Florida F Chaffee Tr Fbo Grace Hospital Inc 1013002402 in Winston Salem, North Carolina (NC)

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Florida F Chaffee Tr Fbo Grace Hospital Inc 1013002402
Employer Identification Number (EIN)566116946
Name of OrganizationFlorida F Chaffee Tr Fbo Grace Hospital Inc 1013002402
In Care of NameWashovia Bank Na
Address1 W 4th St 4th Fl, Winston Salem, NC 27101-3818
SubsectionCharitable Organization
FoundationPrivate non-operating foundation
OrganizationAssociation
Exempt Organization StatusTrust described in section 4947(a)(2) of the IR Code
Tax Period08/2014
Assets$1,000,000 to $4,999,999
Income$500,000 to $999,999
Filing Requirement990 - Not required to file (all other)
Asset Amount$2,495,102
Amount of Income$986,664
Form 990 Revenue Amount$366,108


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Financial snapshot ($)

Revenue for 2014

Assets at the end of 2014

Expenses for 2014

Analysis of Revenue and Expenses (for 2014)
Revenue and expenses per booksNet investment incomeAdjusted net incomeDisbursements for charitable purposes (cash basis only)
Total revenue$106,616$104,759$0
Contributions, gifts, grants, etc., received$0
Interest on savings and temporary cash investments$0
Dividends and interest from securities$57,053
Gross rents$0
Gross sales price for all assets$929,611
Gross profit from sales of goods$0
Other income$0
Other$49,563
Total expenses and disbursements$156,777$27,717$0$129,060
Compensation of officers, directors, trustees, etc.$36,102
Pension plans, employee benefits$0
Legal fees$0
Accounting fees$1,584
Interest$0
Depreciation$0
Occupancy$0
Travel, conferences, and meetings$0
Printing and publications$0
Total operating and administrative expenses$38,346$27,717$10,629
Contributions, gifts, grants paid$118,431
Excess of revenue over expenses and disbursements$-50,161
Net investment income$77,042
Adjusted net income$0
Balance Sheets
2011201220132014
Book ValueFair Market ValueBook ValueFair Market ValueBook ValueFair Market ValueBook ValueFair Market Value
Total assets$2,532,851$2,636,179$2,581,479$2,685,905$2,545,797$2,732,372$2,495,102$2,935,284
Cash - non-interest-bearing$0$0$0$157
Investments-U.S. and state government obligations$0$0$0$0
Investments-corporate stock$0$0$0$0
Investments-corporate bonds$0$0$0$0
Investments-mortgage loans$0$0$0$0
Investments-other$2,436,892$2,497,905$2,455,330$2,443,337
Other assets$0$0$0
Total liabilities$0$0$0$0
Total liabilities and net assets/fund balances$2,532,851$2,581,479$2,545,797$2,495,102
Capital Gains and Losses for Tax on Investment Income
2011201220132014
Capital gain net income$276,859$96,667$42,952$49,563
Net capital loss$0$0$0$0
Excise Tax Based on Investment Income
2011201220132014
Domestic foundations that meet the section 4940(e) requirements (for Reduced Tax on Net Investment Income)NoNoNoNo
Tax based on investment income$6,834$2,690$872$770
Total credits and payments$1,196$6,836$2,690$872
Current year estimated tax payments and previous year's overpayment credited to current year$1,196$6,836$2,690$872
Exempt foreign organizations-tax withheld at source$0$0$0$0
Tax paid with application for extension of time to file (Form 8868)$0$0$0$0
Backup withholding erroneously withheld$0$0$0$0
Any penalty for underpayment of estimated tax$0$0$0$0
Tax due$0$0$0
Overpayment$4,146$1,818$102
Amount to be credited to next year's estimated tax$0$2,690$872$102
Statements Regarding Activities
2011201220132014
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in any political campaign?NoNoNoNo
Has the foundation engaged in any activities that have not previously been reported to the IRS?NoNoNo
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or bylaws, or other similar instruments?NoNoNo
Has the foundation filed a tax return on Form 990-T for this year?NoNoNo
Was there a liquidation, termination, dissolution, or substantial contraction during the year?NoNoNoNo
Has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate) of each state?YesYesYes
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(j)(5) for current calendar year or the taxable year beginning in this year?NoNoNoNo
Did any persons become substantial contributors during the tax year?NoNoNo
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had advisory privileges?NoNoNo
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?YesYesYes
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041NoNoNo
Statements Regarding Activities for Which Form 4720 May Be Required
2011201220132014
During the year did the foundation (either directly or indirectly):
Engage in the sale or exchange, or leasing of property with a disqualified person?NoNoNoNo
Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person?NoNoNoNo
Furnish goods, services, or facilities to (or accept them from) a disqualified person?NoNoNoNo
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?YesYesYesYes
Transfer any income or assets to a disqualified person (or make any of either available for the benefit or use of a disqualified person)?NoNoNoNo
Agree to pay money or property to a government official?NoNoNoNo
Did any of the acts fail to qualify under the exceptions described in Regulations section 53.4941(d)-3 or in a current notice regarding disaster assistance?NoNoNo
Did the foundation engage in a prior year in any of the acts, other than excepted acts, that were not corrected before the first day of the tax year beginning in this year?NoNoNo
At the end of this tax year, did the foundation have any undistributed income for tax year(s) beginning before this year?NoNoNoNo
Are there any years listed above for which the foundation is not applying the provisions of section 4942(a)(2) (relating to incorrect valuation of assets) to the year's undistributed income?NoNoNo
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time during the year?NoNoNoNo
Did the foundation have excess business holdings in this year as a result of (1) any purchase by the foundation or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3) the lapse of the 10-, 15-, or 20-year first phase holding period?NoNoNoNo
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?NoNoNoNo
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in this year?NoNoNo
During the year did the foundation pay or incur any amount to:
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?NoNoNoNo
Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly, any voter registration drive?NoNoNoNo
Provide a grant to an individual for travel, study, or other similar purposes?NoNoNoNo
Provide a grant to an organization other than a charitable, etc., organization described in section 509(a)(1), (2), or (3), or section 4940(d)(2)?NoNoNoNo
Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals?NoNoNoNo
Did any of the transactions fail to qualify under the exceptions described in Regulations section 53.4945 or in a current notice regarding disaster assistance?NoNoNo
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?NoNoNo
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?NoNoNo
Minimum Investment Return
2011201220132014
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc., purposes$2,717,232$2,616,687$2,768,320$2,893,623
Net value of noncharitable-use assets$2,577,437$2,726,795$2,850,219
Minimum investment return$133,824$128,872$136,340$142,511
Distributable Amount
2011201220132014
Distributable amount$126,990$126,182$135,468$141,741
Undistributed Income
2011201220132014
Distributable amount for this year$126,990$126,182$135,468$141,741
Undistributed income for this year. This amount must be distributed in the next year$60,646$113,332$125,204$137,885
Private Operating Foundations (for 2011 - 2014)
2014201320122011Total
The lesser of the adjusted net income or the minimum investment return$0$0$0$0$0
Qualifying distributions made directly for active conduct of exempt activities$0$0$0$0$0
Value of all assets$0$0$0$0$0
Value of assets qualifying under section 4942(j)(3)(B)(i)$0$0$0$0$0
2/3 of minimum investment return$0$0$0$0$0
Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties)$0$0$0$0$0
Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)$0$0$0$0$0
Gross investment income$0$0$0$0$0
Supplementary Information (for 2014)
Grants approved for future payment$0
Analysis of Income-Producing Activities (for 2014)
AmountRelated or exempt function income
Program service revenue
Fees and contracts from government agencies$0$0
Membership dues and assessments$0$0
Interest on savings and temporary cash investments$0$0
Dividends and interest from securities$57,053$0
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (for 2014)
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Transfers from the reporting foundation to a noncharitable exempt organization of:
CashNo
Other assetsNo
Other transactions:
Sales of assets to a noncharitable exempt organizationNo
Purchases of assets from a noncharitable exempt organizationNo
Rental of facilities, equipment, or other assetsNo
Reimbursement arrangementsNo
Loans or loan guaranteesNo
Performance of services or membership or fundraising solicitationsNo
Sharing of facilities, equipment, mailing lists, other assets, or paid employeesNo
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