PEPIN FAMILY FOUNDATION INC: Form 990PF, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- PEPIN FAMILY FOUNDATION INC (EIN 20-1250899)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-07-13
- IRS object ID
- 201111949349100506
- 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
- Compensation Explanation
- General Explanation Attachment
- Investments Land Schedule2
- Other Expenses Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-13T13:32:51-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PURVIS GRAY & COMPANY | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2347 SE 17TH STREET | AddressLine1 |
| City | OCALA | City |
| State | FL | State |
| ZIP Code | 34471 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201250899 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEPIN FAMILY FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PEPI | NameControl |
| Phone | 8136266176 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4121 NORTH 50TH STREET | AddressLine1 |
| City | TAMPA | City |
| State | FL | State |
| ZIP Code | 33610 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT J AMMON CPA | Name |
| Title | TREASURER | Title |
| Phone | 8136266176 | Phone |
| Date Signed | 2011-05-25 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | S TODD MCMULLEN CPA | Name |
| Phone | 3527323872 | Phone |
| Date Prepared | 2011-05-27 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exempt PF | X | ExemptPF |
| FMV Assets EOY | 169922 | 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 |
| Total Revenue And Expenses | 0 | TotalRevenueAndExpenses |
| Total Net Investment Income | 0 | TotalNetInvestmentIncome |
| Accounting Fees Rev And Expnss | 750 | AccountingFeesRevAndExpnss |
| Taxes Rev And Expnss | 411 | TaxesRevAndExpnss |
| Other Expenses Rev And Expnss | 6129 | OtherExpensesRevAndExpnss |
| Tot Opr Expenses Rev And Expnss | 7290 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 0 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 0 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 1100000 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 1100000 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 1107290 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 0 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 1100000 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | -1107290 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 0 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | 457212 | CashBOY |
| Cash EOY | 169922 | CashEOY |
| Cash EOYFMV | 169922 | CashEOYFMV |
| Investments Land Etc BOY | 820000 | InvestmentsLandEtcBOY |
| Total Assets BOY | 1277212 | TotalAssetsBOY |
| Total Assets EOY | 169922 | TotalAssetsEOY |
| Total Assets EOYFMV | 169922 | TotalAssetsEOYFMV |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Do Not Follow SFAS117 | X | OrgThatDoNotFollowSFAS117 |
| Retained Earnings BOY | 1277212 | RetainedEarningsBOY |
| Retained Earnings EOY | 169922 | RetainedEarningsEOY |
| Total Net Assets BOY | 1277212 | TotalNetAssetsBOY |
| Total Net Assets EOY | 169922 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 1277212 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 169922 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 1277212 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | -1107290 | ExcessOfRevenueOverExpenses |
| Subtotal | 169922 | Subtotal |
| Total Net Assets Fund Balances EOY | 169922 | TotalNetAssetsFundBalancesEOY |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | false | LiableFor4942Tax |
| Noncharitable Assets Year1 | 1058179 | NoncharitableAssetsYear1 |
| Noncharitable Assets Year2 | 77557 | NoncharitableAssetsYear2 |
| Noncharitable Assets Year3 | 78923 | NoncharitableAssetsYear3 |
| Qualifying Distributions Year4 | 5000 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 82684 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.060471 | DistributionRatioYear4 |
| Qualifying Distributions Year5 | 1004805 | QualifyingDistributionsYear5 |
| Noncharitable Assets Year5 | 13573 | NoncharitableAssetsYear5 |
| Distribution Ratio Year5 | 74.029691 | DistributionRatioYear5 |
| Total Distribution Ratio | 74.090162 | TotalDistributionRatio |
| Average Distribution Ratio | 37.045081 | AverageDistributionRatio |
| Net Noncharitable Assets | 222049 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 8225823 | AdjustedNoncharitableAssets |
| Adj Nonchrtbl Assets And One | 8225823 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 1100000 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | 0 | InvestmentIncomeExciseTax |
| Amount Credited To Next Year | 0 | AmountCreditedToNextYear |
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 | FL | 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 |
| Website Address | N/A | WebsiteAddress |
| Books In Care Of Person Name | ROBERT J AMMON CPA | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 8136266176 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4121 NORTH 50TH STREET | AddressLine1 |
| City | TAMPA | City |
| State | FL | State |
| ZIP Code | 33610 | ZIPCode |
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 | true | FurnishedGoodsWithDsqflyPerson |
| Pay Compensation To Dsqfly Person | false | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | false | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | false | PaymentToGovernmentOffical |
| Acts Fail To Qualify As Exceptions | false | ActsFailToQualifyAsExceptions |
| Undistributed Income Prior Years | false | UndistributedIncomePriorYears |
| 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 |
Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo
Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (4 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 |
|---|---|---|---|---|---|---|---|---|
| THOMAS A PEPIN | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | PRESIDENT | 2.00 | 0 | 0 | 0 |
| POLLY V PEPIN | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | DIRECTOR | 2.00 | 0 | 0 | 0 |
| ROBERT J AMMON | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | TREASURER | 2.00 | 0 | 0 | 0 |
| RANDY GARCIA | ||||||||
| 4121 NORTH 50TH ST | TAMPA | FL | 33610 | SECRETARY | 2.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Highest Paid Empl NONE | NONE | CompOfHighestPaidEmplNONE |
| Comp Of Hghst Paid Cntrct NONE | NONE | CompOfHghstPaidCntrctNONE |
Sum Of Program Related Investments SumOfProgramRelatedInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1 |
Minimum Investment Return MinimumInvestmentReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Avg Monthly FMV Of Securities | 0 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 225430 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 225430 | TotalFMVOfUnusedAssets |
| Adj Total FMV Of Unused Assets | 225430 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 3381 | CashDeemedCharitable |
| Net Noncharitable Assets | 222049 | NetNoncharitableAssets |
| Minimum Investment Return | 11102 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 11102 | MinimumInvestmentReturn |
| Distributable Amount Before Adj | 11102 | DistributableAmountBeforeAdj |
| Distributable Amount Before Ded | 11102 | DistributableAmountBeforeDed |
| Distributable Amount As Adjusted | 11102 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 1100000 | ExpensesAndContributions |
| Qualifying Distributions | 1100000 | QualifyingDistributions |
| Adj Qualifying Distributions | 1100000 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 11102 | DistributableAmountAsAdjusted |
| Excess Distri Carryover Year5 | 943393 | ExcessDistriCarryoverYear5 |
| Excess Distri Carryover Year4 | 866 | ExcessDistriCarryoverYear4 |
| Total Excess Distri Carryover | 944259 | TotalExcessDistriCarryover |
| Qualifying Distributions | 1100000 | QualifyingDistributions |
| Applied To Current Year | 11102 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 1088898 | RemainingDistriFromCorpus |
| Total Corpus | 2033157 | TotalCorpus |
| Undistributed Income CY | 0 | UndistributedIncomeCY |
| Excess Distri Cyov From Year5 | 943393 | ExcessDistriCyovFromYear5 |
| Excess Distri Cyov To Next Year | 1089764 | ExcessDistriCyovToNextYear |
| Excess From Year4 | 866 | ExcessFromYear4 |
| Excess From Current Year | 1088898 | ExcessFromCurrentYear |
Supplementary Information SupplementaryInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | POLLY PEPIN | ContributingManager |
| Only Contributes To Preselected | X | OnlyContributesToPreselected |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (2 entries)
| Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient Foundation StatusRecipientFoundationStatus | Purpose Of Grant Or ContributionPurposeOfGrantOrContribution | AmountAmount |
|---|---|---|---|---|---|---|
| UNIVERSITY COMMUNITY HOSP | ||||||
| 3100 E FLETCHER AVENUE | TAMPA | FL | 33613 | 501(C)(3) | CARDIOVASCULAR RESEARCH & TREATMENT | $1,050,000 |
| THE PEPIN ACADEMIES | ||||||
| 3916 E HILLSBOROUGH AVE | TAMPA | FL | 33610 | 501(C)(3) | PUBLIC CHARTER SCHOOL | $50,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 1100000 | TotGrantOrContriPaidDuringYear |
Grant Or Contri Approved For Future GrantOrContriApprovedForFuture
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY COMMUNITY HOSP | BusinessNameLine1 |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 E FLETCHER AVENUE | AddressLine1 |
| City | TAMPA | City |
| State | FL | State |
| ZIP Code | 33613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Foundation Status | 501(C)(3) | RecipientFoundationStatus |
| Purpose Of Grant Or Contribution | CARDIOVASCULAR RESEARCH & TREATMENT | PurposeOfGrantOrContribution |
| Amount | $65,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Approved Future | 65000 | TotGrantOrContriApprovedFuture |
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 | ACCOUNTING FEES | Category |
| Amount | $750 | Amount |
Compensation Explanation CompensationExplanation
Compensation Compensation (4 entries)
| THOMAS A PEPIN |
| POLLY V PEPIN |
| ROBERT J AMMON |
| RANDY GARCIA |
General Explanation Attachment GeneralExplanationAttachment
General Explanation GeneralExplanation (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| GENERAL RETURN INFORMATION | FORM 990-PF, PAGE 1, PART I, LINE 2 OF THE 1,100,000 IN CONTRIBUTIONS, UNIVERSITY COMMUNITY HOSPITAL FOUND THE 1,050,000 CONTRIBUTION TO THE CONSISTED OF: - 230,000 IN CASH CONTRIBUTIO - LAKE HOUSE WITH A FAIR MARKE THE FAIR MARKET VALUE OF THE LAKE H MEASURE OF THE CONTRIBUTION. DESCRIPTION OF THE CONTRIBUTED PROP LAKE HOUSE AT 59 WORMAN DRIVE, BOOK VALUE OF THE CONTRIBUTED PROPE 820,000 METHOD USED TO DETERMINE THE BOOK V THE LAKE HOUSE WAS GIVEN TO TH 2009. THE VALUE OF THE GIFT W APPRAISAL. METHOD USED TO DETERMINE THE FAIR M THE FAIR MARKET VALUE WAS DETE APPRAISAL. DATE OF THE CONTRIBUTION TO UNIVERS FEBRUARY 24, 2010. |
| GENERAL ELECTIONS |
Investments Land Schedule2 InvestmentsLandSchedule2
Investment Land InvestmentLand
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | LAKE HOUSE - 59 WORMAN DRIVE | CategoryOrItem |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | Revenue And Expenses Per BooksRevenueAndExpensesPerBooks |
|---|---|
| EXPENSES | |
| PROPERTY RELATED - TAXES, UTI | 3907 |
| LEGAL AND TITLE EXPENSES | 2222 |
Taxes Schedule TaxesSchedule
Taxes Taxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INDIRECT TAXES/LICENSES | Category |
| Amount | $411 | Amount |