TY 2023 Form 990PF

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	-3
	2	Savings and temporary cash investments.........	12,051	16,396	16,396
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	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) 9,002
		Less: allowance for doubtful accounts	9,002	List of Attached Documents: // Content 9,002	9,002
	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).......	885,100	List of Attached Documents: // Content 1,056,212	1,056,212
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	906,150	1,081,610	1,081,610
	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 )
	23	Total liabilities (add lines 17 through 22).........		0
		Foundations that follow FASB ASC 958, check here
		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
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........
	27	Paid-in or capital surplus, or land, bldg., and equipment fund
	28	Retained earnings, accumulated income, endowment, or other funds	906,150	1,081,610
	29	Total net assets or fund balances (see instructions).....	906,150	1,081,610
	30	Total liabilities and net assets/fund balances (see instructions).	906,150	1,081,610

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

906,150

Enter amount from Part I, line 27a .....................

6,150

Other increases not included in line 2 (itemize) right arrow

List of Attached Documents:

// Content

169,310

Add lines 1, 2, and 3 ..........................

1,081,610

Decreases not included in line 2 (itemize) right arrow

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

1,081,610

(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	(d) Date sold (mo., day, yr.)
1 a	BANK OF NEW YORK MELLON CORP	P	2023-09-25
b
c
d
e

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	13,923	8,511	5,412
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			5,412
b
c
d
e

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	5,412
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 ...................		3

1a	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)	1	30
b	All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) 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
3	Add lines 1 and 2...........................	3	30
4	Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	4
5	Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- .....	5	30
6	Credits/Payments:

a	2023 estimated tax payments and 2022 overpayment credited to 2023	6a
b	Exempt foreign organizations—tax withheld at source......	6b
c	Tax paid with application for extension of time to file (Form 8868)...	6c
d	Backup withholding erroneously withheld ..........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9	30
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10
11	Enter the amount of line 10 to be: Credited to 2024 estimated tax	Refunded	11

(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
ANN BURKHOLDER	PRESIDENT 2.00	0	0	0
PO BOX 88 COZAD,NE69130
DIANNA KOSMAN	VICE PRESIDE 2.00	0	0	0
PO BOX 991 ALACHUA,FL32615
HH KOSMAN	SECRETARY/TR 2.00	0	0	0
190498 COUNTY ROAD G SCOTTSBLUFF,NE69363
MATT BURKHOLDER	DIRECTOR 1.00	0	0	0
3309 AVENUE O COZAD,NE69130
LARA BURKHOLDER	DIRECTOR 1.00	0	0	0
2114 MEADE LN DURHAM,NC27707
H HUNTER KOSMAN	DIRECTOR 1.00	0	0	0
180958 ENGLEMAN LN MITCHELL,NE69357
JENNIFER BOSTIC	DIRECTOR 1.00	0	0	0
736 N DEAN ST CHANDLER,AZ85226
RUDY ROTHSEIDEN	DIRECTOR 1.00	0	0	0
PO BOX 991 ALACHUA,FL32615

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


2


3


4

Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.	Amount
1	N/A
2


All other program-related investments. See instructions.
3

		(a) Corpus	(d) 2023
1 Distributable amount for 2023 from Part X, line 7			49,120
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only.......
b Total for prior years:20 , 20, 20
3 Excess distributions carryover, if any, to 2022:
a From 2018......	9,453
b From 2019......	4,980
c From 2020......
d From 2021......
e From 2022......
f Total of lines 3a through e ........		14,433
4Qualifying distributions for 2023 from Part
XI, line 4: $ 46,000
a Applied to 2022, 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 2023 distributable amount.....			46,000
e Remaining amount distributed out of corpus
5 Excess distributions carryover applied to 2023.		3,120	3,120
(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		11,313
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 2022. Subtract line 4a from line 2a. Taxable amount—see instructions .............
f Undistributed income for 2023. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2024 ..........			0
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 2018 not applied on line 5 or line 7 (see instructions) ...		6,333
9 Excess distributions carryover to 2024. Subtract lines 7 and 8 from line 6a ......		4,980
10 Analysis of line 9:
a Excess from 2019....	4,980
b Excess from 2020....
c Excess from 2021....
d Excess from 2022....
e Excess from 2023....

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part IX for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2023	(b) 2022	(c) 2021	(d) 2020	(e) Total

b 85% (0.85) of line 2a .........
c Qualifying distributions from Part XI, line 4 for each year listed .....
d Amounts included in line 2c not used directly for active conduct of exempt activities ..........
e Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c ....
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part IX, line 6 for each year listed ..
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) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

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:

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
COLLEGE OF CHARLESTON FOUNDATION 66 GEORGE ST CHARLESTON,SC29424	NONE	PUBLIC	GENERAL	2,000
PLATTE RIVER BASIS ENVIRONMENTS PO BOX 2308 SCOTTSBLUFF,NE69363	NONE	PUBLIC	GENERAL	15,000
ALACHUA CO LIBRARY FOUNDATION 401 EAST UNIVERSITY AVE GAINSVILLE,FL32601	NONE	PUBLIC	GENERAL	2,000
FLORIDA SPRINGS FOUNDATION 23695 US 27 HIGH SPRINGS,FL32601	NONE	PUBLIC	GENERAL	2,000
LEAGUE OF WOMEN VOTERS 1730 M ST NW SUITE 10 WASHINGTON,DC20036	NONE	PUBLIC	GENERAL	1,000
AL MEBANE HIGHSCHOOL ALUMNI 16401 NW140TH ST ALACHUA,FL32615	NONE	PUBLIC	GENERAL	7,000
10-42 CORPORATION 16048 NW 208TH WAY HIGH SPRINGS,FL32643	NONE	PUBLIC	GENERAL	2,000
FRIENDS OF THE MIDWEST THEATER PO BOX 276 1707 BROADWAY SCOTTSBLUFF,NE69363	NONE	PUBLIC	GENERAL	1,000
COZAD PUBLIC SCHOOLS FOUNDATION PO BOX 540 COZAD,NE69130	NONE	PRIVATE	GENERAL	5,000
TEAMMATES 1810 MERIDIAN AVE COZAD,NE69130	NONE	PUBLIC	GENERAL	3,000
CHARITABLE FUND OF COZAD US 30 COZAD,NE69130	NONE	PUBLIC	GENERAL	2,000
WILSON PUBLIC LIBRARY 910 MERIDIAN AVE COZAD,NE69130	NONE	PUBLIC	GENERAL	2,000
ROBERT HENRI MUSEUM 218 E 8TH ST COZAD,NE69130	NONE	PUBLIC	GENERAL	1,000
TRI FAITH INITIATIVE 13136 FAITH PLAZA OMAHA,NE68144	NONE	PUBLIC	GENERAL	1,000
Total ................................. 3a				46,000

	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)


1	Contributions, gifts, grants, etc., received (attach schedule)	50,000
2	Check .............
3	Interest on savings and temporary cash investments	85		85	85
4	Dividends and interest from securities...	9,872		9,872	9,872
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		5,412
b	Gross sales price for all assets on line 6a 13,923
7	Capital gain net income (from Part IV, line 2)...			5,412
8	Net short-term capital gain.........
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).......
12	Total. Add lines 1 through 11........	65,369		15,369	9,957
13	Compensation of officers, directors, trustees, etc.
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......	List of Attached Documents: // Content	715	715	715
c	Other professional fees (attach schedule)....	List of Attached Documents: // Content	12,313	12,313	12,313
17	Interest...............
18	Taxes (attach schedule) (see instructions)...	List of Attached Documents: // Content	166	166	166
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......	List of Attached Documents: // Content	25	25	25
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	13,219		13,219	13,219	0
25	Contributions, gifts, grants paid.......	46,000				46,000
26	Total expenses and disbursements. Add lines 24 and 25	59,219		13,219	13,219	46,000
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	6,150
b	Net investment income (if negative, enter -0-)			2,150
c	Adjusted net income (if negative, enter -0-)...

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

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	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments ....
3 Interest on savings and temporary cash investments ...........			14	85
4 Dividends and interest from securities ....			14	9,872
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 ............			18	5,412
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) ..				15,369

(a) Line No.	(b) Amount involved	(c) Name of noncharitable exempt organization	(d) Description of transfers, transactions, and sharing arrangements

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name				Firm's EIN
	Firm's address				Phone no.


(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...................

bApproved for future payment

Total ................................. 3b

Name of organization KOSMAN FOUNDATION

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
1	KOSMAN INC 190498 CTY RD G SCOTTSBLUFF, NE69361	$ 50,000	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Name of organization KOSMAN FOUNDATION		Employer identification number 55-0850261

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)


Name of organization KOSMAN FOUNDATION			Employer identification number 55-0850261
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

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