MARY M PECKMAN TR FBO CHEN MEM HOSPITAL: Form 990PF, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: MARY M PECKMAN TR FBO CHEN MEM HOSPITAL (EIN 15-6017708)
Tax period: 2012-04-01 to 2013-03-31
Filed: 2013-07-22
IRS object ID: 201302039349100210
Schema version: 2012v2.1
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
Form 990-PF
Accounting Fees Schedule
Investments Corp Bonds Schedule
Investments Corp Stock Schedule
Investments Govt Obligations Sch
Investments Other Schedule2
Other Expenses Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-07-22T11:47:39-06:00	Timestamp
Tax Period End Date	2013-03-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THOMSON REUTERS (TAX & ACCOUNTING)	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	343 THORNALL ST STE 710	AddressLine1
City	EDISON	City
State	NJ	State
ZIP Code	08837	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnType
Tax Period Begin Date	2012-04-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	156017708	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MARY PECKHAM FBO CHENANGO MEM HOSPITAL 003154	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	PECK	NameControl
Phone	6073376497	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	C/O NBT BANK NA 52 S BROAD ST	AddressLine1
City	NORWICH	City
State	NY	State
ZIP Code	13815	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARY ANN SCHEER	Name
Title	ASSISTANT VP	Title
Phone	6073376497	Phone
Date Signed	2013-07-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	LOUIS J DEROSE	Name
Phone	7327679100	Phone
Date Prepared	2013-07-15	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-12-30 17:16:21Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Exempt PF	X	ExemptPF
FMV Assets EOY	3448194	FMVAssetsEOY

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Not Required To Attach Schedule B	X	NotRequiredToAttachScheduleB
Interest On Savings Rev And Expnss	10	InterestOnSavingsRevAndExpnss
Interest On Savings Net Invst Incm	9	InterestOnSavingsNetInvstIncm
Dividends Rev And Expnss	84554	DividendsRevAndExpnss
Dividends Net Invst Incm	86344	DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss	45486	NetGainSaleAssetsRevAndExpnss
Gross Sales Price	501219	GrossSalesPrice
Capital Gain Net Incm Net Invst Incm	45229	CapitalGainNetIncmNetInvstIncm
Net STCG Adj Net Incm	0	NetSTCGAdjNetIncm
Total Revenue And Expenses	130050	TotalRevenueAndExpenses
Total Net Investment Income	131582	TotalNetInvestmentIncome
Comp Ofcr Dir Trst Rev And Expnss	20949	CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm	18854	CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps	2095	CompOfcrDirTrstDsbrsChrtblPrps
Oth Empl Slrs Wgs Net Invst Incm	0	OthEmplSlrsWgsNetInvstIncm
Oth Empl Slrs Wgs Adj Net Incm	0	OthEmplSlrsWgsAdjNetIncm
Oth Empl Slrs Wgs Dsbrs Chrtbl Prps	0	OthEmplSlrsWgsDsbrsChrtblPrps
Pension Empl Bnft Net Invst Incm	0	PensionEmplBnftNetInvstIncm
Pension Empl Bnft Adj Net Incm	0	PensionEmplBnftAdjNetIncm
Legal Fees Dsbrs Chrtbl Prps	0	LegalFeesDsbrsChrtblPrps
Accounting Fees Rev And Expnss	650	AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm	0	AccountingFeesNetInvstIncm
Accounting Fees Adj Net Incm	0	AccountingFeesAdjNetIncm
Accounting Fees Dsbrs Chrtbl Prps	0	AccountingFeesDsbrsChrtblPrps
Other Prof Fees Dsbrs Chrtbl Prps	0	OtherProfFeesDsbrsChrtblPrps
Interest Dsbrs Chrtbl Prps	0	InterestDsbrsChrtblPrps
Taxes Rev And Expnss	3724	TaxesRevAndExpnss
Taxes Net Invst Incm	1462	TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps	0	TaxesDsbrsChrtblPrps
Deprec And Depletion Rev And Expnss	0	DeprecAndDepletionRevAndExpnss
Deprec And Depletion Net Invst Incm	0	DeprecAndDepletionNetInvstIncm
Trav Conf Meeting Net Invst Incm	0	TravConfMeetingNetInvstIncm
Trav Conf Meeting Adj Net Incm	0	TravConfMeetingAdjNetIncm
Printing And Pub Net Invst Incm	0	PrintingAndPubNetInvstIncm
Printing And Pub Adj Net Incm	0	PrintingAndPubAdjNetIncm
Other Expenses Rev And Expnss	250	OtherExpensesRevAndExpnss
Other Expenses Dsbrs Chrtbl Prps	250	OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss	25573	TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm	20316	TotOprExpensesNetInvstIncm
Tot Opr Expenses Adj Net Incm	0	TotOprExpensesAdjNetIncm
Tot Opr Expenses Dsbrs Chrtbl Prps	2345	TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss	158667	ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps	158667	ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss	184240	TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm	20316	TotalExpensesNetInvstIncm
Total Expenses Adj Net Incm	0	TotalExpensesAdjNetIncm
Total Expenses Dsbrs Chrtbl Prps	161012	TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses	-54190	ExcessOfRevenueOverExpenses
Net Investment Income	111266	NetInvestmentIncome
Adjusted Net Income	0	AdjustedNetIncome

Balance Sheets BalanceSheets

Field	Value	IRS element (for citing)
Savings And Temp Cash Invst BOY	116502	SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY	59987	SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV	59987	SavingsAndTempCashInvstEOYFMV
Accounts Receivable EOY	0	AccountsReceivableEOY
Accounts Receivable EOYFMV	0	AccountsReceivableEOYFMV
Allwnc For Dbtfl Acct Other Rcvbl	0	AllwncForDbtflAcctOtherRcvbl
Investments Govt Oblig BOY	542576	InvestmentsGovtObligBOY
Investments Govt Oblig EOY	469066	InvestmentsGovtObligEOY
Investments Govt Oblig EOYFMV	505788	InvestmentsGovtObligEOYFMV
Investments Corp Stock BOY	899872	InvestmentsCorpStockBOY
Investments Corp Stock EOY	929236	InvestmentsCorpStockEOY
Investments Corp Stock EOYFMV	1213642	InvestmentsCorpStockEOYFMV
Investments Corp Bonds BOY	150325	InvestmentsCorpBondsBOY
Investments Corp Bonds EOY	201764	InvestmentsCorpBondsEOY
Investments Corp Bonds EOYFMV	213785	InvestmentsCorpBondsEOYFMV
Investments Other BOY	1331069	InvestmentsOtherBOY
Investments Other EOY	1326101	InvestmentsOtherEOY
Investments Other EOYFMV	1454992	InvestmentsOtherEOYFMV
Total Assets BOY	3040344	TotalAssetsBOY
Total Assets EOY	2986154	TotalAssetsEOY
Total Assets EOYFMV	3448194	TotalAssetsEOYFMV
Total Liabilities EOY	0	TotalLiabilitiesEOY
Org That Do Not Follow SFAS117	X	OrgThatDoNotFollowSFAS117
Capital Stock BOY	3040344	CapitalStockBOY
Capital Stock EOY	2986154	CapitalStockEOY
Total Net Assets BOY	3040344	TotalNetAssetsBOY
Total Net Assets EOY	2986154	TotalNetAssetsEOY
Total Liabilities Net Assets BOY	3040344	TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY	2986154	TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

Field	Value	IRS element (for citing)
Total Net Assets Fund Balances BOY	3040344	TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses	-54190	ExcessOfRevenueOverExpenses
Other Increases	0	OtherIncreases
Subtotal	2986154	Subtotal
Other Decreases	0	OtherDecreases
Total Net Assets Fund Balances EOY	2986154	TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (82 entries)

Description Of AssetDescriptionOfAsset	How AcquiredHowAcquired	Date AcquiredDateAcquired	Date SoldDateSold	Gross Sales PriceGrossSalesPrice	Cost Or Other BasisCostOrOtherBasis	Gain Or LossGainOrLoss	Gains Minus Excess Or LossesGainsMinusExcessOrLosses
10. APPLE COMPUTER	P	2007-02-01	2012-04-17	6037	858	5179	5179
18. BED BATH & BEYOND INC	P	2011-06-21	2012-04-17	1253	973	280	280
67. BERKSHIRE HATHAWAY INC-CL B	P	2011-06-21	2012-04-17	5408	5112	296	296
65. DISNEY WALT CO COM DISNEY	P	2009-07-31	2012-04-17	2763	1640	1123	1123
116.77 DODGE & COX INTL STOCK FUND	P	2011-10-26	2012-04-17	3723	3709	14	14
93. E M C CORP MASS COM	P	2011-06-21	2012-04-17	2719	2455	264	264
60. INTEL CORP COM	P	2009-07-31	2012-04-17	1710	1163	547	547
5. INTL BUSINESS MACHINES CORP COM	P	2004-08-25	2012-04-17	1023	425	598	598
145. J P MORGAN CHASE & CO COM	P	2008-05-28	2012-04-17	6344	6187	157	157
341.704 LAZARD EMERGING MKTS PORT-IN	P	2011-10-26	2012-04-17	6588	6397	191	191
36. MICROSOFT CORP COM	P	2003-08-28	2012-04-17	1126	956	170	170
150. PFIZER INC COM	P	2011-06-21	2012-04-17	3326	3048	278	278
19. PRUDENTIAL FINL INC COM	P	2007-03-20	2012-04-17	1153	1712	-559	-559
72. QUALCOMM INC COM	P	2011-06-21	2012-04-17	4864	3904	960	960
25. KBW REGIONAL BANKING ETF	P	2008-08-25	2012-04-17	693	769	-76	-76
575. SUNCOR ENERGY INC	P	2010-11-01	2012-04-17	18302	18739	-437	-437
145. SUNCOR ENERGY INC	P	2011-10-24	2012-04-17	4615	4485	130	130
37. TEVA PHARMACEUTICAL INDS ADR	P	2011-06-21	2012-04-17	1685	1737	-52	-52
46.322 CRM MID CAP VALUE FD INSTL	P	2011-10-26	2012-04-17	1366	1246	120	120
114. WAL MART STORES INC COM	P	2011-06-21	2012-04-17	7027	6042	985	985
46. COVIDIEN PLC	P	2011-06-21	2012-04-17	2486	2456	30	30
.5 PHILLIPS 66	P	1997-04-28	2012-05-23	16	5	11	11
25. GOLDMAN SACHS GROUP INC COM	P	2008-05-28	2012-05-25	2425	4367	-1942	-1942
16. GOLDMAN SACHS GROUP INC COM	P	2011-06-21	2012-05-25	1552	2165	-613	-613
200. J P MORGAN CHASE & CO COM	P	2008-05-28	2012-05-25	6752	8534	-1782	-1782
10. PHILLIPS 66	P	2012-04-17	2012-06-04	294	359	-65	-65
162. PHILLIPS 66	P		2012-06-04	4759	3343	1416	1416
556. CISCO SYS INC COM	P		2012-07-26	8558	12690	-4132	-4132
785. FIRST TRUST ISE GLOBAL ENGIN	P	2011-06-21	2012-07-27	28122	34410	-6288	-6288
70. FIRST TRUST ISE GLOBAL ENGIN	P	2012-04-17	2012-07-27	2508	2822	-314	-314
110. FIRST TRUST ISE GLOBAL ENGIN	P	2011-10-24	2012-07-27	3941	4257	-316	-316
10. APPLE COMPUTER	P	2007-02-01	2012-08-28	6732	858	5874	5874
50000. FNMA 4.375% 9/15/12	P	2007-01-19	2012-09-15	50000	48616	1384	1384
20. BERKSHIRE HATHAWAY INC-CL B	P	2011-06-21	2012-11-27	1755	1526	229	229
13. DANAHER CORP	P	2004-08-25	2012-11-27	676	326	350	350
78. DISNEY WALT CO COM DISNEY	P	2009-07-31	2012-11-27	3808	1969	1839	1839
278.784 DODGE & COX INTL STOCK FUND	P	2011-10-26	2012-11-27	9219	8854	365	365
14. EXXON MOBIL CORP COM	P	2004-08-25	2012-11-27	1226	632	594	594
135. GENERAL ELEC CO COM	P		2012-11-27	2828	2212	616	616
16. GOLDMAN SACHS GROUP INC COM	P	2011-06-21	2012-11-27	1920	2165	-245	-245
1. GOOGLE INC CL A	P	2009-07-31	2012-11-27	661	444	217	217
35. HEINZ H J CO COM	P	2012-02-07	2012-11-27	2020	1821	199	199
147. HONEYWELL INTL INC COM	P	2012-07-27	2012-11-27	8905	8642	263	263
28. ISHARES NASDAQ BIOTECH INDX	P	2007-11-29	2012-11-27	3840	2356	1484	1484
152. J P MORGAN CHASE & CO COM	P	2011-06-21	2012-11-27	6238	6209	29	29
35. J P MORGAN CHASE & CO COM	P	2008-05-28	2012-11-27	1436	1493	-57	-57
30. JOHNSON & JOHNSON COM	P		2012-11-27	2058	1958	100	100
111.58 LAZARD EMERGING MKTS PORT-IN	P	2011-10-26	2012-11-27	2132	2089	43	43
76. LOWES COS INC COM	P	2007-03-20	2012-11-27	2678	2367	311	311
6. MARKET VECTORS AGRIBUSINESS	P	2009-07-31	2012-11-27	307	227	80	80
235. THE MOSAIC COMPANY	P	2011-06-21	2012-11-27	12605	14725	-2120	-2120
36. NOVARTIS A G SPONSORED ADR	P	2011-10-24	2012-11-27	2179	2119	60	60
104. PFIZER INC COM	P	2011-06-21	2012-11-27	2533	2113	420	420
10. PROCTER & GAMBLE CO COM	P	1992-11-24	2012-11-27	688	137	551	551
10. ENERGY SELECT SECTOR SPDR	P	2011-06-21	2012-11-27	698	731	-33	-33
20. TARGET CORP COM	P	1997-09-16	2012-11-27	1256	326	930	930
31. UNION PAC CORP COM	P	2010-11-01	2012-11-27	3781	2754	1027	1027
77.594 CRM MID CAP VALUE FD INSTL	P	2011-10-26	2012-11-27	2326	2087	239	239
192. XYLEM INC	P	2011-06-21	2012-11-27	4913	6227	-1314	-1314
24. COVIDIEN PLC	P	2011-06-21	2012-11-27	1371	1281	90	90
73. BERKSHIRE HATHAWAY INC-CL B	P	2011-06-21	2012-11-30	6422	5570	852	852
74. MCDONALDS CORP COM	P	2011-06-21	2012-11-30	6390	6116	274	274
92. PROCTER & GAMBLE CO COM	P	1992-11-24	2012-11-30	6400	1259	5141	5141
691. KBW REGIONAL BANKING ETF	P		2012-11-30	19017	20821	-1804	-1804
92. WAL MART STORES INC COM	P	2011-06-21	2012-11-30	6586	4876	1710	1710
544.089 DODGE & COX INCOME FUND	P	2009-10-23	2012-12-27	7541	7035	506	506
4910.26 FEDERATED TOTAL RETURN BOND FUND #328	P	2009-10-23	2012-12-27	57008	53375	3633	3633
29. CHEVRONTEXACO CORP COM	P	2011-06-21	2013-01-30	3381	2933	448	448
220.507 DODGE & COX INTL STOCK FUND	P	2011-10-26	2013-01-30	8000	7003	997	997
3. GOOGLE INC CL A	P	2009-07-31	2013-01-30	2266	1332	934	934
42.409 HARTFORD MIDCAP FUND-Y	P	2011-10-26	2013-01-30	1000	951	49	49
53. HONEYWELL INTL INC COM	P	2012-07-27	2013-01-30	3657	3116	541	541
246.914 ROYCE PENNSYLVANIA MUT FUND-IN	P	2011-10-26	2013-01-30	3000	2751	249	249
17. SCHLUMBERGER LTD COM	P	2005-11-01	2013-01-30	1333	769	564	564
79. TEVA PHARMACEUTICAL INDS ADR	P	2012-11-27	2013-02-21	2994	3187	-193	-193
560. TEVA PHARMACEUTICAL INDS ADR	P		2013-02-21	21224	25609	-4385	-4385
90. HEINZ H J CO COM	P	2012-02-07	2013-02-26	6508	4683	1825	1825
25000. FFCB 5.000% 3/06/13	P	2006-10-19	2013-03-06	25000	24894	106	106
161.747 HARTFORD MIDCAP FUND-Y	P	2011-10-26	2013-03-27	4000	3628	372	372
8. ISHARES NASDAQ BIOTECH INDX	P	2007-11-29	2013-03-27	1236	673	563	563
33. JOHNSON & JOHNSON COM	P	2007-03-20	2013-03-27	2667	2021	646	646
59.471 CRM MID CAP VALUE FD INSTL	P	2011-10-26	2013-03-27	2000	1599	401	401

Field	Value	IRS element (for citing)
Capital Gain Net Income	45229	CapitalGainNetIncome

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

Field	Value	IRS element (for citing)
Liable For4942 Tax	false	LiableFor4942Tax
Qualifying Distributions Year1	159469	QualifyingDistributionsYear1
Noncharitable Assets Year1	3238521	NoncharitableAssetsYear1
Distribution Ratio Year1	0.049241	DistributionRatioYear1
Qualifying Distributions Year2	190353	QualifyingDistributionsYear2
Noncharitable Assets Year2	3210499	NoncharitableAssetsYear2
Distribution Ratio Year2	0.059291	DistributionRatioYear2
Qualifying Distributions Year3	127424	QualifyingDistributionsYear3
Noncharitable Assets Year3	2991204	NoncharitableAssetsYear3
Distribution Ratio Year3	0.0426	DistributionRatioYear3
Qualifying Distributions Year4	136403	QualifyingDistributionsYear4
Noncharitable Assets Year4	2992873	NoncharitableAssetsYear4
Distribution Ratio Year4	0.045576	DistributionRatioYear4
Total Distribution Ratio	0.196708	TotalDistributionRatio
Average Distribution Ratio	0.049177	AverageDistributionRatio
Net Noncharitable Assets	3291618	NetNoncharitableAssets
Adjusted Noncharitable Assets	161872	AdjustedNoncharitableAssets
One Percent Net Investment Income	1113	OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One	162985	AdjNonchrtblAssetsAndOnePct
Qualifying Distributions	161012	QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

Field	Value	IRS element (for citing)
Investment Income Excise Tax	2225	InvestmentIncomeExciseTax
Tax Under Section511	0	TaxUnderSection511
Subtotal	2225	Subtotal
Subtitle A Tax	0	SubtitleATax
Tax Based On Investment Income	2225	TaxBasedOnInvestmentIncome
Est Tax Payments And Overpayment	2188	EstTaxPaymentsAndOverpayment
Tax Paid With Extension	0	TaxPaidWithExtension
Total Credits And Payments	2188	TotalCreditsAndPayments
Penalty For Underpayment	0	PenaltyForUnderpayment
Tax Due	37	TaxDue
Amount Credited To Next Year	0	AmountCreditedToNextYear
Amount To Be Refunded	0	AmountToBeRefunded

Statements Regarding Activities StatementsRegardingActivities

Field	Value	IRS element (for citing)
Legislative Political Activities	false	LegislativePoliticalActivities
More Than100 Spent	false	MoreThan100Spent
Form1120 POL Filed	false	Form1120POLFiled
Activities Not Prev Reported	false	ActivitiesNotPrevReported
Changes To Articles Or Bylaws	false	ChangesToArticlesOrBylaws
Unrelated Bus Income Over1000	false	UnrelatedBusIncomeOver1000
Termination Etc	false	TerminationEtc
Requirements Of Sect508e	true	RequirementsOfSect508e
At Least5000 In Assets	true	AtLeast5000InAssets
States Filed With	NY	StatesFiledWith
Form990 PF Filed With AG	true	Form990PFFiledWithAG
Private Operating Foundation	false	PrivateOperatingFoundation
New Substantial Contributors	false	NewSubstantialContributors
Interest In Controlled Entity	false	InterestInControlledEntity
Applicable Insurance Contract	false	ApplicableInsuranceContract
Comply With Public Inspection Rqr	true	ComplyWithPublicInspectionRqr

Books In Care Of Business Name BooksInCareOfBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NBT BANK NA	BusinessNameLine1

Field	Value	IRS element (for citing)
Books In Care Of Phone Number	6073376497	BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

Field	Value	IRS element (for citing)
Address Line1	52 S BROAD STREET	AddressLine1
City	NORWICH	City
State	NY	State
ZIP Code	13815	ZIPCode

Field	Value	IRS element (for citing)
Foreign Bank	false	ForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

Field	Value	IRS element (for citing)
Sale Or Exchange With Dsqfly Person	false	SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person	false	BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person	false	FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person	true	PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person	false	TransferAssetsToDsqflyPerson
Payment To Government Offical	false	PaymentToGovernmentOffical
Acts Fail To Qualify As Exceptions	false	ActsFailToQualifyAsExceptions
Uncorrected Prior Acts	false	UncorrectedPriorActs
Undistributed Income Prior Years	false	UndistributedIncomePriorYears
Undistr Income4942a2 Not Applied	false	UndistrIncome4942a2NotApplied
Business Holdings	false	BusinessHoldings
Jeopardy Investments	false	JeopardyInvestments
Uncorrected Jeopardy Investments	false	UncorrectedJeopardyInvestments
Influence Legislation	false	InfluenceLegislation
Influence Election	false	InfluenceElection
Grants To Individuals	false	GrantsToIndividuals
Grants To Organizations	false	GrantsToOrganizations
Noncharitable Purpose	false	NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract	false	RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract	false	PayPremiumsPrsnlBnftContract
Prohibited Tax Shelter Transactn	false	ProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee

Field	Value	IRS element (for citing)
Person Name	NBT BANK NA	PersonName

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	52 SOUTH BROAD STREET	AddressLine1
City	NORWICH	City
State	NY	State
ZIP Code	13815	ZIPCode

Field	Value	IRS element (for citing)
Title	TRUSTEE	Title
Avg Hours Per Wk Devoted To Position	1	AvgHoursPerWkDevotedToPosition
Compensation	20949	Compensation

Field	Value	IRS element (for citing)
Comp Of Highest Paid Empl NONE	NONE	CompOfHighestPaidEmplNONE
Tot Number Of Oth Empl Paid Over50k	0	TotNumberOfOthEmplPaidOver50k
Comp Of Hghst Paid Cntrct NONE	NONE	CompOfHghstPaidCntrctNONE
Tot Number Of Cntrct Paid Over50k	0	TotNumberOfCntrctPaidOver50k

Field	Value	IRS element (for citing)
Summary Of Direct Charitable Acty		SummaryOfDirectCharitableActy
Sum Of Program Related Investments		SumOfProgramRelatedInvestments

Minimum Investment Return MinimumInvestmentReturn

Field	Value	IRS element (for citing)
Avg Monthly FMV Of Securities	3242794	AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances	98950	AvgMonthlyCashBalances
FMV All Other Noncharitable Assets	0	FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets	3341744	TotalFMVOfUnusedAssets
Reduction Claimed	0	ReductionClaimed
Acquisition Indebtedness	0	AcquisitionIndebtedness
Adj Total FMV Of Unused Assets	3341744	AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable	50126	CashDeemedCharitable
Net Noncharitable Assets	3291618	NetNoncharitableAssets
Minimum Investment Return	164581	MinimumInvestmentReturn

Distributable DistributableAmount

Field	Value	IRS element (for citing)
Minimum Investment Return	164581	MinimumInvestmentReturn
Tax Based On Investment Income	2225	TaxBasedOnInvestmentIncome
Total Tax	2225	TotalTax
Distributable Amount Before Adj	162356	DistributableAmountBeforeAdj
Recoveries Qlfy Distributions	0	RecoveriesQlfyDistributions
Distributable Amount Before Ded	162356	DistributableAmountBeforeDed
Deduction Fr Distributable	$0	DeductionFrDistributableAmount
Distributable Amount As Adjusted	162356	DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

Field	Value	IRS element (for citing)
Expenses And Contributions	161012	ExpensesAndContributions
Program Related Investments Total	0	ProgramRelatedInvestmentsTotal
Amounts Paid Acq Charitable Assets	0	AmountsPaidAcqCharitableAssets
Amounts Set Aside Suitability Test	0	AmountsSetAsideSuitabilityTest
Amounts Set Aside Cash Distri Test	0	AmountsSetAsideCashDistriTest
Qualifying Distributions	161012	QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm	0	OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions	161012	AdjQualifyingDistributions

Undistributed Income UndistributedIncome

Field	Value	IRS element (for citing)
Distributable Amount As Adjusted	162356	DistributableAmountAsAdjusted
Undistributed Income Prior Year	0	UndistributedIncomePriorYear
Total For Prior Years	0	TotalForPriorYears
Excess Distri Carryover Year5	0	ExcessDistriCarryoverYear5
Excess Distri Carryover Year4	0	ExcessDistriCarryoverYear4
Excess Distri Carryover Year3	0	ExcessDistriCarryoverYear3
Excess Distri Carryover Year2	537	ExcessDistriCarryoverYear2
Excess Distri Carryover Year1	1919	ExcessDistriCarryoverYear1
Total Excess Distri Carryover	2456	TotalExcessDistriCarryover
Qualifying Distributions	161012	QualifyingDistributions
Applied To Year1	0	AppliedToYear1
Applied To Prior Years	0	AppliedToPriorYears
Treated As Distri From Corpus	0	TreatedAsDistriFromCorpus
Applied To Current Year	161012	AppliedToCurrentYear
Remaining Distri From Corpus	0	RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus	1344	ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY	1344	ExcessDistriCyovAppliedCY
Total Corpus	1112	TotalCorpus
Prior Year Undistributed Income	0	PriorYearUndistributedIncome
Prior Year Deficiency Or Tax	0	PriorYearDeficiencyOrTax
Taxable Amount1	0	TaxableAmount1
Taxable Amount2	0	TaxableAmount2
Undistributed Income CY	0	UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g3	0	DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year5	0	ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year	1112	ExcessDistriCyovToNextYear
Excess From Year4	0	ExcessFromYear4
Excess From Year3	0	ExcessFromYear3
Excess From Year2	0	ExcessFromYear2
Excess From Year1	1112	ExcessFromYear1

Supplementary Information SupplementaryInformation

Field	Value	IRS element (for citing)
Only Contributes To Preselected	X	OnlyContributesToPreselected

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Chenango Memorial	BusinessNameLine1
Business Name Line2	Hospital	BusinessNameLine2

Recipient US Address RecipientUSAddress

Field	Value	IRS element (for citing)
Address Line1	179 NORTH BROAD STREET	AddressLine1
City	Norwich	City
State	NY	State
ZIP Code	13815	ZIPCode

Field	Value	IRS element (for citing)
Recipient Relationship	N/A	RecipientRelationship
Recipient Foundation Status	EXEMPT	RecipientFoundationStatus
Purpose Of Grant Or Contribution	GENERAL PURPOSES - MEMORY	PurposeOfGrantOrContribution
Amount	$158,667	Amount

Field	Value	IRS element (for citing)
Tot Grant Or Contri Paid During Year	158667	TotGrantOrContriPaidDuringYear

Analysis Income Producing Acty AnalysisIncomeProducingActy

Field	Value	IRS element (for citing)
Fees Contracts From Govt Agencies		FeesContractsFromGovtAgencies
Membership Dues And Assessments		MembershipDuesAndAssessments

Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst

Field	Value	IRS element (for citing)
Exclusion Code	14	ExclusionCode
Exclusion	$10	ExclusionAmount

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

Field	Value	IRS element (for citing)
Exclusion Code	14	ExclusionCode
Exclusion	$84,554	ExclusionAmount

Field	Value	IRS element (for citing)
Net Rental Incm Re Debt Fincd Prop		NetRentalIncmReDebtFincdProp
Net Rntl Incm Re Not Debt Fincd Prop		NetRntlIncmReNotDebtFincdProp
Net Rental Incm Personal Property		NetRentalIncmPersonalProperty
Other Investment Income Part VII		OtherInvestmentIncomePartVII

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

Field	Value	IRS element (for citing)
Exclusion Code	18	ExclusionCode
Exclusion	$45,486	ExclusionAmount

Field	Value	IRS element (for citing)
Net Income Loss From Special Events		NetIncomeLossFromSpecialEvents
Gross Profit Loss Sales Of Invntry		GrossProfitLossSalesOfInvntry

Subtotals Part XVIA SubtotalsPartXVIA

Field	Value	IRS element (for citing)
Exclusion	$130,050	ExclusionAmount

Field	Value	IRS element (for citing)
Total Part XVIA	130050	TotalPartXVIA

Field	Value	IRS element (for citing)
Rln Of Acty To Accom Of Exempt Prps		RlnOfActyToAccomOfExemptPrps

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

Field	Value	IRS element (for citing)
Trnsfr Of Cash To Noncharitable EO	false	TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO	false	TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets	false	SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO	false	PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc	false	RentalOfFacilitiesEtc
Reimbursement Arrangements	false	ReimbursementArrangements
Loans Or Loan Guarantees	false	LoansOrLoanGuarantees
Performance Of Services Etc	false	PerformanceOfServicesEtc
Sharing Of Facilities Etc	false	SharingOfFacilitiesEtc
Relationships Noncharitable E Os	false	RelationshipsNoncharitableEOs

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

Field	Value	IRS element (for citing)
Category	TAX PREPARATION FEES	Category
Amount	$650	Amount

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corp Bonds InvestmentsCorpBonds (4 entries)

Name Of BondNameOfBond	EOY Book ValueEOYBookValue	EOYFMVEOYFMV
BANK OF AMERICA 6.4% 8-15-19	50000	58240
GE CAPITAL 4.4% 4/15/2014	50000	51506
GOLDMAN SACHS 3.625% 2/7/16	50325	53099
COLGATE- PALM 2.45% 11/15/2021	51439	50940

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock (43 entries)

Name Of StockNameOfStock	EOY Book ValueEOYBookValue	EOYFMVEOYFMV
MCDONALDS CORP	24740	29608
UNION PAC CORP	18714	29906
CHURCH & DWIGHT INC	19579	23396
BED BATH & BEYOND INC	23904	28023
APPLE INC	24831	49578
HEINZ H J CO	18508	25656
EMC CORP MASS	27004	24798
CISCO SYSTEMS	10908	14626
CONOCOPHILLIPS	17774	27105
DANAHER CORP	16781	30205
EXXON MOBIL CORP	22867	32530
CVS CAREMARK CORP	32048	38878
GENERAL ELECTRIC CO	31022	35166
GOLDMAN SACHS GROUP	19489	23397
BERKSHIRE HATHAWAY INC CL B	16557	22611
INTL BUSINESS MACHINES	16073	35408
JPMORGAN CHASE	11927	14855
JOHNSON & JOHNSON	29333	37748
LOWES COS	22240	34356
MICROSOFT CORP	31040	33439
THE MOSAIC COMPANY	14154	14306
WAL MART STORES INC	20626	27388
ORACLE CORP	36406	37567
CHEVRON CORP	27890	32676
NOVARTIS A G	24661	30063
T ROWE PRICE GROUP INC	18611	22162
PROCTER & GAMBLE CO	12709	28435
PRUDENTIAL FINL	38247	29200
SCHLUMBERGER LTD	19021	26212
DISNEY WALT CO	13588	29650
TARGET CORP	13116	27928
PFIZER INC	21186	30188
XYLEM INC	21138	20477
UNITED TECHNOLOGIES	22990	30458
US BANCORP	12426	13436
COVIDIEN PLC	23353	30257
WELLS FARGO & CO	11616	12946
GOOGLE INC CL A	25584	43680
INTEL	25300	28123
QUALCOMM INC	22470	27445
UNITEDHEALTH GROUP INC	28046	29177
HONEYWELL INTERNATIONAL INC	27925	35791
MONSANTO CO	12834	14788

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

Field	Value	IRS element (for citing)
US Govt Securities EOY Book Value	469066	USGovtSecuritiesEOYBookValue
US Govt Securities EOYFMV	505788	USGovtSecuritiesEOYFMV

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOther (17 entries)

Category Or ItemCategoryOrItem	Listed At Cost Or FMVListedAtCostOrFMV	Book ValueBookValue	EOYFMVEOYFMV
UTILITIES SELECT SECTOR SPDR	AT COST	25843	29012
ROYCE PENNSYLVANIA MUT FD	AT COST	127785	145234
ISHARES TR NASDAQ BIO INDEX	AT COST	21293	37264
HARTFORD MIDCAP FD-Y	AT COST	128225	142692
CRM MID CAP VALUE FD	AT COST	112928	142283
KBW REGL BKG ETF	AT COST	10862	14623
ENERGY SELECT SECTOR SPDR	AT COST	26286	28631
FINANCIAL SELECT SECTOR SPDR	AT COST	24459	28224
MARKET VECTORS AGRI	AT COST	22605	26750
DODGE & COX INCOME FD	AT COST	142965	150802
FEDERATED TOTAL RETURN BOND	AT COST	148734	149918
VANGUARD GNMA FD	AT COST	149518	148960
VANGUARD REIT ETF	AT COST	19013	21159
LAZARD EMERGING MKTS	AT COST	144379	149111
DODGE & COX INTL STOCK FD	AT COST	134161	151664
ISHARES DJ US TELCOM	AT COST	12045	13268
TEMPLETON GLOBAL BD FD	AT COST	75000	75397

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses

Field	Value	IRS element (for citing)
Description	NYS EPTL FILING FEE	Description
Revenue And Expenses Per Books	250	RevenueAndExpensesPerBooks
Net Investment Income	0	NetInvestmentIncome
Disbursements Charitable Prps	250	DisbursementsCharitablePrps

Taxes Schedule TaxesSchedule

Taxes Taxes (3 entries)

CategoryCategory	AmountAmount	Net Investment IncomeNetInvestmentIncome
FOREIGN TAX W/H	$464	1462
ESTIMATED EXCISE TAXES PAID	$2,188	0
EXCISE TAX BALANCE DUE	$1,072	0