DORIS AND NORMA VAN GORP FOUNDATION: Form 990PF, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- DORIS AND NORMA VAN GORP FOUNDATION (EIN 20-1285681)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-06-12
- IRS object ID
- 201321639349100202
- 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
- General Explanation Attachment
- Investments Other Schedule2
- Legal Fees Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-06-12T08:18:06-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381910111 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UHY ADVISORS MI INC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12900 HALL ROAD STE 510 | AddressLine1 |
| City | STERLING HEIGHTS | City |
| State | MI | State |
| ZIP Code | 48313 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201285681 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DORIS AND NORMA VAN GORP FOUNDATION | BusinessNameLine1 |
| Business Name Line2 | C/O PAUL ARSLANIAN | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DORI | NameControl |
| Phone | 2485407500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 E LONG LAKE ROAD NO 100 | AddressLine1 |
| City | BLOOMFIELD HILLS | City |
| State | MI | State |
| ZIP Code | 48304 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL ARSLANIAN | Name |
| Title | PRESIDENT | Title |
| Phone | 2485407500 | Phone |
| Date Signed | 2013-05-20 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TODD BENSLEY | Name |
| PTIN | P00052452 | PTIN |
| Phone | 5862548141 | Phone |
| Date Prepared | 2013-05-20 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exempt PF | X | ExemptPF |
| FMV Assets EOY | 1659483 | FMVAssetsEOY |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
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 | 677 | InterestOnSavingsRevAndExpnss |
| Interest On Savings Net Invst Incm | 677 | InterestOnSavingsNetInvstIncm |
| Dividends Rev And Expnss | 38139 | DividendsRevAndExpnss |
| Dividends Net Invst Incm | 38139 | DividendsNetInvstIncm |
| Net Gain Sale Assets Rev And Expnss | 4850 | NetGainSaleAssetsRevAndExpnss |
| Gross Sales Price | 19779 | GrossSalesPrice |
| Capital Gain Net Incm Net Invst Incm | 4850 | CapitalGainNetIncmNetInvstIncm |
| Total Revenue And Expenses | 43666 | TotalRevenueAndExpenses |
| Total Net Investment Income | 43666 | TotalNetInvestmentIncome |
| Comp Ofcr Dir Trst Rev And Expnss | 3535 | CompOfcrDirTrstRevAndExpnss |
| Comp Ofcr Dir Trst Net Invst Incm | 0 | CompOfcrDirTrstNetInvstIncm |
| Comp Ofcr Dir Trst Dsbrs Chrtbl Prps | 3535 | CompOfcrDirTrstDsbrsChrtblPrps |
| Legal Fees Rev And Expnss | 7212 | LegalFeesRevAndExpnss |
| Legal Fees Net Invst Incm | 0 | LegalFeesNetInvstIncm |
| Legal Fees Dsbrs Chrtbl Prps | 7212 | LegalFeesDsbrsChrtblPrps |
| Accounting Fees Rev And Expnss | 3200 | AccountingFeesRevAndExpnss |
| Accounting Fees Net Invst Incm | 0 | AccountingFeesNetInvstIncm |
| Accounting Fees Dsbrs Chrtbl Prps | 3200 | AccountingFeesDsbrsChrtblPrps |
| Other Prof Fees Rev And Expnss | 5830 | OtherProfFeesRevAndExpnss |
| Other Prof Fees Net Invst Incm | 5830 | OtherProfFeesNetInvstIncm |
| Other Prof Fees Dsbrs Chrtbl Prps | 0 | OtherProfFeesDsbrsChrtblPrps |
| Taxes Rev And Expnss | 400 | TaxesRevAndExpnss |
| Taxes Net Invst Incm | 400 | TaxesNetInvstIncm |
| Taxes Dsbrs Chrtbl Prps | 0 | TaxesDsbrsChrtblPrps |
| Other Expenses Rev And Expnss | 70 | OtherExpensesRevAndExpnss |
| Other Expenses Net Invst Incm | 0 | OtherExpensesNetInvstIncm |
| Other Expenses Dsbrs Chrtbl Prps | 70 | OtherExpensesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 20247 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 6230 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 14017 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 66000 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 66000 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 86247 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 6230 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 80017 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | -42581 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 37436 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Savings And Temp Cash Invst BOY | 251526 | SavingsAndTempCashInvstBOY |
| Savings And Temp Cash Invst EOY | 201296 | SavingsAndTempCashInvstEOY |
| Savings And Temp Cash Invst EOYFMV | 201296 | SavingsAndTempCashInvstEOYFMV |
| Investments Other BOY | 1288402 | InvestmentsOtherBOY |
| Investments Other EOY | 1296051 | InvestmentsOtherEOY |
| Investments Other EOYFMV | 1458187 | InvestmentsOtherEOYFMV |
| Total Assets BOY | 1539928 | TotalAssetsBOY |
| Total Assets EOY | 1497347 | TotalAssetsEOY |
| Total Assets EOYFMV | 1659483 | TotalAssetsEOYFMV |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Follow SFAS117 | X | OrgThatFollowSFAS117 |
| Unrestricted BOY | 1539928 | UnrestrictedBOY |
| Unrestricted EOY | 1497347 | UnrestrictedEOY |
| Total Net Assets BOY | 1539928 | TotalNetAssetsBOY |
| Total Net Assets EOY | 1497347 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 1539928 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 1497347 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 1539928 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | -42581 | ExcessOfRevenueOverExpenses |
| Other Increases | 0 | OtherIncreases |
| Subtotal | 1497347 | Subtotal |
| Other Decreases | 0 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 1497347 | TotalNetAssetsFundBalancesEOY |
Capital Gains And Losses CapitalGainsAndLosses
Capital Gains And Losses Info CapitalGainsAndLossesInfo (2 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 |
|---|---|---|---|---|---|---|---|
| AMERIPRISE | P | 2006-01-17 | 2012-12-05 | 15582 | 14929 | 653 | 653 |
| CAPITAL GAINS DIVIDENDS | P | 4197 | 4197 | 4197 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | 4850 | CapitalGainNetIncome |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | 0 | LiableFor4942Tax |
| Qualifying Distributions Year1 | 81416 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 1647932 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.049405 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 75339 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 1606730 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.046890 | DistributionRatioYear2 |
| Qualifying Distributions Year3 | 79927 | QualifyingDistributionsYear3 |
| Noncharitable Assets Year3 | 1481436 | NoncharitableAssetsYear3 |
| Distribution Ratio Year3 | 0.053952 | DistributionRatioYear3 |
| Qualifying Distributions Year4 | 92935 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 1732642 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.053638 | DistributionRatioYear4 |
| Qualifying Distributions Year5 | 89729 | QualifyingDistributionsYear5 |
| Noncharitable Assets Year5 | 1949615 | NoncharitableAssetsYear5 |
| Distribution Ratio Year5 | 0.046024 | DistributionRatioYear5 |
| Total Distribution Ratio | 0.249909 | TotalDistributionRatio |
| Average Distribution Ratio | 0.049982 | AverageDistributionRatio |
| Net Noncharitable Assets | 1633751 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 81658 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 374 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 82032 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 80017 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | 749 | InvestmentIncomeExciseTax |
| Tax Under Section511 | 0 | TaxUnderSection511 |
| Subtotal | 749 | Subtotal |
| Subtitle A Tax | 0 | SubtitleATax |
| Tax Based On Investment Income | 749 | TaxBasedOnInvestmentIncome |
| Est Tax Payments And Overpayment | 69 | EstTaxPaymentsAndOverpayment |
| Tax Paid With Extension | 880 | TaxPaidWithExtension |
| Total Credits And Payments | 949 | TotalCreditsAndPayments |
| Overpayment | 200 | Overpayment |
| Amount Credited To Next Year | 200 | AmountCreditedToNextYear |
| Amount To Be Refunded | 0 | AmountToBeRefunded |
Statements Regarding Activities StatementsRegardingActivities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Activities | 0 | LegislativePoliticalActivities |
| More Than100 Spent | 0 | MoreThan100Spent |
| Form1120 POL Filed | 0 | Form1120POLFiled |
| Sect4955 Tax On Organization | 0 | Sect4955TaxOnOrganization |
| Sect4955 Tax On Managers | 0 | Sect4955TaxOnManagers |
| Reimbursement Of Tax | 0 | ReimbursementOfTax |
| Activities Not Prev Reported | 0 | ActivitiesNotPrevReported |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylaws |
| Unrelated Bus Income Over1000 | 0 | UnrelatedBusIncomeOver1000 |
| Termination Etc | 0 | TerminationEtc |
| Requirements Of Sect508e | 1 | RequirementsOfSect508e |
| At Least5000 In Assets | 1 | AtLeast5000InAssets |
| States Filed With | MI | StatesFiledWith |
| Form990 PF Filed With AG | 1 | Form990PFFiledWithAG |
| Private Operating Foundation | 0 | PrivateOperatingFoundation |
| New Substantial Contributors | 0 | NewSubstantialContributors |
| Interest In Controlled Entity | 0 | InterestInControlledEntity |
| Applicable Insurance Contract | 0 | ApplicableInsuranceContract |
| Comply With Public Inspection Rqr | 1 | ComplyWithPublicInspectionRqr |
| Website Address | N/A | WebsiteAddress |
| Books In Care Of Person Name | PAUL ARSLANIAN | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 2485407500 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 E LONG LAKE ROAD SUITE 100 | AddressLine1 |
| City | BLOOMFIELD HILLS | City |
| State | MI | State |
| ZIP Code | 48304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Bank | 0 | ForeignBank |
Statements Regarding Acty4720 StatementsRegardingActy4720
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exchange With Dsqfly Person | 0 | SaleOrExchangeWithDsqflyPerson |
| Borrow Or Lend With Dsqfly Person | 0 | BorrowOrLendWithDsqflyPerson |
| Furnished Goods With Dsqfly Person | 0 | FurnishedGoodsWithDsqflyPerson |
| Pay Compensation To Dsqfly Person | 1 | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | 0 | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | 0 | PaymentToGovernmentOffical |
| Acts Fail To Qualify As Exceptions | 0 | ActsFailToQualifyAsExceptions |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActs |
| Undistributed Income Prior Years | 0 | UndistributedIncomePriorYears |
| Business Holdings | 0 | BusinessHoldings |
| Jeopardy Investments | 0 | JeopardyInvestments |
| Uncorrected Jeopardy Investments | 0 | UncorrectedJeopardyInvestments |
| Influence Legislation | 0 | InfluenceLegislation |
| Influence Election | 0 | InfluenceElection |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Noncharitable Purpose | 0 | NoncharitablePurpose |
| Rcv Funds To Pay Prsnl Bnft Contract | 0 | RcvFundsToPayPrsnlBnftContract |
| Pay Premiums Prsnl Bnft Contract | 0 | PayPremiumsPrsnlBnftContract |
| Prohibited Tax Shelter Transactn | 0 | ProhibitedTaxShelterTransactn |
Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo
Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|---|
| PAUL ARSLANIAN | ||||||||
| 74 EAST LONG LAKE ROAD SUITE 100 | BLOOMFIELD HILLS | MI | 48304 | PRESIDENT, DIRECTOR | 0.50 | 0 | 0 | 0 |
| MARY K ROBERTSON | ||||||||
| 74 EAST LONG LAKE ROAD SUITE 100 | BLOOMFIELD HILLS | MI | 48304 | TREASURER, SECRETARY, DIRE | 1.50 | 0 | 0 | 0 |
| DAWN ARSLANIAN | ||||||||
| 74 EAST LONG LAKE ROAD SUITE 100 | BLOOMFIELD HILLS | MI | 48304 | DIRECTOR | 0.50 | 0 | 0 | 0 |
| 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 |
Sum Of Program Related Investments SumOfProgramRelatedInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Minimum Investment Return MinimumInvestmentReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Avg Monthly FMV Of Securities | 1411062 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 247568 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 1658630 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Acquisition Indebtedness | 0 | AcquisitionIndebtedness |
| Adj Total FMV Of Unused Assets | 1658630 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 24879 | CashDeemedCharitable |
| Net Noncharitable Assets | 1633751 | NetNoncharitableAssets |
| Minimum Investment Return | 81688 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 81688 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 749 | TaxBasedOnInvestmentIncome |
| Total Tax | 749 | TotalTax |
| Distributable Amount Before Adj | 80939 | DistributableAmountBeforeAdj |
| Recoveries Qlfy Distributions | 0 | RecoveriesQlfyDistributions |
| Distributable Amount Before Ded | 80939 | DistributableAmountBeforeDed |
| Deduction Fr Distributable | $0 | DeductionFrDistributableAmount |
| Distributable Amount As Adjusted | 80939 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 80017 | ExpensesAndContributions |
| Program Related Investments Total | 0 | ProgramRelatedInvestmentsTotal |
| Qualifying Distributions | 80017 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 0 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 80017 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 80939 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 65756 | UndistributedIncomePriorYear |
| Total For Prior Years | 0 | TotalForPriorYears |
| Total Excess Distri Carryover | 0 | TotalExcessDistriCarryover |
| Qualifying Distributions | 80017 | QualifyingDistributions |
| Applied To Year1 | 65756 | AppliedToYear1 |
| Applied To Prior Years | 0 | AppliedToPriorYears |
| Treated As Distri From Corpus | 0 | TreatedAsDistriFromCorpus |
| Applied To Current Year | 14261 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 0 | RemainingDistriFromCorpus |
| Excess Distri Cyov App CY Corpus | 0 | ExcessDistriCyovAppCYCorpus |
| Excess Distri Cyov Applied CY | 0 | ExcessDistriCyovAppliedCY |
| Total Corpus | 0 | 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 | 66678 | UndistributedIncomeCY |
| Distri From Corpus170b1 E Or4942g3 | 0 | DistriFromCorpus170b1EOr4942g3 |
| Excess Distri Cyov From Year5 | 0 | ExcessDistriCyovFromYear5 |
| Excess Distri Cyov To Next Year | 0 | ExcessDistriCyovToNextYear |
Supplementary Information SupplementaryInformation
Appication Submission Info AppicationSubmissionInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Name | PAUL ARSLANIAN | RecipientName |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 E LONG LAKE ROAD SUITE 100 | AddressLine1 |
| City | BLOOMFIELD HILLS | City |
| State | MI | State |
| ZIP Code | 48304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone Number | 2485407500 | RecipientPhoneNumber |
| Form And Info And Materials | WRITTEN APPLICATION | FormAndInfoAndMaterials |
| Submission Deadlines | NONE | SubmissionDeadlines |
| Restrictions On Awards | NONE | RestrictionsOnAwards |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DR GARY BURNSTEIN COMMUNITY HEALTH CLINIC | BusinessNameLine1 |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 90 WEST UNIVERSITY DRIVE | AddressLine1 |
| City | PONTIAC | City |
| State | MI | State |
| ZIP Code | 48342 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | NONE | RecipientRelationship |
| Recipient Foundation Status | 501(C)(3) | RecipientFoundationStatus |
| Purpose Of Grant Or Contribution | FUNDING ENDOWMENT | PurposeOfGrantOrContribution |
| Amount | $66,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 66000 | TotGrantOrContriPaidDuringYear |
| Tot Grant Or Contri Approved Future | 0 | TotGrantOrContriApprovedFuture |
Analysis Income Producing Acty AnalysisIncomeProducingActy
Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $677 | ExclusionAmount |
Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $38,139 | ExclusionAmount |
Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 18 | ExclusionCode |
| Exclusion | $4,850 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Income | $0 | UnrelatedBusinessIncomeAmount |
| Exclusion | $43,666 | ExclusionAmount |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 43666 | TotalPartXVIA |
Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Noncharitable EO | 0 | TrnsfrOfCashToNoncharitableEO |
| Trnsfr Oth Assets Noncharitable EO | 0 | TrnsfrOthAssetsNoncharitableEO |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssets |
| Purchase Assets Noncharitable EO | 0 | PurchaseAssetsNoncharitableEO |
| Rental Of Facilities Etc | 0 | RentalOfFacilitiesEtc |
| Reimbursement Arrangements | 0 | ReimbursementArrangements |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuarantees |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtc |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtc |
| Relationships Noncharitable E Os | 0 | RelationshipsNoncharitableEOs |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees AccountingFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | Category |
| Amount | $3,200 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 3200 | DisbursementsCharitablePrps |
General Explanation Attachment GeneralExplanationAttachment
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PAGE 6 - PART VIII - ITEM 1THE AMOUNT OF ZERO (0) IS LISTED IN COLUMN (C) FORTHE FIRST TWO DIRECTORS SINCE APPROVED COMPENSATION FORSERVICES THAT THEY RENDERED TO THE ORGANIZATION DURINGCALENDAR YEAR 2012, IN THE AMOUNT OF $2,022, WAS PAIDTO THE ARSLANIAN LAW FIRM, P.C. ("THE RECIPIENT"), EIN 38-3129436, WHICHIS THE EMPLOYER OF SUCH TWO DIRECTORS.ADDITIONAL SERVICES RENDERED BY SUCH TWO DIRECTORS INCALENDAR YEAR 2011 AMOUNTED TO $1,513 AND WERE PAID TO THERECIPIENT IN CALENDAR YEAR 2012. NEITHER THE ORGANIZATIONNOR THE RECIPIENT PAID THESE AMOUNTS TO SUCH TWO DIRECTORS.DIRECTOR DAWN ARSLANIAN RECEIVED NO COMPENSATION. | Explanation |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOther (2 entries)
| Category Or ItemCategoryOrItem | Listed At Cost Or FMVListedAtCostOrFMV | Book ValueBookValue | EOYFMVEOYFMV |
|---|---|---|---|
| AMERIPRISE FINANCIAL | AT COST | 709712 | 725414 |
| WELLS FARGO ADVISORS | AT COST | 586339 | 732773 |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL FEES | Category |
| Amount | $7,212 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 7212 | DisbursementsCharitablePrps |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | Revenue And Expenses Per BooksRevenueAndExpensesPerBooks | Net Investment IncomeNetInvestmentIncome | Disbursements Charitable PrpsDisbursementsCharitablePrps |
|---|---|---|---|
| STATE FILING FEES | 20 | 0 | 20 |
| BANK FEES | 50 | 0 | 50 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees OtherProfessionalFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT ADVISOR FEES | Category |
| Amount | $5,830 | Amount |
| Net Investment Income | 5830 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Taxes Schedule TaxesSchedule
Taxes Taxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | FEDERAL TAXES | Category |
| Amount | $400 | Amount |
| Net Investment Income | 400 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |