MARY M PECKMAN TR FBO CHEN MEM HOSPITAL: Form 990PF, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MARY M PECKMAN TR FBO CHEN MEM HOSPITAL (EIN 15-6017708)
- Tax period
- 2010-04-01 to 2011-03-31
- Filed
- 2009-10-15
- IRS object ID
- 201102089349100700
- Schema version
- 2010v3.2
- 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
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Assets Schedule
- Other Expenses Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2009-10-15T15:15:33+05:00 | Timestamp |
| Tax Period End Date | 2011-03-31 | 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 SUITE 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 | 2010-04-01 | 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 | 2011-07-12 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LOUIS J DEROSE | Name |
| Phone | 7327679100 | Phone |
| Date Prepared | 2011-07-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | 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 | 3402239 | 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 | 84 | InterestOnSavingsRevAndExpnss |
| Interest On Savings Net Invst Incm | 84 | InterestOnSavingsNetInvstIncm |
| Dividends Rev And Expnss | 104236 | DividendsRevAndExpnss |
| Dividends Net Invst Incm | 104818 | DividendsNetInvstIncm |
| Net Gain Sale Assets Rev And Expnss | -28458 | NetGainSaleAssetsRevAndExpnss |
| Gross Sales Price | 234575 | GrossSalesPrice |
| Capital Gain Net Incm Net Invst Incm | 0 | CapitalGainNetIncmNetInvstIncm |
| Net STCG Adj Net Incm | 0 | NetSTCGAdjNetIncm |
| Total Revenue And Expenses | 75862 | TotalRevenueAndExpenses |
| Total Net Investment Income | 104902 | TotalNetInvestmentIncome |
| Comp Ofcr Dir Trst Rev And Expnss | 14736 | CompOfcrDirTrstRevAndExpnss |
| Comp Ofcr Dir Trst Net Invst Incm | 13262 | CompOfcrDirTrstNetInvstIncm |
| Comp Ofcr Dir Trst Dsbrs Chrtbl Prps | 1474 | 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 | 580 | 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 | 2603 | TaxesRevAndExpnss |
| Taxes Net Invst Incm | 859 | 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 Rev And Expnss | 3 | PrintingAndPubRevAndExpnss |
| Printing And Pub Net Invst Incm | 0 | PrintingAndPubNetInvstIncm |
| Printing And Pub Adj Net Incm | 0 | PrintingAndPubAdjNetIncm |
| Printing And Pub Dsbrs Chrtbl Prps | 3 | PrintingAndPubDsbrsChrtblPrps |
| Other Expenses Rev And Expnss | 250 | OtherExpensesRevAndExpnss |
| Other Expenses Dsbrs Chrtbl Prps | 250 | OtherExpensesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 18172 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 14121 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Adj Net Incm | 0 | TotOprExpensesAdjNetIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 1727 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 189534 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 189534 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 207706 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 14121 | TotalExpensesNetInvstIncm |
| Total Expenses Adj Net Incm | 0 | TotalExpensesAdjNetIncm |
| Total Expenses Dsbrs Chrtbl Prps | 191261 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | -131844 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 90781 | NetInvestmentIncome |
| Adjusted Net Income | 0 | AdjustedNetIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | 442 | CashBOY |
| Cash EOY | 531 | CashEOY |
| Cash EOYFMV | 531 | CashEOYFMV |
| Savings And Temp Cash Invst BOY | 115160 | SavingsAndTempCashInvstBOY |
| Savings And Temp Cash Invst EOY | 157864 | SavingsAndTempCashInvstEOY |
| Savings And Temp Cash Invst EOYFMV | 157864 | SavingsAndTempCashInvstEOYFMV |
| Accounts Receivable EOY | 0 | AccountsReceivableEOY |
| Accounts Receivable EOYFMV | 0 | AccountsReceivableEOYFMV |
| Allwnc For Dbtfl Acct Other Rcvbl | 0 | AllwncForDbtflAcctOtherRcvbl |
| Investments Govt Oblig BOY | 442575 | InvestmentsGovtObligBOY |
| Investments Govt Oblig EOY | 492576 | InvestmentsGovtObligEOY |
| Investments Govt Oblig EOYFMV | 544187 | InvestmentsGovtObligEOYFMV |
| Investments Corp Stock BOY | 937819 | InvestmentsCorpStockBOY |
| Investments Corp Stock EOY | 877669 | InvestmentsCorpStockEOY |
| Investments Corp Stock EOYFMV | 1125850 | InvestmentsCorpStockEOYFMV |
| Investments Corp Bonds BOY | 295444 | InvestmentsCorpBondsBOY |
| Investments Corp Bonds EOY | 200000 | InvestmentsCorpBondsEOY |
| Investments Corp Bonds EOYFMV | 206382 | InvestmentsCorpBondsEOYFMV |
| Investments Other BOY | 1058772 | InvestmentsOtherBOY |
| Investments Other EOY | 1123062 | InvestmentsOtherEOY |
| Investments Other EOYFMV | 1234092 | InvestmentsOtherEOYFMV |
| Other Assets BOY | 266667 | OtherAssetsBOY |
| Other Assets EOY | 133333 | OtherAssetsEOY |
| Other Assets EOYFMV | 133333 | OtherAssetsEOYFMV |
| Total Assets BOY | 3116879 | TotalAssetsBOY |
| Total Assets EOY | 2985035 | TotalAssetsEOY |
| Total Assets EOYFMV | 3402239 | TotalAssetsEOYFMV |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Do Not Follow SFAS117 | X | OrgThatDoNotFollowSFAS117 |
| Capital Stock BOY | 3114990 | CapitalStockBOY |
| Capital Stock EOY | 3045274 | CapitalStockEOY |
| Retained Earnings BOY | 1889 | RetainedEarningsBOY |
| Retained Earnings EOY | -60239 | RetainedEarningsEOY |
| Total Net Assets BOY | 3116879 | TotalNetAssetsBOY |
| Total Net Assets EOY | 2985035 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 3116879 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 2985035 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 3116879 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | -131844 | ExcessOfRevenueOverExpenses |
| Other Increases | 0 | OtherIncreases |
| Subtotal | 2985035 | Subtotal |
| Other Decreases | 0 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 2985035 | TotalNetAssetsFundBalancesEOY |
Capital Gains And Losses CapitalGainsAndLosses
Capital Gains And Losses Info CapitalGainsAndLossesInfo (13 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 |
|---|---|---|---|---|---|---|---|
| 1000. AMERICAN INTL GROUP PFD 7.70% # | P | 2007-12-11 | 2011-01-03 | 24310 | 25000 | -690 | -690 |
| 1000. BAC CAP TRUST III 7.00% PFD | P | 2002-08-05 | 2010-11-01 | 24759 | 25000 | -241 | -241 |
| 225. BP PLC SPONSORED ADR | P | 2004-08-25 | 2010-06-16 | 6866 | 11793 | -4927 | -4927 |
| 55. BP PLC SPONSORED ADR | P | 2007-10-30 | 2010-06-16 | 1678 | 4228 | -2550 | -2550 |
| 150. BP PLC SPONSORED ADR | P | 2008-08-25 | 2010-06-16 | 4577 | 8501 | -3924 | -3924 |
| 50000. JOHN DEERE CAPITAL CORP MED TERM 4.00 03-15-11 | P | 2009-03-20 | 2011-03-15 | 50000 | 50000 | ||
| .222 FRONTIER COMMUNICATIONS COM | P | 2008-05-28 | 2010-08-04 | 2 | 2 | ||
| 45000. GENL ELEC CAP CORP MED TERM 6.125 02-22-11 | P | 2001-08-06 | 2011-02-22 | 45000 | 45444 | -444 | -444 |
| 1000. JP MOR 7.00%PFD | P | 2002-02-05 | 2011-01-03 | 25300 | 25000 | 300 | 300 |
| 1000. MORGAN STANLEY CP TR IV PFD 6.25% | P | 2003-04-10 | 2011-01-03 | 22730 | 25000 | -2270 | -2270 |
| 345. PETROLEO BRASILEIRO SA PETROSPONSORED ADR | P | 2008-05-28 | 2010-11-01 | 11813 | 25130 | -13317 | -13317 |
| 180. PETROLEO BRASILEIRO SA PETROSPONSORED ADR | P | 2008-08-25 | 2010-11-01 | 6163 | 9218 | -3055 | -3055 |
| 120. TOYOTA MOTOR CORP SP ADR REP2COM | P | 2008-10-29 | 2011-03-16 | 9679 | 8717 | 962 | 962 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | -28458 | CapitalGainNetIncome |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | false | LiableFor4942Tax |
| Qualifying Distributions Year1 | 127424 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 2991204 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.0426 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 136403 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 2992873 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.045576 | DistributionRatioYear2 |
| Total Distribution Ratio | 0.088176 | TotalDistributionRatio |
| Average Distribution Ratio | 0.044088 | AverageDistributionRatio |
| Net Noncharitable Assets | 3210499 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 141544 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 908 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 142452 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 191261 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | X | DomesticOrgMeetingSect4940e |
| Investment Income Excise Tax | 908 | InvestmentIncomeExciseTax |
| Tax Under Section511 | 0 | TaxUnderSection511 |
| Subtotal | 908 | Subtotal |
| Subtitle A Tax | 0 | SubtitleATax |
| Tax Based On Investment Income | 908 | TaxBasedOnInvestmentIncome |
| Est Tax Payments And Overpayment | 2024 | EstTaxPaymentsAndOverpayment |
| Tax Paid With Extension | 0 | TaxPaidWithExtension |
| Total Credits And Payments | 2024 | TotalCreditsAndPayments |
| Penalty For Underpayment | 0 | PenaltyForUnderpayment |
| Overpayment | 1116 | Overpayment |
| Amount Credited To Next Year | 1116 | 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 | 14736 | 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 | 3131360 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 128030 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 3259390 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Acquisition Indebtedness | 0 | AcquisitionIndebtedness |
| Adj Total FMV Of Unused Assets | 3259390 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 48891 | CashDeemedCharitable |
| Net Noncharitable Assets | 3210499 | NetNoncharitableAssets |
| Minimum Investment Return | 160525 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 160525 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 908 | TaxBasedOnInvestmentIncome |
| Total Tax | 908 | TotalTax |
| Distributable Amount Before Adj | 159617 | DistributableAmountBeforeAdj |
| Recoveries Qlfy Distributions | 0 | RecoveriesQlfyDistributions |
| Distributable Amount Before Ded | 159617 | DistributableAmountBeforeDed |
| Deduction Fr Distributable | $0 | DeductionFrDistributableAmount |
| Distributable Amount As Adjusted | 159617 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 191261 | 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 | 191261 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 908 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 190353 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 159617 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 31107 | 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 | 0 | ExcessDistriCarryoverYear2 |
| Excess Distri Carryover Year1 | 0 | ExcessDistriCarryoverYear1 |
| Total Excess Distri Carryover | 0 | TotalExcessDistriCarryover |
| Qualifying Distributions | 191261 | QualifyingDistributions |
| Applied To Year1 | 31107 | AppliedToYear1 |
| Applied To Prior Years | 0 | AppliedToPriorYears |
| Treated As Distri From Corpus | 0 | TreatedAsDistriFromCorpus |
| Applied To Current Year | 159617 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 537 | RemainingDistriFromCorpus |
| Excess Distri Cyov App CY Corpus | 0 | ExcessDistriCyovAppCYCorpus |
| Excess Distri Cyov Applied CY | 0 | ExcessDistriCyovAppliedCY |
| Total Corpus | 537 | 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 | 537 | ExcessDistriCyovToNextYear |
| Excess From Year4 | 0 | ExcessFromYear4 |
| Excess From Year3 | 0 | ExcessFromYear3 |
| Excess From Year2 | 0 | ExcessFromYear2 |
| Excess From Year1 | 0 | ExcessFromYear1 |
| Excess From Current Year | 537 | ExcessFromCurrentYear |
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 WM PECKHAM | PurposeOfGrantOrContribution |
| Amount | $189,534 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 189534 | 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 | $84 | ExclusionAmount |
Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $104,236 | 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 | -$28,458 | 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 | $75,862 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 75862 | 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 | $580 | Amount |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corp Bonds InvestmentsCorpBonds (4 entries)
| Name Of BondNameOfBond | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| CATERPILLAR FIN 5.75% 10/15/11 | 50000 | 51135 |
| BANK OF AMERICA 6.4% 8-15-19 | 50000 | 52442 |
| GE CAPITAL 4.4% 4/15/2014 | 50000 | 51662 |
| HOUSEHOLD FIN 6.15% 11/15/2011 | 50000 | 51143 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corp Stock InvestmentsCorpStock (40 entries)
| Name Of StockNameOfStock | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| BANK OF AMERICA CORP | 19389 | 19995 |
| UNION PAC CORP | 35540 | 39332 |
| SUNCOR ENERGY INC | 32002 | 44840 |
| ABBOTT LABS | 24873 | 23053 |
| APPLE INC | 12980 | 46003 |
| COLGATE PALMOLIVE | 22511 | 25036 |
| CATERPILLAR INC | 42508 | 74604 |
| CISCO SYSTEMS | 31578 | 22295 |
| CONOCOPHILLIPS | 17378 | 39930 |
| DANAHER CORP | 27404 | 49305 |
| EXXON MOBIL CORP | 17649 | 25660 |
| FISERV INC | 23469 | 28036 |
| GENERAL ELECTRIC CO | 37086 | 44611 |
| GOLDMAN SACHS GROUP | 16595 | 15067 |
| HEWLETT PACKARD CO | 19948 | 20444 |
| INTL BUSINESS MACHINES | 16269 | 29516 |
| JPMORGAN CHASE | 17495 | 18901 |
| JOHNSON & JOHNSON | 21567 | 20441 |
| LOWES COS | 34655 | 34359 |
| MICROSOFT CORP | 24237 | 22724 |
| MONSANTO CO | 5901 | 13585 |
| FRONTIER COMMUNICATIONS | 1300 | 1093 |
| BHP BILLITON LTD | 14152 | 24353 |
| GLAXOSMITHKLINE PLC | 24454 | 21510 |
| NOVARTIS A G | 26699 | 26360 |
| PEPSICO INC | 19146 | 25442 |
| PROCTER & GAMBLE CO | 8355 | 24517 |
| PRUDENTIAL FINL | 31560 | 22169 |
| SCHLUMBERGER LTD | 24594 | 46630 |
| DISNEY WALT CO | 19433 | 33179 |
| TARGET CORP | 12621 | 23104 |
| TOYOTA MOTOR | 9405 | 9550 |
| US BANCORP | 23416 | 20219 |
| UNITED TECHNOLOGIES | 36780 | 45711 |
| VERIZON COMMUNICATIONS | 19693 | 21390 |
| WALGREEN CO | 26749 | 29021 |
| WELLS FARGO & CO | 19016 | 19977 |
| 22201 | 29338 | |
| INTEL | 21426 | 22299 |
| PRICE T ROWE GROUP INC | 15635 | 22251 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Securities EOY Book Value | 492576 | USGovtSecuritiesEOYBookValue |
| US Govt Securities EOYFMV | 544187 | USGovtSecuritiesEOYFMV |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOther (13 entries)
| Category Or ItemCategoryOrItem | Listed At Cost Or FMVListedAtCostOrFMV | Book ValueBookValue | EOYFMVEOYFMV |
|---|---|---|---|
| ISHARES TR MSCI EMERGING MKTS | AT COST | 77307 | 97437 |
| ISHARES TR MSCI EAFE INDEX | AT COST | 197386 | 172310 |
| ISHARES TR NASDAQ BIO INDEX | AT COST | 22801 | 27143 |
| ISHARES RUSSELL 2000 | AT COST | 153848 | 193507 |
| SPDR S&P MIDCAP 400 ETF TR | AT COST | 222507 | 291948 |
| SPDR SERIES KBW REGL BKG | AT COST | 28719 | 26630 |
| SELECT SECTOR SPDR MATERIALS | AT COST | 20864 | 21851 |
| SELECT SECTOR SPDR UTILITIES | AT COST | 24615 | 19568 |
| MARKET VECTORS ETF AGRI | AT COST | 25015 | 33624 |
| DODGE & COX INCOME FD | AT COST | 75000 | 76972 |
| FEDERATED TOTAL RETURN BOND | AT COST | 125000 | 125256 |
| VANGUARD GNMA FD ADMIRAL SHS | AT COST | 75000 | 74861 |
| VANGUARD INTER TERM TREA | AT COST | 75000 | 72985 |
Other Assets Schedule OtherAssetsSchedule
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CHENANGO MEM HOSPITAL LOAN 6% | Description |
| BOY Book Value | 266667 | BOYBookValue |
| EOY Book Value | 133333 | EOYBookValue |
| EOYFMV | 133333 | EOYFMV |
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 | Disbursements Charitable PrpsDisbursementsCharitablePrps |
|---|---|---|---|
| FOREIGN TAX WITHHELD | $241 | 859 | 0 |
| EXCISE TAX 2009 BALANCE | $338 | 0 | 0 |
| ESTIMATED EXCISE TAX PAID | $2,024 | 0 | 0 |