Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 28,326 | 1,948 | 103,831 | 27,068 | 240,000 | 401,173 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 28,326 | 1,948 | 103,831 | 27,068 | 240,000 | 401,173 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 401,173 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 28,326 | 1,948 | 103,831 | 27,068 | 240,000 | 401,173 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | 401,173 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 21013554 |
| Software Version: | 21.0.5.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 2,000, Revenue 0 Ck 1007 Miller to UNK for Tanner Maddox scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1008 Miller to Mid-plains community college for Logan Vogel Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 3,000, Revenue 0 Ck 1009, 1010, 1011 Miller - CCC in Hastings, Columbus and Grand Island for three scholarships to Jakob Syring, Teegan Hansel, Noel Roan |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 2,000, Revenue 0 Ck 1012 Miller to UNL for Valerie Christesen scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1013 Miller to Wayne State College for Zoi Hymer Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1014 Miller to Creighton University for Carley Dixson Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 1015 Miller to UNK College for Austin Dubas Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 1016 MIller to UNL for Asia Ambrose Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1017 Miller to UNK for Josie Jakubowski Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1018 Miller to UNL for Gunnar Nyberg Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1019 Miller to UNK for Tayla Goettsch Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1020 Miller to Wayne State College for Camryn Morgan Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1021 Miller to CCC - Grand Island for Dolcey Van Winkle Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1022 Miller to CCC - Columbus for Abby Elstermeier Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1023 Miller to Northeast Comm College for Haley Hansen Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1024 Miller to CCC-Grand Island for Jackson Lamm Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1025 Miller to UNK College for Jaden B. Dzingle Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1026 Miller to UNL for Jacob Wells Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1027 Miller to Josephs Cosmetology College for Braelyn Iiams scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 CK 1028 Miller to Doane University for Brenden Knapp Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 1,000, Revenue 0 Ck 1029 Miller to Univeristy of Wyoming for Tommy Wroblewski Scholarship |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 45,000, Revenue 0 CK 1030 Miller to Howard County Senior Center for two Hot Shot vehicles for meals on wheels deliveries |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 62,000, Revenue 0 CK 1031 HCF to Centura Education Foundation for renovation of gym |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 3,500, Revenue 0 CK 1032 Miller to Friends of Paplin Church for painting project |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 17,000, Revenue 0 Ck 1035 Library Foundation to St. Paul Early Childhood Development for curriculum materials, teacher wages |
| Form 990, Part VI, Section c, Line 19 | The governing documents, conflict of interest statements from board members and financial statements are available upon request. Several members of the Donor Advised Funds receive monthly brokerage statments and the HCF has a finance committee that receives the monthly brokerage statements. |
| Form 990, Part X, Line 28 | The restricted funds include the following HCF of 750,000.00 is a permanent restriction from the Betty Roemich Estate. In 2020 the Miller DAF restriction was 120,000.00. The Miller DAF reduces the restriction by 40,000.00 each year as provided in the Will of Elda Miller to reduce by 10 of the original donation 400,000.00 each year. Funds left at the end of the ten years have no restrictions. |
| Form 990, Part VI, Section B, Line 11b | The tax return was reviewed by the board this year by e-maling a copy of the return to the board members prior to filing. We did not hold our 3rd quarter meeting in person due to lack of business and contined Co-Vid 19 concerns |
| Form 990, Part V, Line 1c | The organization did not participate in any gambling activities. |
| Form 990, Part VI, Section B, Line 12c | Compliance by the officers and directors to annually disclose interests that could give rise to a conflict of interest is signed at the beginning of each year prior to the February meeting. This is also a point of review with each application for a gift. |
| Form 990, Part III, Line 4e | All grants totaled 159,000.00 and are shown on Schedule O attachment |
| Form 990, Part IV, Section B, Line 11b | The Form 990 Tax Return was e-mailed to all board member this year on October 26, 2022 and then review and Q and A were completed at the November 1, 2022 board meeting. The return is reviewed by a CPA prior to being sent to the board. |
| Form 990, Part IV, Section B, Line 12C | At the first meeting of the year, each board member is required to complete a Conflict of Interest statement. In addition, upon each vote the question is asked if anyone has a conflict of interest. |
| Form 990, Part X, Line 28 | The endowment amount comes from two sources The HCF initial gift had a 750,000.00 endowment clause. The Miller DAF had an quasi-endowment clause that said that only 40,000.00 plus interest and dividends earned in the prior year could be gifted. The original amount was 400,000.00 and each year the quasi-endowment amount decreases by 50,000.00. This is the seventh year so at the end of the year there was 120,000.00 left for future years gifts. |
| Software ID: | 21013554 |
| Software Version: | 21.0.5.0 |