| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|
| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|---|---|---|---|---|---|---|---|---|
| 620 West Table Rock Rd, Alta, WY | 2008-11-30 | 936,000 | 212,550 | Straight Line | 0000000040.000000000000 | ||||
| New Hardwood Floors | 2015-05-20 | 5,975 | 2,589 | Straight Line | 0000000005.000000000000 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| Expenditure Responsibility Statement Part VII-B Lince 5C Grantee ACO-Africa Address PO Box 10184, Ka | Expenditure Responsibility Statement Part VIIB Lince 5C Grantee ACOAfrica Address PO Box 10184 Kampala Uganda Grant Purpose To improve the quality of life of disadvantaged girls in Kityana and RakaiKyotera Districts by the year 2020 through educational opportunities for 31 adolesscent girls and income generating activities among their families Grant Amount 5000 Date of Grant 3/7/19 Amount expended 5000 Dates of reports by grantee Pre grant inquiry 2017 Final Report 2019. No diversions to the foundations knowledge. Grantee Bulogo Womens Group Address Butuba Zone Namwendwa Road Bulogo Village Namwendwa Sub County Grant Purpose Equip girls and women in Kamuli district with education tools and skills to access development opportunities and become agents of change within their communities. Specific project will target 300 women with entrepreneurial skills training and small grants based on the Street Business School training modules. Grant Amount 5000 Date of Grant 2/28/18 Amount expended 5000 Dates of reports by grantee Pre grant inquiry 2018 Final Report 2019. No diversions to the foundations knowledge. Expenditure Responsibility Statement Part VIIB Lince 5C Grantee Estrella de Mar Address Km 137 Caserio Xolbe Canton El Tablon Solola Guatemala Grant Purpose Support adolescent girls from Estrella de Mar program and 810 girls to attend the leadership programs including Chispa Leadership Summit. Grant Amount 10000 Date of Grant 2/1/2018 Amount expended 10000 Dates of reports by grantee Pregrant inquiry 2018 Final Report 2019. No diversions to the foundations knowledge. Grantee Gulu Persons Disabled Union Address PO Box 549 Gulu Uganda Grant Purpose Provide 20 locally made wheelchairs to schoolage children in Gulu District to enable them to attend school. Grant Amount 5000 Date of Grant 2/28/18 Amount expended 5000 Dates of reports by grantee Pre grant inquiry 2018 Final Report 2019. No diversions to the foundations knowledge. Grantee Jifundishe Address PO Box 795 Usa River Tanzania Grant Purpose Support 40 girls through independent study program incorporating Tanz curriculum with leadership programming Expenditure Responsibility Statement Part VIIB Lince 5C Grant amount 5000 Date of grant 2/1/2018 Amount expended 5000 Dates of reports by grantee Pregrant inquiry 2018 Final Report 2019 No diversions Grantee Katalemwa Cheshire Home Address PO Box 16548 Kampala Uganda Grant Purpose Provide locally produced wheelchairs prostheses other devices to children with disabilities Grant Amount 5000 Date of Grant 2/1/2018 Amount expended 5000 Dates of reports by grantee Pregrant inquiry 2017 Final Report 2019 No diversions Expenditure Responsibility Statement Part VIIB Lince 5C Grantee The Action Foundation Address PO Box 5954100200 Nairobi Kenya Grant Purpose support early intervention e.g. occu therapy mobility devices) for youth with disabilities Grant Amount 11500 Date of Grant 3/12/2018 Amount expended 11500 Dates of reports by grantee Pregrant inquiry 2018 Final Report 2019 No diversions Grantee Youth with Physical Disabilities Address PO Box 2071 Kampala Uganda Grant Purpose To support children with disabilities with 30 wheelchairs 13 elbow crutches 2 prosthetic Expenditure Responsibility Statement Part VIIB Lince 5C limbs and a 1day training for parents/guardians on assistive device management. Grant Amount 10000 Date of Grant 3/12/2018 Amount Expended 10000 Dates of reports by grantee Pregrant inquiry 2017 Final Report 2019 No diversions Usa River Rehab received small sized board discretionary grant of 1500 in 2018. Organization is prior foundation grantee and foundation has completed required due diligence in prior years. |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| Publicly traded bonds | 589,996 | 572,480 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| Publicly traded stock | 1,755,654 | 2,097,833 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| Loan to Halogen Systems, Inc. | AT COST | 100,000 | 100,000 |
| CNote Investment | AT COST | 100,000 | 100,000 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| Table Rock House | 936,000 | |||
| Hardwood Floors | 5,979 | |||
| Table Rock Land 1031 exchange | 1,000 | |||
| Spa | 9,612 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|
| Description | Amount |
|---|---|
| Estimated tax paid | 30,338 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Bank Fees | 563 | 23 | 540 | |
| Computer and Internet | 978 | 117 | 861 | |
| Dues and Subscriptions | 16 | |||
| Insurance Commercial Property Rental | -377 | -377 | ||
| Maintenance and Repairs Rental | 4,076 | 4,076 | ||
| Office Expense includes postage and delivery | 3,080 | 370 | 2,710 | |
| Professional Development | 479 | 479 | ||
| Telephone, fax, emal | 147 | 18 | 129 | |
| Utilities Rental | 5,844 | 5,844 | ||
| Board Fees | 3,000 | 3,000 | ||
| Depreciation | 9,452 | 9,452 | ||
| Management Expense Rental | 362 | 362 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| Payroll liabilities | 1,639 | |
| Capital One Visa | 5,816 | 6,923 |
| Unrealized Gain or Loss -FX transactions | -1,813 | 26,853 |
| Name | Address |
|---|---|
| Arthur B Schultz |
501 Lakeshore Blvd Unit 50 Incline Village,NV89452 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Tax on investment income | 30,450 | |||
| Property Tax Rental | 4,641 | 4,641 | ||
| License and Permits | 27 |