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JOHN AND GAYE PATTON CHARITABLE FOUNDATION INC: Form 990PF, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
JOHN AND GAYE PATTON CHARITABLE FOUNDATION INC (EIN 27-1890638)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-03-09
IRS object ID
201200699349100700
Schema version
2011v1.2
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)
Timestamp2012-03-09T10:51:14-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN593584250EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SUSAN M SURBER PA CPABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1124 E MIRACLE STRIP PARKWAY SUITE 2AddressLine1
CityMARY ESTHERCity
StateFLState
ZIP Code325691990ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN271890638EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE JOHN AND GAYE PATTON CHARITABLEBusinessNameLine1
Business Name Line2FOUNDATION INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlJOHNNameControl
Phone8502678467Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1205 VILLAGE BEACH ROAD WESTAddressLine1
CitySANTA ROSA BEACHCity
StateFLState
ZIP Code32459ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCONNIE MONSOURName
TitleDIRECTOR/PRESIDENTTitle
Phone4787491724Phone
Date Signed2012-03-08DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSUSAN M SURBERName
PTINP00237217PTIN
Phone8502444108Phone
Date Prepared2012-03-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY302835FMVAssetsEOY
Method Of Accounting CashXMethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Not Required To Attach Schedule BXNotRequiredToAttachScheduleB
Dividends Rev And Expnss8153DividendsRevAndExpnss
Dividends Net Invst Incm8153DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss8427NetGainSaleAssetsRevAndExpnss
Gross Sales Price317778GrossSalesPrice
Capital Gain Net Incm Net Invst Incm154275CapitalGainNetIncmNetInvstIncm
Total Revenue And Expenses16580TotalRevenueAndExpenses
Total Net Investment Income162428TotalNetInvestmentIncome
Total Adjusted Net Income0TotalAdjustedNetIncome
Comp Ofcr Dir Trst Rev And Expnss1500CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm250CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Adj Net Incm0CompOfcrDirTrstAdjNetIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps1250CompOfcrDirTrstDsbrsChrtblPrps
Accounting Fees Rev And Expnss485AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm0AccountingFeesNetInvstIncm
Accounting Fees Adj Net Incm0AccountingFeesAdjNetIncm
Accounting Fees Dsbrs Chrtbl Prps0AccountingFeesDsbrsChrtblPrps
Other Prof Fees Rev And Expnss1524OtherProfFeesRevAndExpnss
Other Prof Fees Net Invst Incm1524OtherProfFeesNetInvstIncm
Other Prof Fees Adj Net Incm0OtherProfFeesAdjNetIncm
Other Prof Fees Dsbrs Chrtbl Prps0OtherProfFeesDsbrsChrtblPrps
Interest Rev And Expnss7InterestRevAndExpnss
Interest Net Invst Incm0InterestNetInvstIncm
Interest Adj Net Incm0InterestAdjNetIncm
Interest Dsbrs Chrtbl Prps0InterestDsbrsChrtblPrps
Taxes Rev And Expnss1578TaxesRevAndExpnss
Taxes Net Invst Incm1578TaxesNetInvstIncm
Taxes Adj Net Incm0TaxesAdjNetIncm
Taxes Dsbrs Chrtbl Prps0TaxesDsbrsChrtblPrps
Deprec And Depletion Rev And Expnss138DeprecAndDepletionRevAndExpnss
Deprec And Depletion Net Invst Incm138DeprecAndDepletionNetInvstIncm
Deprec And Depletion Adj Net Incm0DeprecAndDepletionAdjNetIncm
Trav Conf Meeting Rev And Expnss1248TravConfMeetingRevAndExpnss
Trav Conf Meeting Net Invst Incm312TravConfMeetingNetInvstIncm
Trav Conf Meeting Adj Net Incm0TravConfMeetingAdjNetIncm
Trav Conf Meeting Dsbrs Chrtbl Prps936TravConfMeetingDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss6480TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm3802TotOprExpensesNetInvstIncm
Tot Opr Expenses Adj Net Incm0TotOprExpensesAdjNetIncm
Tot Opr Expenses Dsbrs Chrtbl Prps2186TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss2600ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps2600ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss9080TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm3802TotalExpensesNetInvstIncm
Total Expenses Adj Net Incm0TotalExpensesAdjNetIncm
Total Expenses Dsbrs Chrtbl Prps4786TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses7500ExcessOfRevenueOverExpenses
Net Investment Income158626NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Savings And Temp Cash Invst BOY6981SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY12689SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV12689SavingsAndTempCashInvstEOYFMV
Investments Other BOY291734InvestmentsOtherBOY
Investments Other EOY299893InvestmentsOtherEOY
Investments Other EOYFMV289457InvestmentsOtherEOYFMV
Land Building And Equipment Basis827LandBuildingAndEquipmentBasis
Accum Deprec Land Bldg And Equip138AccumDeprecLandBldgAndEquip
Land Building And Equipment BOY0LandBuildingAndEquipmentBOY
Land Building And Equipment EOY689LandBuildingAndEquipmentEOY
Land Building And Equipment EOYFMV689LandBuildingAndEquipmentEOYFMV
Total Assets BOY298715TotalAssetsBOY
Total Assets EOY313271TotalAssetsEOY
Total Assets EOYFMV302835TotalAssetsEOYFMV
Loans From Officers BOY7961LoansFromOfficersBOY
Loans From Officers EOY7961LoansFromOfficersEOY
Other Liabilities BOY1472OtherLiabilitiesBOY
Other Liabilities EOY1578OtherLiabilitiesEOY
Total Liabilities BOY9433TotalLiabilitiesBOY
Total Liabilities EOY9539TotalLiabilitiesEOY
Org That Do Not Follow SFAS117XOrgThatDoNotFollowSFAS117
Capital Stock BOY0CapitalStockBOY
Capital Stock EOY0CapitalStockEOY
Paid In Or Capital Surplus BOY0PaidInOrCapitalSurplusBOY
Paid In Or Capital Surplus EOY0PaidInOrCapitalSurplusEOY
Retained Earnings BOY289282RetainedEarningsBOY
Retained Earnings EOY303732RetainedEarningsEOY
Total Net Assets BOY289282TotalNetAssetsBOY
Total Net Assets EOY303732TotalNetAssetsEOY
Total Liabilities Net Assets BOY298715TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY313271TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY289282TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses7500ExcessOfRevenueOverExpenses
Other Increases6950OtherIncreases
Subtotal303732Subtotal
Other Decreases0OtherDecreases
Total Net Assets Fund Balances EOY303732TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (3 entries)

Description Of AssetDescriptionOfAssetHow AcquiredHowAcquiredGross Sales PriceGrossSalesPriceCost Or Other BasisCostOrOtherBasisGain Or LossGainOrLossGains Minus Excess Or LossesGainsMinusExcessOrLosses
PUBLICLY TRADED SECURITIESD20093442301158633158633
PUBLICLY TRADED SECURITIESP114510121202-6692-6692
CAPITAL GAINS DIVIDENDSP233423342334
FieldValueIRS element (for citing)
Capital Gain Net Income154275CapitalGainNetIncome

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 Tax0LiableFor4942Tax
Qualifying Distributions Year10QualifyingDistributionsYear1
Noncharitable Assets Year113037NoncharitableAssetsYear1
Distribution Ratio Year10.0DistributionRatioYear1
Total Distribution Ratio0.0TotalDistributionRatio
Average Distribution Ratio0.0AverageDistributionRatio
Net Noncharitable Assets301950NetNoncharitableAssets
Adjusted Noncharitable Assets0AdjustedNoncharitableAssets
One Percent Net Investment Income1586OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One1586AdjNonchrtblAssetsAndOnePct
Qualifying Distributions5613QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eXDomesticOrgMeetingSect4940e
Investment Income Excise Tax1586InvestmentIncomeExciseTax
Tax Under Section5110TaxUnderSection511
Subtotal1586Subtotal
Subtitle A Tax0SubtitleATax
Tax Based On Investment Income1586TaxBasedOnInvestmentIncome
Total Credits And Payments0TotalCreditsAndPayments
Form2220 AttachedXForm2220Attached
Tax Due1586TaxDue

Statements Regarding Activities StatementsRegardingActivities

FieldValueIRS element (for citing)
Legislative Political Activities0LegislativePoliticalActivities
More Than100 Spent0MoreThan100Spent
Form1120 POL Filed0Form1120POLFiled
Sect4955 Tax On Organization0Sect4955TaxOnOrganization
Sect4955 Tax On Managers0Sect4955TaxOnManagers
Reimbursement Of Tax0ReimbursementOfTax
Activities Not Prev Reported0ActivitiesNotPrevReported
Changes To Articles Or Bylaws0ChangesToArticlesOrBylaws
Unrelated Bus Income Over10000UnrelatedBusIncomeOver1000
Termination Etc0TerminationEtc
Requirements Of Sect508e0RequirementsOfSect508e
At Least5000 In Assets1AtLeast5000InAssets
Form990 PF Filed With AG0Form990PFFiledWithAG
Private Operating Foundation0PrivateOperatingFoundation
New Substantial Contributors0NewSubstantialContributors
Interest In Controlled Entity0InterestInControlledEntity
Applicable Insurance Contract0ApplicableInsuranceContract
Comply With Public Inspection Rqr1ComplyWithPublicInspectionRqr
Website AddressN/AWebsiteAddress

Books In Care Of Business Name BooksInCareOfBusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN AND GAYE PATTONBusinessNameLine1
FieldValueIRS element (for citing)
Books In Care Of Phone Number8502678467BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line1205 VILLAGE BEACH ROAD WESTAddressLine1
CitySANTA ROSA BEACHCity
StateFLState
ZIP Code32459ZIPCode
FieldValueIRS element (for citing)
Foreign Bank0ForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

FieldValueIRS element (for citing)
Sale Or Exchange With Dsqfly Person0SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person0BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person0FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person0PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person0TransferAssetsToDsqflyPerson
Payment To Government Offical0PaymentToGovernmentOffical
Uncorrected Prior Acts0UncorrectedPriorActs
Undistributed Income Prior Years0UndistributedIncomePriorYears
Business Holdings0BusinessHoldings
Jeopardy Investments0JeopardyInvestments
Uncorrected Jeopardy Investments0UncorrectedJeopardyInvestments
Influence Legislation0InfluenceLegislation
Influence Election0InfluenceElection
Grants To Individuals0GrantsToIndividuals
Grants To Organizations0GrantsToOrganizations
Noncharitable Purpose0NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract0RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract0PayPremiumsPrsnlBnftContract
Prohibited Tax Shelter Transactn0ProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
CONNIE K MONSOUR
205 VILLAGE BEACH ROAD WESTSANTA ROSA BEACHFL32459DIRECTOR/PRESIDENT10.00150000
GAYE S PATTON
205 VILLAGE BEACH ROAD WESTSANTA ROSA BEACHFL32459DIRECTOR/VICE-PRESIDENT3.00000
JOHN M PATTON MD
205 VILLAGE BEACH ROAD WESTSANTA ROSA BEACHFL32459DIRECTOR/SECRETARY-TREASUR10.00000
FieldValueIRS element (for citing)
Comp Of Highest Paid Empl NONENONECompOfHighestPaidEmplNONE
Tot Number Of Oth Empl Paid Over50k0TotNumberOfOthEmplPaidOver50k
Comp Of Hghst Paid Cntrct NONENONECompOfHghstPaidCntrctNONE
Tot Number Of Cntrct Paid Over50k0TotNumberOfCntrctPaidOver50k

Sum Of Program Related Investments SumOfProgramRelatedInvestments

FieldValueIRS element (for citing)
Total0Total

Minimum Investment Return MinimumInvestmentReturn

FieldValueIRS element (for citing)
Avg Monthly FMV Of Securities301415AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances5133AvgMonthlyCashBalances
FMV All Other Noncharitable Assets0FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets306548TotalFMVOfUnusedAssets
Reduction Claimed0ReductionClaimed
Acquisition Indebtedness0AcquisitionIndebtedness
Adj Total FMV Of Unused Assets306548AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable4598CashDeemedCharitable
Net Noncharitable Assets301950NetNoncharitableAssets
Minimum Investment Return15098MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return15098MinimumInvestmentReturn
Tax Based On Investment Income1586TaxBasedOnInvestmentIncome
Total Tax1586TotalTax
Distributable Amount Before Adj13512DistributableAmountBeforeAdj
Recoveries Qlfy Distributions0RecoveriesQlfyDistributions
Distributable Amount Before Ded13512DistributableAmountBeforeDed
Deduction Fr Distributable$0DeductionFrDistributableAmount
Distributable Amount As Adjusted13512DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions4786ExpensesAndContributions
Program Related Investments Total0ProgramRelatedInvestmentsTotal
Amounts Paid Acq Charitable Assets827AmountsPaidAcqCharitableAssets
Qualifying Distributions5613QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm1586OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions4027AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted13512DistributableAmountAsAdjusted
Undistributed Income Prior Year0UndistributedIncomePriorYear
Total For Prior Years0TotalForPriorYears
Total Excess Distri Carryover0TotalExcessDistriCarryover
Qualifying Distributions5613QualifyingDistributions
Applied To Year10AppliedToYear1
Applied To Prior Years0AppliedToPriorYears
Treated As Distri From Corpus0TreatedAsDistriFromCorpus
Applied To Current Year5613AppliedToCurrentYear
Remaining Distri From Corpus0RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus0ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY0ExcessDistriCyovAppliedCY
Total Corpus0TotalCorpus
Prior Year Undistributed Income0PriorYearUndistributedIncome
Prior Year Deficiency Or Tax0PriorYearDeficiencyOrTax
Taxable Amount10TaxableAmount1
Taxable Amount20TaxableAmount2
Undistributed Income CY7899UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g30DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year50ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year0ExcessDistriCyovToNextYear

Supplementary Information SupplementaryInformation

FieldValueIRS element (for citing)
Contributing ManagerGAYE S PATTONContributingManager
Contributing ManagerJOHN M PATTON MDContributingManager

Appication Submission Info AppicationSubmissionInfo

FieldValueIRS element (for citing)
Recipient NameTHE JOHN AND GAYE PATTON CHARITABLERecipientName

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1205 VILLAGE BEACH ROAD WESTAddressLine1
CitySANTA ROSA BEACHCity
StateFLState
ZIP Code32459ZIPCode
FieldValueIRS element (for citing)
Recipient Phone Number4787491724RecipientPhoneNumber
Form And Info And MaterialsNO SPECIFIC FORMAT OR FORMAL GRANT PROPOSAL PROCESS HAS BEEN ESTABLISHED.FormAndInfoAndMaterials
Submission DeadlinesN/ASubmissionDeadlines
Restrictions On AwardsN/ARestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (2 entries)

Address Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient Foundation StatusRecipientFoundationStatusPurpose Of Grant Or ContributionPurposeOfGrantOrContributionAmountAmount
ALAQUA ANIMAL REFUGE INC
959 WHITFIELD ROADFREEPORTFL32439PUBLIC CHARITY 501(CANIMAL RESCUE$1,600
COFFEEN LAND TRUST INC
146 COFFEEN HILL ROADSANTA ROSA BEACHFL32459PUBLIC CHARITY 501(CMAINTENANCE/SUPPORT OF NATURE PRESERVE$1,000
FieldValueIRS element (for citing)
Tot Grant Or Contri Paid During Year2600TotGrantOrContriPaidDuringYear
Tot Grant Or Contri Approved Future0TotGrantOrContriApprovedFuture

Analysis Income Producing Acty AnalysisIncomeProducingActy

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

FieldValueIRS element (for citing)
Exclusion Code01ExclusionCode
Exclusion$8,153ExclusionAmount

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

FieldValueIRS element (for citing)
Exclusion Code01ExclusionCode
Exclusion$8,427ExclusionAmount

Subtotals Part XVIA SubtotalsPartXVIA

FieldValueIRS element (for citing)
Unrelated Business Income$0UnrelatedBusinessIncomeAmount
Exclusion$16,580ExclusionAmount
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Part XVIA16580TotalPartXVIA

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

FieldValueIRS element (for citing)
Trnsfr Of Cash To Noncharitable EO0TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO0TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO0PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc0RentalOfFacilitiesEtc
Reimbursement Arrangements0ReimbursementArrangements
Loans Or Loan Guarantees0LoansOrLoanGuarantees
Performance Of Services Etc0PerformanceOfServicesEtc
Sharing Of Facilities Etc0SharingOfFacilitiesEtc
Relationships Noncharitable E Os0RelationshipsNoncharitableEOs

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategory
Amount$485Amount
Net Investment Income0NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps0DisbursementsCharitablePrps

Depreciation Schedule DepreciationSchedule

Depreciation Depreciation

FieldValueIRS element (for citing)
Description Of PropertyCOMPUTERDescriptionOfProperty
Date Acquired2011-03-11DateAcquired
Cost Or Other Basis827CostOrOtherBasis
Computation MethodSLComputationMethod
Life5.000000000000Life
Current Year Expense138CurrentYearExpense
Net Investment Income0NetInvestmentIncome
Adjusted Net Income138AdjustedNetIncome

Expln Of Non Filing With AG Stmt ExplnOfNonFilingWithAGStmt

FieldValueIRS element (for citing)
StatementTHE ORGANIZATION DOES NOT INTEND TO SOLICIT CONTRIBUTIONS BY ANY MEANS OR HAVE FUNDS SOLICITED ON ITS BEHALF (FL STATUTE TITLE XXXIII, SEC. 496.401(1)(A))Statement

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOther

FieldValueIRS element (for citing)
Category Or ItemPUBLICLY TRADED STOCKCategoryOrItem
Listed At Cost Or FMVAT COSTListedAtCostOrFMV
Book Value299893BookValue
EOYFMV289457EOYFMV

Land Etc Schedule2 LandEtcSchedule2

Land Etc LandEtc

FieldValueIRS element (for citing)
Category Or ItemCOMPUTERCategoryOrItem
Cost Or Other Basis827CostOrOtherBasis
Accumulated Depreciation138AccumulatedDepreciation
Book Value689BookValue
EOYFMV0EOYFMV

Loans From Officers Schedule LoansFromOfficersSchedule

Loans From Officer LoansFromOfficer

FieldValueIRS element (for citing)
Lenders NameJOHN AND GAYE PATTONLendersName
Lenders TitleDIRECTORSLendersTitle
Balance Due7961BalanceDue
Purpose Of LoanSTART-UP EXPENSESPurposeOfLoan

Other Increases Schedule OtherIncreasesSchedule

Other Increases OtherIncreases

FieldValueIRS element (for citing)
DescriptionUNREALIZED LOSSES ON MARKETABLE SECURITIESDescription
Amount$6,950Amount

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionEXCISE TAXES PAYABLEDescription
BOY Book Value1472BOYBookValue
EOY Book Value1578EOYBookValue

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees OtherProfessionalFees

FieldValueIRS element (for citing)
CategoryBROKERAGE FEESCategory
Amount$1,524Amount
Net Investment Income1524NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps0DisbursementsCharitablePrps

Taxes Schedule TaxesSchedule

Taxes Taxes

FieldValueIRS element (for citing)
CategoryEXCISE TAXCategory
Amount$1,578Amount
Net Investment Income1578NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps0DisbursementsCharitablePrps