES INC$79,359$87,660
BB&T CORPORATION$41,136$45,880
BERKSHIRE HATHAWAY INC - CL B$24,782$43,118
BOEING CO$24,398$59,228
BRISTOL MYERS SQUIBB$33,335$59,821
CATERPILLAR INC
CALGENE$38,399$95,468
CHEVRON CORP$21,270$38,897
CISCO SYSTEMS$38,308$52,305
CITIGROUP$147,032$150,879
COSTCO WHOLESALE CORPORATION$19,753$54,710
DEERE & COMPANY$54,351$53,762
DISNEY WALT CO HOLDINGS
DU PONT E I DE NEMOURS & COMPANY$40,222$56,680
EMC CORPORATION$65,651$78,791
EMERSON ELECTRIC CO$25,155$37,926
EXELON CORPORATION$56,036$46,822
EXXON MOBIL CORP$14,692$48,155
FORD MOTOR COMPANY$54,807$72,122
GENERAL ELECTRIC CO$62,019$93,093
GENERAL MOTORS$17,987
GILEAD SCIENCES INC.$35,492$99,696
JACOBS ENGINEERING$60,572$46,000
JOHNSON CONTROLS INC
J.P. MORGAN CHASE & CO$80,474$143,085
MCKESSON CORPORATION$26,642$54,176
MICROSOFT CORPORATION$56,814$96,173
MONDELEZ INTERNATIONAL INC$33,956$70,948
NATIONAL OILWELL VARCO INC
NORDSTROM$55,937$61,297
PEPSICO$19,897$66,117
PHILIP MORRIS INTERNATIONAL$37,122$51,007
PROCTOR & GAMBLE CO$27,473$45,763
QUALCOMM INC$26,521$49,200
SCHLUMBERGER LIMITED$35,803$41,268
SKYWORKS SOLUTIONS INC$32,544$99,949
SOUTHERN CO$6,839$45,100
TARGET CORP$58,634$85,901
TERADATA CORP$59,799$28,757
US BANCORP$51,457$55,129
UNION PACIFIC$55,942$62,902
UNITEDHEALTH GROUP INC$55,571$122,609
PUBLIC STORAGE 6.50% PFD
TENN VALLEY AUTH 6/1/28
ROUCHE HOLDINGS LTD
BHP BILLITON LIMITED ADR
GS-INTERNATIONAL SML CAP INSIGHTS
OPPENHEIMER MAIN ST SMALL CAP
T ROWE PRICE MID CAP FUND$50,000$80,540
T ROWE PRICE MID CAP VALUE FUND$50,000$65,552
AMERICAN EUROPACIFIC GROWTH FUND
HARBOR INTERNATIONAL FUND
OPPENHEIMER DEVELOPING MARKETS FUND
PRINCIPAL GOLBAL REAL ESTATE SEC
WARRANTS
AMERICAN EUROPACIFIC GROWTH FUND$93,447$118,929
BHP BILLITON LIMITED ADR$52,508$23,220
DFA EMERGING MARKETS SMALL CAP$50,000$44,495
DFA US SMALL CAP PORTFOLIO$50,000$47,755
FIREEYE INC$31,293$27,562
GOLDMAN SACHS INTERNATIONAL SMALL CA$50,000$55,355
HARBOR INTERNATIONAL FUND$88,089$119,061
MOTORS LIQUIDATIONS CO GUC TRUST$1,652
OPPENHEIMER DEVELOPING MARKETS FD$100,798$89,925
OPPENHEIMER MAIN STREET SMALL & MID$50,000$68,249
ROCHE HOLDINGS AG SPN ADR EACH REP$65,440$84,539
WALT DISNEY$47,632$126,024

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescMINERAL RIGHTSDesc
BOY Book Value$22,982BOYBookValueAmt
EOY Book Value$22,982EOYBookValueAmt
EOYFMV$85,125EOYFMVAmt

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail

FieldValueIRS element (for citing)
DescFEDERAL TAXES PAYABLEDesc
BOY Book Value$1,723BOYBookValueAmt
EOY Book Value$391EOYBookValueAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT MANAGEMENT FEESCategoryTxt
Amt$31,995Amt
Net Investment Income$31,995NetInvestmentIncomeAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
PAYROLL TAXES$2,982$1,491$1,491
EXCISE TAXES$2,991
FOREIGN TAXES$423$423