Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
FOX CITIES RETIREMENT VILLAGE INC
 
Number and street (or P.O. box number if mail is not delivered to street address)160 S GREEN BAY ROAD
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEENAH, WI54956
A Employer identification number

39-1335177
B Telephone number (see instructions)

(920) 850-5974
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$2,502,419J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 10,022 10,022 10,022
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 139,877 0 139,877
12 Total. Add lines 1 through 11........ 149,899 10,022 149,899
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 6,832 0 6,832 0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 8,118 0 8,118 0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 128 128 0 0
19 Depreciation (attach schedule) and depletion... Click to see attachment 36,774 0 36,774
20 Occupancy.............. 48,552 0 48,552 0
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 51,445 0 51,445 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 151,849 128 151,721 0
25 Contributions, gifts, grants paid....... 2,500 2,500
26 Total expenses and disbursements. Add lines 24 and 25 154,349 128 151,721 2,500
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -4,450
b Net investment income (if negative, enter -0-) 9,894
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 10,395 16,062 16,062
2 Savings and temporary cash investments......... 590,133 677,357 677,357
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet1,790,142
Less: accumulated depreciation (attach schedule) bullet1,464,751 304,253 Click to see attachment325,391 1,809,000
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 904,781 1,018,810 2,502,419
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment681,085 Click to see attachment799,564
23 Total liabilities (add lines 17 through 22)......... 681,085 799,564
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 0 0
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 223,696 219,246
29 Total net assets or fund balances (see instructions)..... 223,696 219,246
30 Total liabilities and net assets/fund balances (see instructions). 904,781 1,018,810
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
223,696
2
Enter amount from Part I, line 27a .....................
2
-4,450
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
219,246
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
219,246
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 138
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 138
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 138
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 0
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 138
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 138
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 0
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
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? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
     
    No
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletWI
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
    Yes
     
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletCYNTHIA PETERSON Telephone no.bullet (920) 205-3990

    Located atbullet320 HARRISON STNEENAHWI ZIP+4bullet54956
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), 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? See instructions ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a 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? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 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? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2020.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    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 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), 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? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    EMIL LEPPIAHO PRESIDENT
    1.00     		0 0 0
    160 S GREEN BAY RD APT 107
    NEENAH,WI54956
    JANE ARPS VICE PRESIDENT
    1.00     		0 0 0
    160 S GREEN BAY RD APT 206
    NEENAH,WI54956
    JACQUELINE GULLICKSON MANAGER/DIRECTOR
    1.00     		3,198 0 0
    160 S GREEN BAY RD APT 109
    NEENAH,WI54956
    BENNETT HILLIKER DIRECTOR
    1.00     		1,520 0 0
    160 S GREEN BAY RD APT 110
    NEENAH,WI54956
    CYNTHIA PETERSON FINANCIAL SECRETARY
    1.00     		2,114 0 0
    320 HARRISON ST
    NEENAH,WI54956
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 OPERATE APARTMENTS FOR THE ELDERLY 154,349
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    633,745
    b
    Average of monthly cash balances.......................
    1b
    13,229
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    646,974
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    646,974
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    9,705
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    637,269
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    31,863
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
     
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
     
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
     
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
     
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
     
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    2,500
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    2,500
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    2,500
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2019     		(c)
    2019     		(d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7  
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015......  
    b From 2016......  
    c From 2017......  
    d From 2018......  
    e From 2019......  
    fTotal of lines 3a through e........  
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$  
    a Applied to 2019, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2020 distributable amount.....  
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2020.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		 
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2016....  
    b Excess from 2017....  
    c Excess from 2018....  
    d Excess from 2019....  
    e Excess from 2020....  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet
    1979-01-01
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
    0 4,964 17,170 27,981 50,115
    b 85% of line 2a ......... 0 4,219 14,595 23,784 42,598
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		2,500 0 0 0 2,500
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		0 0 0 0 0
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		2,500 0 0 0 2,500
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......         0
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		         0
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		21,242 17,620 16,943 18,654 74,459
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		        0
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		        0
    (3) Largest amount of support
    from an exempt organization    		         0
    (4) Gross investment income         0
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    NEENAH WISCONSIN PARKS & RECREATION DEPARTMENT
    211 WALNUT ST PO BOX 426
    NEENAH,WI549570426     		  GOV CHARITABLE GIVING 2,000
    ST MARK'S FOOD PANTRY
    140 S GREEN BAY ROAD
    NEENAH,WI54956     		  PC CHARITABLE GIVING 500
    Total .................................bullet 3a 2,500
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    aMAINTENANCE FEE-APARTMENTS         75,940
    bRENTAL AMORTIZATION INCOME         63,937
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 10,022  
    4 Dividends and interest from securities....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 10,022 139,877
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    149,899
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    1A THESE CHARGES ARE FOR PAYING UTILITIES AND MAINTAINING THE GROUNDS AND MAINTENANCE ON THE APARTMENTS
    1B AMORTIZATION FOR THE YEAR OF THE APARTMENT EACH PERSON OCCUPIES
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2020)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2020 AccountingFeesSchedule
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
      8,118 0 8,118 0

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2020 DepreciationSchedule
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    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
    AIR CONDITIONER - LOUNGE 1992-06-03 682 682 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. #101 1992-12-11 1,096 1,096 200DB 7.000000000000 0 0 0  
    COPIER - ST. MARK'S OFFICE 1992-03-28 1,155 1,155 200DB 7.000000000000 0 0 0  
    CARPET & VINYL APT. #210, LOUNGE 1992-02-01 11,528 11,528 200DB 7.000000000000 0 0 0  
    CARPET - APT. #113 1992-10-03 1,597 1,597 200DB 7.000000000000 0 0 0  
    USED WHEEL CHAIR 1992-11-02 350 350 200DB 7.000000000000 0 0 0  
    VACCUUM CLEANER 1992-12-31 252 252 200DB 7.000000000000 0 0 0  
    2 WASHERS & DRYERS 1993-04-14 2,048 2,048 200DB 7.000000000000 0 0 0  
    CARPET & VINYL APT. #101 1993-01-15 2,512 2,512 200SL 7.000000000000 0 0 0  
    CARPET - APT. #110 1993-07-21 1,912 1,912 200DB 7.000000000000 0 0 0  
    FIRE PROOF FILING CABINET 1993-12-15 1,071 1,071 200DB 7.000000000000 0 0 0  
    COPIER 1994-02-21 2,387 2,387 200DB 7.000000000000 0 0 0  
    AIR CONDITIONER 1994-07-07 549 549 200DB 7.000000000000 0 0 0  
    WASHER & DRYER 1994-07-31 984 984 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. #210 1994-11-06 1,029 1,029 200DB 7.000000000000 0 0 0  
    USED DESK - OFFICE 1995-04-19 200 200 200DB 7.000000000000 0 0 0  
    AIR CONDITIONER - LOBBY 1995-05-03 674 674 200DB 7.000000000000 0 0 0  
    CARPETING - APT. #104 1995-05-31 2,733 2,733 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR 1995-05-01 1,165 1,165 200DB 7.000000000000 0 0 0  
    SINK/DISPOSAL 1995-06-01 575 575 200DB 7.000000000000 0 0 0  
    CARPET & VINYL APT. #112 1995-10-03 2,482 2,482 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APTS 1995-10-10 2,210 2,210 200DB 7.000000000000 0 0 0  
    AIR CONDITIONER 1996-08-12 525 525 200DB 7.000000000000 0 0 0  
    2 AIR CONDITIONERS 1996-09-27 1,004 1,004 200DB 7.000000000000 0 0 0  
    STOVE/REFRIGERATOR - APT. 203 1997-01-25 1,134 1,134 200DB 7.000000000000 0 0 0  
    WASHER & DRYER 1997-04-02 945 945 200DB 7.000000000000 0 0 0  
    REFRIGERATOR 1997-06-03 630 630 200DB 7.000000000000 0 0 0  
    REFRIGERATOR/STOVE - APT. 209 1997-09-29 1,113 1,113 200DB 7.000000000000 0 0 0  
    CHAIRS & ROUNDS TABLES - LOUNGE 1997-11-13 619 619 200DB 7.000000000000 0 0 0  
    CARPET/VINYL/FLOORING - APT. 203 1997-01-29 2,733 2,733 200DB 7.000000000000 0 0 0  
    BLINDS - LOUNGE 1997-03-09 1,141 1,141 200DB 7.000000000000 0 0 0  
    CARPET/VINYL/FLOORING - APT. 209 1997-09-29 2,867 2,867 200DB 7.000000000000 0 0 0  
    WASHER & DRYER 1978-01-01 647 647 200SL 5.000000000000 0 0 0  
    WASHER & DRYER 1981-01-01 405 405 PRE 5.000000000000 0 0 0  
    2 WASHERS & DRYERS & 3 HUMIDIFIERS 1983-07-01 1,883 1,883 PRE 5.000000000000 0 0 0  
    2 REFUSE CONTAINERS 1985-07-01 427 427 PRE 5.000000000000 0 0 0  
    DRAPES 1988-07-01 1,503 1,503 200DB 7.000000000000 0 0 0  
    CARPET 1988-07-01 4,617 4,617 200DB 7.000000000000 0 0 0  
    AIR CONDITIONER 1989-06-13 441 441 200DB 7.000000000000 0 0 0  
    STOVE #207 1990-06-27 672 672 200DB 7.000000000000 0 0 0  
    REFRIGERATOR #207 1990-07-02 618 618 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR #205 1990-07-02 1,195 1,195 200DB 7.000000000000 0 0 0  
    CARPET & VINYL 1990-06-21 2,393 2,393 200DB 7.000000000000 0 0 0  
    STOVE/REFRIGERATOR 1991-12-02 1,055 1,055 200DB 7.000000000000 0 0 0  
    CARPET #213 1991-09-03 1,912 1,912 200DB 7.000000000000 0 0 0  
    CARPET/VINYL #103 1991-11-05 2,394 2,394 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR 1992-04-02 1,150 1,150 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR #109 1998-10-09 1,235 1,235 200DB 7.000000000000 0 0 0  
    2 TABLES & CHAIRS FOR LOBBY 1998-10-22 571 571 200DB 7.000000000000 0 0 0  
    CARPET #112 1998-09-28 371 371 200DB 7.000000000000 0 0 0  
    CARPET & VINYL #109 1998-09-30 3,017 3,017 200DB 7.000000000000 0 0 0  
    INTERCOM SYSTEM 1999-07-02 1,901 1,901 200DB 7.000000000000 0 0 0  
    REFRIGERATOR - APT. 107 1999-09-02 630 630 200DB 7.000000000000 0 0 0  
    LOUNGE FURNITURE 1999-11-16 500 500 200DB 7.000000000000 0 0 0  
    FURNITURE - LOUNGE 2000-02-10 3,173 3,173 200DB 7.000000000000 0 0 0  
    FURNITURE - LOUNGE 2000-02-10 483 483 200DB 7.000000000000 0 0 0  
    GLASS ON RAILING - UPPER LOUNGE 2000-02-22 952 952 200DB 7.000000000000 0 0 0  
    LAMPS - LOUNGE 2000-03-08 408 408 200DB 7.000000000000 0 0 0  
    END TABLE - LOUNGE 2000-03-23 678 678 200DB 7.000000000000 0 0 0  
    STOVE - APT #205 2000-05-30 556 556 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. 211 2000-06-12 1,260 1,260 200DB 7.000000000000 0 0 0  
    REFRIGERATOR - APT. 205 2000-09-27 661 661 200DB 7.000000000000 0 0 0  
    CARPET & VINYL - APT. 106 2000-04-07 3,286 3,286 200DB 7.000000000000 0 0 0  
    BASEBOARDS - APT. 106 2000-04-11 466 466 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. 106 2000-04-11 1,197 1,197 200DB 7.000000000000 0 0 0  
    CARPET & VINYL - APT. 211 2000-06-12 3,557 3,557 200DB 7.000000000000 0 0 0  
    CARPET & VINYL - APT 205 2000-09-15 2,703 2,703 200DB 7.000000000000 0 0 0  
    CARPET & VINYL - APT. 207 2000-12-23 3,101 3,101 200DB 7.000000000000 0 0 0  
    STOVE - APT. 107 2001-01-13 745 745 200DB 7.000000000000 0 0 0  
    REFRIGERATOR - APT. 107 2001-01-13 1,344 1,344 200DB 7.000000000000 0 0 0  
    CARPETING - APT. 107 2001-01-26 3,580 3,580 200DB 7.000000000000 0 0 0  
    CARPETING - APT. 208 2001-06-25 3,298 3,298 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. 208 2001-07-19 1,134 1,134 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. 202 2001-07-28 1,123 1,123 200DB 7.000000000000 0 0 0  
    REFRIGERATOR - APT. 210 2001-10-09 609 609 200DB 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - APT. 105 2001-12-18 1,312 1,312 200DB 7.000000000000 0 0 0  
    FLOOR COVERING - APT. 105 2001-12-19 3,696 3,696 200DB 7.000000000000 0 0 0  
    STOVE - APT. 201 2002-02-07 580 580 SL 7.000000000000 0 0 0  
    EMERGENCY LIGHTING SYSTEM 2002-03-04 102 102 SL 7.000000000000 0 0 0  
    FLOOR COVERINGS 2003-03-18 4,333 4,333 200SL 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR 2003-03-24 1,071 1,071 200SL 7.000000000000 0 0 0  
    FLOOR COVERING 2003-04-02 3,897 3,897 200SL 7.000000000000 0 0 0  
    FLOOR COVERING 2003-04-02 4,031 4,031 200SL 7.000000000000 0 0 0  
    STOVES & REFRIGERATORS 2003-05-01 2,142 2,142 200SL 7.000000000000 0 0 0  
    AWNING 2004-08-20 1,058 1,058 200SL 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR #111 2004-10-30 1,071 1,071 200SL 7.000000000000 0 0 0  
    FLOOR COVERING #111 2004-11-04 4,384 4,384 200SL 7.000000000000 0 0 0  
    WATER HEATER 2005-01-22 3,836 3,836 200SL 7.000000000000 0 0 0  
    STOVE & REFRIGERATOR - #103 2005-06-06 1,092 1,092 200SL 7.000000000000 0 0 0  
    FLOOR COVERING #103 2005-07-07 3,790 3,790 200SL 7.000000000000 0 0 0  
    AIR CONDITIONER #205 2005-08-30 630 630 200SL 7.000000000000 0 0 0  
    REFRIGERATORS #112 & #201 2005-11-08 903 903 200SL 7.000000000000 0 0 0  
    FLOOR COVERING LAMINATE 2006-04-05 2,545 2,333 SL 15.000000000000 170 0 170  
    AIR CONDITIONER 2006-08-05 655 655 200SL 7.000000000000 0 0 0  
    STOVE #104 2006-08-22 583 583 200SL 7.000000000000 0 0 0  
    VINYL & LAMINATE #202 2006-10-05 2,973 2,627 SL 15.000000000000 198 0 198  
    TWO DEHUMIDIFIERS 2007-05-27 483 483 200SL 7.000000000000 0 0 0  
    STOVE & FRIDGE #206 2007-11-14 1,018 1,018 200SL 7.000000000000 0 0 0  
    CARPET - #206 2007-11-19 3,500 3,500 200SL 7.000000000000 0 0 0  
    SNOW BLOWER 2008-03-04 740 740 200SL 7.000000000000 0 0 0  
    AIR CONDITIONER - APT 105 2008-07-15 525 525 200SL 7.000000000000 0 0 0  
    NEW STOVE #113 2009-05-15 609 609 200SL 7.000000000000 0 0 0  
    CARPETING #213 2009-11-03 3,394 3,394 200SL 7.000000000000 0 0 0  
    NEW ROOF ON OLD SECTION 1998-11-03 17,950 9,723 SL 39.000000000000 460 0 460  
    CONCRETE WALL - GARAGE 1999-05-03 15,894 8,406 SL 39.000000000000 408 0 408  
    PARKING LOT 1999-08-05 14,825 7,745 SL 39.000000000000 380 0 380  
    CABINET - APT. 106 2000-04-03 2,575 2,575 200DB 7.000000000000 0 0 0  
    PAINTING/VARNISHING - OLDER SECTION 2000-03-18 4,150 4,150 200DB 7.000000000000 0 0 0  
    CABINETS - APT. 217 2000-05-10 975 975 200DB 7.000000000000 0 0 0  
    CABINETS - APT. 205 2000-08-04 1,775 1,775 200DB 7.000000000000 0 0 0  
    CABINETS - APT. 107 & 207 2000-11-21 3,550 3,550 200DB 7.000000000000 0 0 0  
    PAINTING - APT. 106 &211 2000-04-08 2,488 2,488 200DB 7.000000000000 0 0 0  
    PAINTING APT 205 2000-08-14 975 975 200DB 7.000000000000 0 0 0  
    PAINTING APT 207 2000-11-24 640 640 200DB 7.000000000000 0 0 0  
    PAINTING APT 107 2001-01-14 1,440 1,440 200DB 7.000000000000 0 0 0  
    CABINETS APT 201 & 208 2001-03-19 3,550 3,550 200DB 7.000000000000 0 0 0  
    PAINTING APT 201 2001-04-17 1,005 1,005 200DB 7.000000000000 0 0 0  
    IMPROVEMENTS APTS 201 & 208 2001-06-30 2,888 2,888 200DB 7.000000000000 0 0 0  
    PAINTING APT 208 2001-06-06 1,370 1,370 200DB 7.000000000000 0 0 0  
    RAMP & RAIL 2001-09-18 4,090 4,090 200DB 7.000000000000 0 0 0  
    CABINETS APT105 2001-09-20 1,775 1,775 200DB 7.000000000000 0 0 0  
    EMERGENCY LIGHTING SYSTEM 2002-05-14 437 437 SL 7.000000000000 0 0 0  
    CABINETS APT 101 2002-11-27 1,775 1,775 200SL 7.000000000000 0 0 0  
    CABINETS #110 2003-01-20 1,775 1,775 200SL 7.000000000000 0 0 0  
    CABINETS #212 2003-03-03 1,775 1,775 200SL 7.000000000000 0 0 0  
    SHRUBBERY 2003-12-05 2,347 2,347 200SL 7.000000000000 0 0 0  
    LANDSCAPING - SHRUBS 2004-08-02 347 347 200SL 7.000000000000 0 0 0  
    CABINET SAVERS #103 2005-06-20 1,875 1,875 200SL 7.000000000000 0 0 0  
    NEW ROOF ON NEW ADDITION 2005-08-08 16,895 6,227 SL 39.000000000000 433 0 433  
    WINDOWS 2006-01-01 52,795 18,897 SL 39.000000000000 1,354 0 1,354  
    ELEVATOR 2006-08-01 99,534 34,136 SL 39.000000000000 2,552 0 2,552  
    WINDOWS - NEW SECTION 2006-01-15 41,126 14,720 SL 39.000000000000 1,054 0 1,054  
    CABINETS - #210 2006-08-11 900 900 200SL 7.000000000000 0 0 0  
    CABINETS - #202 2006-09-11 975 975 200SL 7.000000000000 0 0 0  
    CARPET LAUNDRY & ELEVATOR 2007-02-27 1,704 1,704 200SL 7.000000000000 0 0 0  
    CURBING AROUND BUILDING 2007-05-16 1,950 1,625 SL 15.000000000000 130 0 130  
    LANDSCAPING - STONES 2007-06-19 6,146 5,122 SL 15.000000000000 410 0 410  
    CABINETS #206 2007-10-06 1,875 1,875 200SL 7.000000000000 0 0 0  
    STEEL POORS 2007-11-19 1,691 1,409 SL 15.000000000000 113 0 113  
    SIDEWALK REPLACEMENTS 2008-08-11 11,225 10,048 150SL 15.000000000000 329 0 329  
    ADDITIONS & IMPROVEMENTS 1989-12-01 4,275 4,077 SL 31.500000000000 136 0 136  
    CARPORT 1990-01-02 1,912 1,818 SL 31.500000000000 61 0 61  
    CARPORT ROOF 1990-01-02 2,700 2,568 SL 31.500000000000 86 0 86  
    DRAINAGE DITCH 1990-10-27 2,983 2,766 SL 31.500000000000 95 0 95  
    PLUMB/STORM SEWER 1991-12-17 3,310 2,947 SL 31.500000000000 105 0 105  
    CANOPY & PATIO DOOR 1992-04-06 509 448 SL 31.500000000000 16 0 16  
    LANDSCAPING 1992-05-24 867 760 SL 31.500000000000 28 0 28  
    CARPORT ADDITION 1992-11-10 20,000 17,222 SL 31.500000000000 635 0 635  
    CARPORT 1993-01-08 4,563 4,099 200SL 31.500000000000 103 0 103  
    ARCHITECT'S FEES 1984-08-01 4,770 4,770 SL 18.000000000000 0 0 0  
    BUILDING - NEW 1984-08-01 303,904 303,904 SL 18.000000000000 0 0 0  
    BUILDING 1985-07-01 202,362 202,362 SL 19.000000000000 0 0 0  
    ADDITION 1986-07-01 47,716 47,716 SL 19.000000000000 0 0 0  
    BUILDING 1978-10-01 420,531 420,531 SL 20.000000000000 0 0 0  
    CARPORT 1980-01-01 15,607 15,607 SL 20.000000000000 0 0 0  
    BUILDING 1981-01-01 4,079 4,079 SL 20.000000000000 0 0 0  
    ARCHITECT'S FEES 1978-01-01 3,401 3,401 SL 20.000000000000 0 0 0  
    ARCHITECT'S FEES 1978-01-01 1,200 1,200 SL 20.000000000000 0 0 0  
    ARCHITECT'S FEES 1978-01-01 800 800 SL 20.000000000000 0 0 0  
    STOVE APT #210 2010-10-04 651 651 200SL 7.000000000000 0 0 0  
    STOVE APT #207 2010-12-03 629 629 200SL 7.000000000000 0 0 0  
    NEW WASHER & DRYER 2011-11-22 1,036 1,036 200DB 7.000000000000 0 0 0  
    NEW DRIVE WAY AND PARKING LOT 2014-07-28 10,910 4,000 SL 15.000000000000 727 0 727  
    REFRIGERATOR, APT #113 2015-01-26 745 579 200DB 7.000000000000 67 0 67  
    WASHER AND DRYER 2015-11-11 907 705 200DB 7.000000000000 81 0 81  
    CABINETS, APT # 103 2015-05-19 1,945 1,511 200DB 7.000000000000 174 0 174  
    CABINETS, APT # 204 2015-07-22 1,946 1,512 200DB 7.000000000000 174 0 174  
    CARPET, APT # 213 2015-12-05 1,631 1,267 200DB 7.000000000000 146 0 146  
    DECK 2016-09-28 4,039 341 SL 39.000000000000 104 0 104  
    AIR CONDITIONERS 2016-06-30 4,592 3,157 200DB 7.000000000000 410 0 410  
    CARPETING 2016-06-30 19,133 15,827 200DB 5.000000000000 2,204 0 2,204  
    CABINETS, #113 2016-12-02 3,875 2,665 200DB 7.000000000000 346 0 346  
    CABINETS & COUNTERTOPS 2017-09-18 5,460 3,072 200DB 7.000000000000 682 0 682  
    AIR CONDITIONER 2017-06-03 2,642 1,486 200DB 7.000000000000 330 0 330  
    DRYER 2017-11-01 882 496 200DB 7.000000000000 110 0 110  
    FLOORING - APT. #105 2018-12-04 4,410 1,896 200DB 5.000000000000 1,006 0 1,006  
    FLOORING - APT. #113 2018-02-12 1,448 883 200DB 5.000000000000 226 0 226  
    BATHROOM REMODELS 2019-07-01 80,470 946 SL 39.000000000000 2,063 0 2,063  
    FLOORING 2019-07-01 23,554 4,711 200DB 5.000000000000 7,537 0 7,537  
    REFRIGERATORS 2019-07-01 2,187 312 200DB 7.000000000000 536 0 536  
    STOVES 2019-07-01 1,400 200 200DB 7.000000000000 343 0 343  
    GARAGE DOOR 2019-02-25 1,343 192 200DB 7.000000000000 329 0 329  
    WATER HEATERS 2019-03-13 11,139 1,591 200DB 7.000000000000 2,728 0 2,728  
    2 HOT WATER HEATERS 2020-12-02 12,516   200DB 7.000000000000 1,788 0 1,788  
    2 AIR CONDITIONERS FOR LOBBY 2020-07-27 10,437   200DB 7.000000000000 1,491 0 1,491  
    BATHROOM REMODELS 2020-04-21 15,300   SL 39.000000000000 278 0 278  
    CABINETS & COUNTERTOPS 2020-03-05 5,050   200DB 7.000000000000 721 0 721  
    FLOORING 2020-07-01 14,608   200DB 5.000000000000 2,917 0 2,917  

    TY 2020 LandEtcSchedule2
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    AIR CONDITIONER - LOUNGE 682 682 0  
    STOVE & REFRIGERATOR - APT. #101 1,096 1,096 0  
    COPIER - ST. MARK'S OFFICE 1,155 1,155 0  
    CARPET & VINYL APT. #210, LOUNGE 11,528 11,528 0  
    CARPET - APT. #113 1,597 1,597 0  
    USED WHEEL CHAIR 350 350 0  
    VACCUUM CLEANER 252 252 0  
    2 WASHERS & DRYERS 2,048 2,048 0  
    CARPET & VINYL APT. #101 2,512 2,512 0  
    CARPET - APT. #110 1,912 1,912 0  
    FIRE PROOF FILING CABINET 1,071 1,071 0  
    COPIER 2,387 2,387 0  
    AIR CONDITIONER 549 549 0  
    WASHER & DRYER 984 984 0  
    STOVE & REFRIGERATOR - APT. #210 1,029 1,029 0  
    USED DESK - OFFICE 200 200 0  
    AIR CONDITIONER - LOBBY 674 674 0  
    CARPETING - APT. #104 2,733 2,733 0  
    STOVE & REFRIGERATOR 1,165 1,165 0  
    SINK/DISPOSAL 575 575 0  
    CARPET & VINYL APT. #112 2,482 2,482 0  
    STOVE & REFRIGERATOR - APTS 2,210 2,210 0  
    AIR CONDITIONER 525 525 0  
    2 AIR CONDITIONERS 1,004 1,004 0  
    STOVE/REFRIGERATOR - APT. 203 1,134 1,134 0  
    WASHER & DRYER 945 945 0  
    REFRIGERATOR 630 630 0  
    REFRIGERATOR/STOVE - APT. 209 1,113 1,113 0  
    CHAIRS & ROUNDS TABLES - LOUNGE 619 619 0  
    CARPET/VINYL/FLOORING - APT. 203 2,733 2,733 0  
    BLINDS - LOUNGE 1,141 1,141 0  
    CARPET/VINYL/FLOORING - APT. 209 2,867 2,867 0  
    WASHER & DRYER 647 647 0  
    WASHER & DRYER 405 405 0  
    2 WASHERS & DRYERS & 3 HUMIDIFIERS 1,883 1,883 0  
    2 REFUSE CONTAINERS 427 427 0  
    DRAPES 1,503 1,503 0  
    CARPET 4,617 4,617 0  
    AIR CONDITIONER 441 441 0  
    STOVE #207 672 672 0  
    REFRIGERATOR #207 618 618 0  
    STOVE & REFRIGERATOR #205 1,195 1,195 0  
    CARPET & VINYL 2,393 2,393 0  
    STOVE/REFRIGERATOR 1,055 1,055 0  
    CARPET #213 1,912 1,912 0  
    CARPET/VINYL #103 2,394 2,394 0  
    STOVE & REFRIGERATOR 1,150 1,150 0  
    STOVE & REFRIGERATOR #109 1,235 1,235 0  
    2 TABLES & CHAIRS FOR LOBBY 571 571 0  
    CARPET #112 371 371 0  
    CARPET & VINYL #109 3,017 3,017 0  
    INTERCOM SYSTEM 1,901 1,901 0  
    REFRIGERATOR - APT. 107 630 630 0  
    LOUNGE FURNITURE 500 500 0  
    FURNITURE - LOUNGE 3,173 3,173 0  
    FURNITURE - LOUNGE 483 483 0  
    GLASS ON RAILING - UPPER LOUNGE 952 952 0  
    LAMPS - LOUNGE 408 408 0  
    END TABLE - LOUNGE 678 678 0  
    STOVE - APT #205 556 556 0  
    STOVE & REFRIGERATOR - APT. 211 1,260 1,260 0  
    REFRIGERATOR - APT. 205 661 661 0  
    CARPET & VINYL - APT. 106 3,286 3,286 0  
    BASEBOARDS - APT. 106 466 466 0  
    STOVE & REFRIGERATOR - APT. 106 1,197 1,197 0  
    CARPET & VINYL - APT. 211 3,557 3,557 0  
    CARPET & VINYL - APT 205 2,703 2,703 0  
    CARPET & VINYL - APT. 207 3,101 3,101 0  
    STOVE - APT. 107 745 745 0  
    REFRIGERATOR - APT. 107 1,344 1,344 0  
    CARPETING - APT. 107 3,580 3,580 0  
    CARPETING - APT. 208 3,298 3,298 0  
    STOVE & REFRIGERATOR - APT. 208 1,134 1,134 0  
    STOVE & REFRIGERATOR - APT. 202 1,123 1,123 0  
    REFRIGERATOR - APT. 210 609 609 0  
    STOVE & REFRIGERATOR - APT. 105 1,312 1,312 0  
    FLOOR COVERING - APT. 105 3,696 3,696 0  
    STOVE - APT. 201 580 580 0  
    EMERGENCY LIGHTING SYSTEM 102 102 0  
    FLOOR COVERINGS 4,333 4,333 0  
    STOVE & REFRIGERATOR 1,071 1,071 0  
    FLOOR COVERING 3,897 3,897 0  
    FLOOR COVERING 4,031 4,031 0  
    STOVES & REFRIGERATORS 2,142 2,142 0  
    AWNING 1,058 1,058 0  
    STOVE & REFRIGERATOR #111 1,071 1,071 0  
    FLOOR COVERING #111 4,384 4,384 0  
    WATER HEATER 3,836 3,836 0  
    STOVE & REFRIGERATOR - #103 1,092 1,092 0  
    FLOOR COVERING #103 3,790 3,790 0  
    AIR CONDITIONER #205 630 630 0  
    REFRIGERATORS #112 & #201 903 903 0  
    FLOOR COVERING LAMINATE 2,545 2,503 42  
    AIR CONDITIONER 655 655 0  
    STOVE #104 583 583 0  
    VINYL & LAMINATE #202 2,973 2,825 148  
    TWO DEHUMIDIFIERS 483 483 0  
    STOVE & FRIDGE #206 1,018 1,018 0  
    CARPET - #206 3,500 3,500 0  
    SNOW BLOWER 740 740 0  
    AIR CONDITIONER - APT 105 525 525 0  
    NEW STOVE #113 609 609 0  
    CARPETING #213 3,394 3,394 0  
    NEW ROOF ON OLD SECTION 17,950 10,183 7,767  
    CONCRETE WALL - GARAGE 15,894 8,814 7,080  
    PARKING LOT 14,825 8,125 6,700  
    CABINET - APT. 106 2,575 2,575 0  
    PAINTING/VARNISHING - OLDER SECTION 4,150 4,150 0  
    CABINETS - APT. 217 975 975 0  
    CABINETS - APT. 205 1,775 1,775 0  
    CABINETS - APT. 107 & 207 3,550 3,550 0  
    PAINTING - APT. 106 &211 2,488 2,488 0  
    PAINTING APT 205 975 975 0  
    PAINTING APT 207 640 640 0  
    PAINTING APT 107 1,440 1,440 0  
    CABINETS APT 201 & 208 3,550 3,550 0  
    PAINTING APT 201 1,005 1,005 0  
    IMPROVEMENTS APTS 201 & 208 2,888 2,888 0  
    PAINTING APT 208 1,370 1,370 0  
    RAMP & RAIL 4,090 4,090 0  
    CABINETS APT105 1,775 1,775 0  
    EMERGENCY LIGHTING SYSTEM 437 437 0  
    CABINETS APT 101 1,775 1,775 0  
    CABINETS #110 1,775 1,775 0  
    CABINETS #212 1,775 1,775 0  
    SHRUBBERY 2,347 2,347 0  
    LANDSCAPING - SHRUBS 347 347 0  
    CABINET SAVERS #103 1,875 1,875 0  
    NEW ROOF ON NEW ADDITION 16,895 6,660 10,235  
    WINDOWS 52,795 20,251 32,544  
    ELEVATOR 99,534 36,688 62,846  
    WINDOWS - NEW SECTION 41,126 15,774 25,352  
    CABINETS - #210 900 900 0  
    CABINETS - #202 975 975 0  
    CARPET LAUNDRY & ELEVATOR 1,704 1,704 0  
    CURBING AROUND BUILDING 1,950 1,755 195  
    LANDSCAPING - STONES 6,146 5,532 614  
    CABINETS #206 1,875 1,875 0  
    STEEL POORS 1,691 1,522 169  
    SIDEWALK REPLACEMENTS 11,225 10,377 848  
    ADDITIONS & IMPROVEMENTS 4,275 4,213 62  
    CARPORT 1,912 1,879 33  
    CARPORT ROOF 2,700 2,654 46  
    DRAINAGE DITCH 2,983 2,861 122  
    PLUMB/STORM SEWER 3,310 3,052 258  
    CANOPY & PATIO DOOR 509 464 45  
    LANDSCAPING 867 788 79  
    CARPORT ADDITION 20,000 17,857 2,143  
    CARPORT 4,563 4,202 361  
    ARCHITECT'S FEES 4,770 4,770 0  
    BUILDING - NEW 303,904 303,904 0  
    BUILDING 202,362 202,362 0  
    ADDITION 47,716 47,716 0  
    BUILDING 420,531 420,531 0  
    CARPORT 15,607 15,607 0  
    BUILDING 4,079 4,079 0  
    ARCHITECT'S FEES 3,401 3,401 0  
    ARCHITECT'S FEES 1,200 1,200 0  
    ARCHITECT'S FEES 800 800 0  
    STOVE APT #210 651 651 0  
    STOVE APT #207 629 629 0  
    NEW WASHER & DRYER 1,036 1,036 0  
    NEW DRIVE WAY AND PARKING LOT 10,910 4,727 6,183  
    REFRIGERATOR, APT #113 745 646 99  
    WASHER AND DRYER 907 786 121  
    CABINETS, APT # 103 1,945 1,685 260  
    CABINETS, APT # 204 1,946 1,686 260  
    CARPET, APT # 213 1,631 1,413 218  
    DECK 4,039 445 3,594  
    AIR CONDITIONERS 4,592 3,567 1,025  
    CARPETING 19,133 18,031 1,102  
    CABINETS, #113 3,875 3,011 864  
    CABINETS & COUNTERTOPS 5,460 3,754 1,706  
    AIR CONDITIONER 2,642 1,816 826  
    DRYER 882 606 276  
    FLOORING - APT. #105 4,410 2,902 1,508  
    FLOORING - APT. #113 1,448 1,109 339  
    BATHROOM REMODELS 80,470 3,009 77,461  
    FLOORING 23,554 12,248 11,306  
    REFRIGERATORS 2,187 848 1,339  
    STOVES 1,400 543 857  
    GARAGE DOOR 1,343 521 822  
    WATER HEATERS 11,139 4,319 6,820  
    2 HOT WATER HEATERS 12,516 1,788 10,728  
    2 AIR CONDITIONERS FOR LOBBY 10,437 1,491 8,946  
    BATHROOM REMODELS 15,300 278 15,022  
    CABINETS & COUNTERTOPS 5,050 721 4,329  
    FLOORING 14,608 2,917 11,691  


    TY 2020 OtherExpensesSchedule
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INSURANCE 10,206 0 10,206 0
    GROUNDSKEEPING 4,984 0 4,984 0
    OFFICE EXPENSE 1,087 0 1,087 0
    REPAIRS AND MAINTENANCE 35,168 0 35,168 0


    TY 2020 OtherIncomeSchedule2
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    MAINTENANCE FEE-APARTMENTS 75,940   75,940
    RENTAL AMORTIZATION INCOME 63,937   63,937


    TY 2020 OtherLiabilitiesSchedule
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    Description Beginning of Year - Book Value End of Year - Book Value
    LIFE LEASES 681,085 799,564


    TY 2020 TaxesSchedule
    Name:
    FOX CITIES RETIREMENT VILLAGE INC
    EIN:
    39-1335177
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAXES ON IVESTMENT INCOME 128 128 0 0