J Blood Trust Fbo, Memorial Hospital Foundation in Brooklyn, Ohio (OH)

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J Blood Trust Fbo, Memorial Hospital Foundation
Employer Identification Number (EIN)146015846
Name of OrganizationJ Blood Trust Fbo
Secondary NameMemorial Hospital Foundation
In Care of NameKeybank
Address4900 Tiedeman Rd, Brooklyn, OH 44144-2338
ActivitiesNon-exempt charitable trust described in section 4947(a)(1) of the Code
Subsection4947(a)(1) - Private Foundation (Form 990PF Filer)
FoundationAll organizations except 501(c)(3)
Exempt Organization StatusTrust described in section 4947(a)(2) of the IR Code
Tax Period12/2013
Assets$500,000 to $999,999
Income$25,000 to $99,999
Filing Requirement990 - Not required to file (all other)
Asset Amount$794,225
Amount of Income$92,825
Form 990 Revenue Amount$45,786


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Financial snapshot ($)

Revenue for 2013

Expenses for 2013

Analysis of Revenue and Expenses (for 2013)
Revenue and expenses per booksNet investment incomeAdjusted net incomeDisbursements for charitable purposes (cash basis only)
Total revenue$36,710$36,710$0
Contributions, gifts, grants, etc., received$0
Interest on savings and temporary cash investments$0
Dividends and interest from securities$26,067
Gross rents$0
Gross sales price for all assets$66,758
Gross profit from sales of goods$0
Other income$0
Other$10,643
Total expenses and disbursements$52,679$8,956$0$42,527
Compensation of officers, directors, trustees, etc.$11,942
Pension plans, employee benefits$0
Legal fees$0
Accounting fees$1,000
Interest$0
Depreciation$0
Occupancy$0
Travel, conferences, and meetings$0
Printing and publications$0
Total operating and administrative expenses$14,237$956$4,085
Contributions, gifts, grants paid$38,442
Excess of revenue over expenses and disbursements$-15,969
Net investment income$27,754
Adjusted net income$0
Balance Sheets
201120122013
Book ValueFair Market ValueBook ValueFair Market ValueBook ValueFair Market Value
Total assets$822,384$911,504$810,194$884,235$794,225$942,604
Cash - non-interest-bearing$0$0$0
Investments-U.S. and state government obligations$0$0$0
Investments-corporate stock$0$0$0
Investments-corporate bonds$0$0$0
Investments-mortgage loans$0$0$0
Investments-other$822,384$810,194$794,225
Other assets$0$0
Total liabilities$0$0$0
Total liabilities and net assets/fund balances$822,384$810,194$794,225
Capital Gains and Losses for Tax on Investment Income
201120122013
Capital gain net income$18,205$59,096$10,643
Net capital loss$0$0$0
Excise Tax Based on Investment Income
201120122013
Domestic foundations that meet the section 4940(e) requirements (for Reduced Tax on Net Investment Income)NoNoNo
Tax based on investment income$371$783$555
Total credits and payments$1,240$372$784
Current year estimated tax payments and previous year's overpayment credited to current year$1,240$372$784
Exempt foreign organizations-tax withheld at source$0$0$0
Tax paid with application for extension of time to file (Form 8868)$0$0$0
Backup withholding erroneously withheld$0$0$0
Any penalty for underpayment of estimated tax$0$0$0
Tax due$411$0
Overpayment$0$229
Amount to be credited to next year's estimated tax$372$0$139
Statements Regarding Activities
201120122013
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?NoNoNo
Has the foundation engaged in any activities that have not previously been reported to the IRS?NoNo
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?NoNo
Has the foundation filed a tax return on Form 990-T for this year?NoNo
Was there a liquidation, termination, dissolution, or substantial contraction during the year?NoNoNo
Has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate) of each state?YesYes
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?NoNoNo
Did any persons become substantial contributors during the tax year?NoNo
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had advisory privileges?NoNo
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?YesYes
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041NoNo
Statements Regarding Activities for Which Form 4720 May Be Required
201120122013
During the year did the foundation (either directly or indirectly):
Engage in the sale or exchange, or leasing of property with a disqualified person?NoNoNo
Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person?NoNoNo
Furnish goods, services, or facilities to (or accept them from) a disqualified person?NoNoNo
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?YesYesYes
Transfer any income or assets to a disqualified person (or make any of either available for the benefit or use of a disqualified person)?NoNoNo
Agree to pay money or property to a government official?NoNoNo
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?NoNo
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?NoNo
At the end of this tax year, did the foundation have any undistributed income for tax year(s) beginning before this year?NoNoNo
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?NoNo
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time during the year?NoNoNo
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?NoNoNo
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?NoNoNo
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?NoNo
During the year did the foundation pay or incur any amount to:
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?NoNoNo
Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly, any voter registration drive?NoNoNo
Provide a grant to an individual for travel, study, or other similar purposes?NoNoNo
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)?NoNoNo
Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals?NoNoNo
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?NoNo
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?NoNo
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?NoNo
Minimum Investment Return
201120122013
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc., purposes$945,605$897,513$925,305
Net value of noncharitable-use assets$884,050$911,425
Minimum investment return$46,571$44,203$45,571
Distributable Amount
201120122013
Distributable amount$46,200$43,420$45,016
Undistributed Income
201120122013
Distributable amount for this year$46,200$43,420$45,016
Undistributed income for this year. This amount must be distributed in the next year$42,133$0$761
Private Operating Foundations (for 2010 - 2013)
2013201220112010Total
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 2013)
Grants approved for future payment$0
Analysis of Income-Producing Activities (for 2013)
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$26,067$0
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (for 2013)
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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