STRATEGY STUDIO / PUBLIC DATA EXPLORER

MARY M PECKMAN TR FBO CHEN MEM HOSPITAL: Form 990PF, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
MARY M PECKMAN TR FBO CHEN MEM HOSPITAL (EIN 15-6017708)
Tax period
2014-04-01 to 2015-03-31
Filed
2015-07-29
IRS object ID
201522109349100407
Schema version
2014v5.0
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)
Return2015-07-29T13:00:27-05:00ReturnTs
Tax Period End2015-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line199 WOOD AVE SOUTHAddressLine1Txt
CityISELINCityNm
State AbbreviationNJStateAbbreviationCd
ZIP08830ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2014-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN156017708EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARY PECKHAM FBO CHENANGO MEM HOSPITAL 003154BusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPECKBusinessNameControlTxt
Phone6073376191PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O NBT BANK NA 52 S BROAD STAddressLine1Txt
CityNORWICHCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13815ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY J HANDYPersonNm
Person TitleSENIOR VPPersonTitleTxt
Phone6073376191PhoneNum
Signature2015-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLOUIS J DEROSEPreparerPersonNm
Phone7327679100PhoneNum
Preparation2015-05-15PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,621,015FMVAssetsEOYAmt

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$15InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$16InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$108,122DividendsRevAndExpnssAmt
Dividends Net Invst Incm$110,127DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$103,812NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$654,024GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$103,830CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm$0NetSTCapitalGainAdjNetIncmAmt
Total Rev And Expnss$211,949TotalRevAndExpnssAmt
Total Net Invst Incm$213,973TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$22,652CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$20,387CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$2,265CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm$0OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$0OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Net Invst Incm$0PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Adj Net Incm$0PensionEmplBnftAdjNetIncmAmt
Legal Fees Dsbrs Chrtbl$0LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$750AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm$0AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps$0AccountingFeesChrtblPrpsAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Interest Dsbrs Chrtbl$0InterestDsbrsChrtblAmt
Taxes Rev And Expnss$18,367TaxesRevAndExpnssAmt
Taxes Net Invst Incm$1,845TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$0DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$0DeprecAndDpltnNetInvstIncmAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm$0TravConfMeetingAdjNetIncmAmt
Printing And Pub Rev And Expnss$2PrintingAndPubRevAndExpnssAmt
Printing And Pub Net Invst Incm$0PrintingAndPubNetInvstIncmAmt
Printing And Pub Adj Net Incm$0PrintingAndPubAdjNetIncmAmt
Printing And Pub Dsbrs Chrtbl$2PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$250OtherExpensesRevAndExpnssAmt
Other Expenses Dsbrs Chrtbl$250OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$42,021TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$22,232TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$0TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$2,517TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$166,144ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$166,144ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$208,165TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$22,232TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$0TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$168,661TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$3,784ExcessRevenueOverExpensesAmt
Net Investment Income$191,741NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$1,252CashBOYAmt
Sav And Temp Cash Invst BOY$89,123SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$101,167SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$101,167SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl EOY$0AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$0AcctRcvblEOYFMVAmt
Other Rcvbl Allwnc Dbtfl Acct$0OtherRcvblAllwncDbtflAcctAmt
US Government Obligations BOY$245,501USGovernmentObligationsBOYAmt
US Government Obligations EOY$196,057USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$205,449USGovtObligationsEOYFMVAmt
Corporate Bonds BOY$301,273CorporateBondsBOYAmt
Corporate Bonds EOY$251,273CorporateBondsEOYAmt
Corporate Bonds EOYFMV$264,499CorporateBondsEOYFMVAmt
Other Investments BOY$2,869,447OtherInvestmentsBOYAmt
Other Investments EOY$2,961,883OtherInvestmentsEOYAmt
Other Investments EOYFMV$3,049,900OtherInvestmentsEOYFMVAmt
Total Assets BOY$3,506,596TotalAssetsBOYAmt
Total Assets EOY$3,510,380TotalAssetsEOYAmt
Total Assets EOYFMV$3,621,015TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$3,506,596CapitalStockBOYAmt
Capital Stock EOY$3,510,380CapitalStockEOYAmt
Tot Net Ast Or Fund Balances BOY$3,506,596TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$3,510,380TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,506,596TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$3,510,380TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$3,506,596TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$3,784ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$3,510,380SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$3,510,380TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (27 entries)

PropertyPropertyDescAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmtHow AcquiredHowAcquiredCd
12146.597 DFA GLOBAL REAL ESTATE SECURITIES2014-01-302014-04-11$116,000$109,076$6,924$6,924
50000. GEN ELEC CAP CRP MTN 4.400% 4/15/142008-04-152014-04-15$50,000$50,000
25000. FFCB 4.900% 4/29/142006-08-312014-04-29$25,000$24,684$316$316
621.805 AMERICAN BEACON L/C VALU-IS2014-01-302014-09-08$19,525$17,342$2,183$2,183
2142.343 DFA EMERGING MKTS PORTFOLIO2014-01-302014-09-08$61,742$51,888$9,854$9,854
29.498 DFA US S/C VALUE PORTFOLIO2014-01-302014-09-08$1,081$1,002$79$79
1232.299 DFA GLOBAL REAL ESTATE SECURITIES2014-01-302014-09-08$12,927$11,066$1,861$1,861
121.349 DIAMOND HILL SMALL/MID CAP-I2013-07-192014-09-08$2,295$2,059$236$236
881.027 DODGE & COX INTL STOCK FUND2011-10-262014-09-08$41,435$27,981$13,454$13,454
794.312 LAZARD GL LIST INFRASTRUCTURE-INST2014-04-112014-09-08$11,883$10,922$961$961
3115.135 LAZARD EMERGING MKTS PORT-IN2011-10-262014-09-08$64,982$58,315$6,667$6,667
420.205 OPPENHEIMER INTL GROWTH FD-Y2013-10-072014-09-08$15,707$15,094$613$613
205.819 PRIMECAP ODYSSEY GROWTH2014-01-302014-09-08$5,372$4,913$459$459
89.731 VANGUARD #94 INSTITUTIONAL INDEX2014-01-302014-09-08$16,527$14,759$1,768$1,768
850.547 BLACKROCK HIGH YIELD BD-INST2014-01-302014-10-30$7,000$7,009-$9-$9
1290.323 LOOMIS SAYLES BOND FUND-INS2014-01-022014-10-30$20,000$19,535$465$465
377.929 TEMPLETON GLOBAL BOND FUND-AD2012-12-272014-10-30$5,000$5,015-$15-$15
25000. FHLMC MTN 5.000% 11/13/142007-01-302014-11-13$25,000$24,760$240$240
456.024 DFA EMERGING MKTS PORTFOLIO2014-01-302014-11-26$12,158$11,045$1,113$1,113
523.627 DFA GLOBAL REAL ESTATE SECURITIES2014-01-302014-11-26$5,629$4,702$927$927
384.723 DODGE & COX INTL STOCK FUND2011-10-262014-11-26$17,466$12,219$5,247$5,247
332.64 LAZARD GL LIST INFRASTRUCTURE-INST2014-04-112014-11-26$5,013$4,574$439$439
652.285 LAZARD EMERGING MKTS PORT-IN2011-10-262014-11-26$12,674$12,211$463$463
404.126 OPPENHEIMER INTL GROWTH FD-Y2014-01-302014-11-26$14,755$14,658$97$97
136.588 OPPENHEIMER INTL GROWTH FD-Y2013-10-072014-11-26$4,987$4,906$81$81
2295.327 TEMPLETON GLOBAL BOND FUND-AD2012-12-272014-11-26$30,367$30,459-$92-$92
CAPITAL GAIN DIVIDENDS$49,499P
FieldValueIRS element (for citing)
Capital Gain Net Income$103,830CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$164,822AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$3,536,834NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.046602DistributionYr1Rt
Adjusted Qlfy Distri Yr2$161,012AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$3,291,618NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.048916DistributionYr2Rt
Adjusted Qlfy Distri Yr3$159,469AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$3,238,521NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.049241DistributionYr3Rt
Adjusted Qlfy Distri Yr4$190,353AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$3,210,499NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.059291DistributionYr4Rt
Adjusted Qlfy Distri Yr5$127,424AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$2,991,204NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.0426DistributionYr5Rt
Total Distribution0.24665TotalDistributionRt
Average Distribution0.04933AverageDistributionRt
Net Vl Noncharitable Assets$3,627,624NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$178,951AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$1,917NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$180,868AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$168,661QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$3,835InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$3,835SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$3,835TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$6,872EstimatedPlusOvpmtIncmTxAmt
Applied To Es Tax$0AppliedToEsTaxAmt
Total Payments And Credits$6,872TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Overpayment$3,037OverpaymentAmt
Applied To ES Tax$3,037AppliedToESTaxAmt
Refund$0RefundAmt

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 StateNYOrgReportOrRegisterStateCd
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 Line1NBT BANK NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6073376193PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line152 S BROAD STREETAddressLine1Txt
CityNORWICHCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13815ZIPCd
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
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Undistr Incm Sect4942a2 Not AppfalseUndistrIncmSect4942a2NotAppInd
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

FieldValueIRS element (for citing)
PersonNBT BANK NAPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line152 SOUTH BROAD STREETAddressLine1Txt
CityNORWICHCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13815ZIPCd
FieldValueIRS element (for citing)
TitleTRUSTEETitleTxt
Average Hrs Per Wk Devoted To Pos1AverageHrsPerWkDevotedToPosRt
Compensation$22,652CompensationAmt
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
FieldValueIRS element (for citing)
Summary Of Direct Chrtbl ActySummaryOfDirectChrtblActyGrp
Sum Of Program Related InvstSumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$3,587,434AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$95,433AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$3,682,867TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$3,682,867AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$55,243CashDeemedCharitableAmt
Net Vl Noncharitable Assets$3,627,624NetVlNoncharitableAssetsAmt
Minimum Investment Return$181,381MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$181,381MinimumInvestmentReturnAmt
Tax Based On Investment Income$3,835TaxBasedOnInvestmentIncomeAmt
Total Tax$3,835TotalTaxAmt
Distributable Before Adj$177,546DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$177,546DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$177,546DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$168,661ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$168,661QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$168,661AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$177,546DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$0ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$0ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$1,112ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$0ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$1,723ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$2,835TotalExcessDistributionCyovAmt
Qualifying Distributions$168,661QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$168,661AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$2,835ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$2,835ExcessDistributionCyovAppCYAmt
Total Corpus$0TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$6,050UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$0ExcessDistriCyovToNextYrAmt
Excess From Year4$0ExcessFromYear4Amt
Excess From Year3$0ExcessFromYear3Amt
Excess From Year2$0ExcessFromYear2Amt
Excess From Year1$0ExcessFromYear1Amt
Excess From Current Year$0ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Chenango MemorialBusinessNameLine1Txt
Business Name Line2HospitalBusinessNameLine2Txt

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1179 NORTH BROAD STREETAddressLine1Txt
CityNorwichCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13815ZIPCd
FieldValueIRS element (for citing)
Recipient RelationshipN/ARecipientRelationshipTxt
Recipient Foundation StatusPCRecipientFoundationStatusTxt
Grant Or Contribution PurposeGENERAL PURPOSES - MEMORYGrantOrContributionPurposeTxt
Amt$166,144Amt
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$166,144TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

FieldValueIRS element (for citing)
Fees Contracts From Govt AgFeesContractsFromGovtAgGrp
Membership Dues And AssmntMembershipDuesAndAssmntGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$15ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$108,122ExclusionAmt
FieldValueIRS element (for citing)
Net Rntl Incm Re Debt Fincd PropNetRntlIncmReDebtFincdPropGrp
Net Rntl Incm Re Not Debt Fincd PropNetRntlIncmReNotDebtFincdProp
Net Rental Income Personal PropNetRentalIncomePersonalPropGrp
Other Investment Incm Part VIIOtherInvestmentIncmPartVIIGrp

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$103,812ExclusionAmt
FieldValueIRS element (for citing)
Net Income Loss From Special EvtNetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of InvntryGrossProfitLossSlsOfInvntryGrp

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$211,949ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$211,949TotalIncomeProducingActyAmt
FieldValueIRS element (for citing)
Rln Of Acty To Accom Of Exmpt PrpsRlnOfActyToAccomOfExmptPrpsGrp

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)
CategoryTAX PREPARATION FEECategoryTxt
Amt$750Amt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (4 entries)

BondBondNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
BANK OF AMERICA 6.4% 8-15-19$50,000$57,442
GOLDMAN SACHS 3.625% 2/7/16$50,325$51,070
COLGATE- PALM 2.45% 11/15/2021$51,439$51,196
PEPSICO INC 3.0% 8/25/21$99,509$104,791

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$196,057USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$205,449USGovtObligationsEOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (20 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
DFA INTERNATIONAL SMALL COAT COST$150,060$137,225
OPPENHEIMER INTL GROWTH FD-YAT COST$219,142$220,653
CREDIT SUISSE COMM RETAT COST$81,696$65,061
DFA US S/C VALUE PORTAT COST$35,973$37,911
DFA GLOBAL REAL ESTATE SECAT COST$92,795$112,326
AMERICAN BEACON L/C VALUEAT COST$273,181$283,049
DIAMOND HILL SMALL MIDCAP-1AT COST$103,091$117,063
DFA EMERGING MKTS PORTAT COST$105,466$110,469
DODGE & COX INCOME FDAT COST$105,276$107,514
PRIMECAP ODYSSEY GROWTHAT COST$155,807$174,129
VANGUARD INSTITUTIONAL INDEXAT COST$256,710$292,015
LAZARD EMERGING MKTSAT COST$112,406$102,844
DODGE & COX INTL STOCK FDAT COST$178,766$220,356
DFA U S MICRO CAP PORTAT COST$37,142$38,151
TEMPLETON GLOBAL BD FDAT COST$189,809$177,374
LOOMIS SAYLES BD FDAT COST$307,220$295,626
BLACKROCK HIGH YIELD BD PORTAT COST$181,698$174,434
VANGUARD SHORT-TERM INFLATAT COST$151,828$148,844
VANGUARD TOTAL BD MKT INDEX FDAT COST$116,059$119,066
LAZARD GI LIST INFRASTRUCTUREAT COST$107,758$115,790

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

FieldValueIRS element (for citing)
DescNYS EPTL FILING FEEDesc
Revenue And Expenses Per Books$250RevenueAndExpensesPerBooksAmt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$250DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
2013 EXCISE TAX PAID$11,495$0$0
ESTIMATED EXCISE TAX PAID$6,872$0$0
FOREIGN TAXES PAID$1,845$0