| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX PREPARATION | 1,441 | 1,081 | 1,081 | 360 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| PART XV, SUPPLMENTARY INFORMATION---------------------------------IN COMPLIANCE WITH REGS. SECTION 53.4945-5(D), CONCERNING REPORTING TO THE INTERNAL REVENUE SERVICE REGARDING EXPENDITURE RESPONSIBILITY FOR GRANTS TO A PRIVATE FOUNDATION, THE FOUNDATION PROVIDES THE FOLLOWING INFORMATION:1) NAME AND ADDRESS OF THE GRANTEE: BRENT TAYLOR PERPETUAL CHARITABLE TRUSTMERCANTILE BANK, TRUSTEE200 N. 33RDQUINCY, IL 623052) DATE AND AMOUNT OF GRANT:AUGUST 7, 2012$220,000 3) PURPOSE OF THE GRANTS:PROVIDE FUNDING FOR BRENT TAYLOR MEMORIAL SCHOLARSHIPS, WITH RECIPIENTS TO BE SELECTED BY A COMMITTEE ESTABLISHED BY THE GRANTEE.4) AMOUNTS EXPENDED BY THE GRANTEE IN 2012 (BASED ON THE MOST RECENT REPORT FROM THE GRANTEE): $1,000.00 ON FEBRUARY 1, 2012 $3,078.00 ON FEBRUARY 2, 2012 $4,746.05 ON FEBRUARY 23, 2012 $174,000.00 ON AUGUST 9, 2012 $2,000.00 ON AUGUST 15, 2012 $2,000.00 ON AUGUST 16, 2012 $1,000.00 ON AUGUST 21, 2012 $4,480.83 ON AUGUST 23, 2012 $1,571.00 ON AUGUST 31, 2012 $440.95 ON OCTOBER 3, 2012 $202,316.78 TOTAL FOR 20125) WHETHER THE GRANTEE HAS DIVERTED ANY PORTION OF THE FUNDS FROM THE PURPOSE OF THE GRANT:THE GRANTEE'S WRITTEN REPORTS DEMONSTRATE THAT THE MAJORITY OF GRANT FUNDS WERE EXPENDED FOR THE PURPOSES OF THE GRANT ON THE DATES IDENTIFIED ABOVE. THE REMAINING $17,683.22 OF GRANT FUNDS WILL BE EXPENDED FOR THE PURPOSES OF THE GRANT IN 2013.6) DATE OF WRITTEN REPORT RECEIVED FROM THE GRANTEE:March 20, 20137) DATE OF VERIFICATION OF GRANTEE'S REPORT UNDERTAKEN BY OTHERS AT THE DIRECTION OF THE GRANTOR:ON MAY 13, 2013, THE GRANTOR'S ACCOUNTANTS, GRAY HUNTER STENN LLP, EXAMINED THE 2012 FORM 990-PF OF THE GRANTEE, WHICH AGREES TO THE INFORMATION IN THE GRANTOR'S WRITTEN REPORT. |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| 200,000 ESCROW GM CORP CONV BONDS | ||
| 5,257 GOLDMAN SACHS NEW MONEY SER D PERP | 100,292 | 109,566 |
| 32,155 NEENAH CORPORATION 15.00% 7/29/15 | 32,155 | 29,583 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| 814 GENERAL MOTORS CO COMMON SHARES | 89,661 | 23,468 |
| 5,388 NEENAH ENTERPRISES INC NEW | 60,506 | 22,360 |
| 362 GOLDMAN SACHS GROUP INC | 49,971 | 46,177 |
| 8,278 GOLDMAN SACHS GROWTH STRAT C | 114,253 | 91,230 |
| 3,269 FIDELITY ADV LEVERAGED CO STK FD C | 104,046 | 121,153 |
| 1,465 VANGUARD VALUE ETF | 99,928 | 86,142 |
| 1,575 VANGUARD LARGE-CAP ETF | 100,280 | 102,627 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| 204 MOTOR LIQ CO GUC TR UNIT BEN INT | AT COST | 4,316 | |
| 741 GENERAL MOTORS SER-A WARRANTS | AT COST | 57,889 | 14,450 |
| 741 GENERAL MOTORS SER-B WARRANTS | AT COST | 44,075 | 9,255 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| WIRE TRANSFER FEES | 30 | 22 | 22 | 8 |
| INVESTMENT EXPENSES | 150 | 113 | 113 | 37 |
| ILLINOIS CHARITABLE ANNUAL REPORT | 15 |