TY 2023 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
right arrow

Go to www.irs.gov/Form990PF for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

For calendar year 2023, or tax year beginning 01-01-2023 , and ending 12-31-2023

Name of foundation
THE CHARLES FORD MEMORIAL HOME INC

Number and street (or P.O. box number if mail is not delivered to street address)920 S MAIN STREET
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
NEW HARMONY, IN47631

A Employer identification number

45-5388556

B Telephone number (see instructions)

(812) 682-4675

C If exemption application is pending, check here right arrow

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. right arrow

2. Foreign organizations meeting the 85%
test, check here and attach computation ... right arrow

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... right arrow

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... right arrow

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) right arrow

$10,647,114J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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)	1,652
2	Check .............
3	Interest on savings and temporary cash investments	43,657		43,657	43,657
4	Dividends and interest from securities...	210,955		210,955	210,955
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		46,706
b	Gross sales price for all assets on line 6a 834,925
7	Capital gain net income (from Part IV, line 2)...			46,706
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).......	List of Attached Documents: // Content	1,524,319	437,616	1,524,319
12	Total. Add lines 1 through 11........	1,827,289		738,934	1,778,931
13	Compensation of officers, directors, trustees, etc.	147,259		0	0	147,259
14	Other employee salaries and wages......	1,179,695		0	0	1,326,954
15	Pension plans, employee benefits.......	27,683		0	0	27,863
16a	Legal fees (attach schedule).........	List of Attached Documents: // Content	3,473	1,737	1,736	0
b	Accounting fees (attach schedule).......	List of Attached Documents: // Content	14,775	7,388	7,387	0
c	Other professional fees (attach schedule)....
17	Interest...............	223		0	0	223
18	Taxes (attach schedule) (see instructions)...	List of Attached Documents: // Content	121,328	9,804	9,323	102,201
19	Depreciation (attach schedule) and depletion...	List of Attached Documents: // Content	63,125	0	63,125
20	Occupancy..............	116,018		0	0	116,018
21	Travel, conferences, and meetings.......	1,812		0	0	1,812
22	Printing and publications..........
23	Other expenses (attach schedule).......	List of Attached Documents: // Content	988,685	30,445	0	958,240
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	2,664,076		49,374	81,571	2,680,570
25	Contributions, gifts, grants paid.......	0				0
26	Total expenses and disbursements. Add lines 24 and 25	2,664,076		49,374	81,571	2,680,570
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-836,787
b	Net investment income (if negative, enter -0-)			689,560
c	Adjusted net income (if negative, enter -0-)...				1,697,360

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2023)

Form 990-PF (2023)

Page 2

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.............	392,640	63,021	63,021
	2	Savings and temporary cash investments.........
	3	Accounts receivable 31,525
		Less: allowance for doubtful accounts	26,710	31,525	31,525
	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)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........	20,098	29,715	29,715
	10a	Investments—U.S. and state government obligations (attach schedule)	399,901	List of Attached Documents: // Content 399,901	396,840
	b	Investments—corporate stock (attach schedule).......	2,161,464	List of Attached Documents: // Content 2,173,040	4,465,025
	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)..........	2,770,630	List of Attached Documents: // Content 2,278,928	4,265,200
	14	Land, buildings, and equipment: basis 2,497,706
		Less: accumulated depreciation (attach schedule) 1,111,614	1,344,681	List of Attached Documents: // Content 1,386,092	1,377,490
	15	Other assets (describe )	List of Attached Documents: // Content 19,821	List of Attached Documents: // Content 18,298	List of Attached Documents: // Content 18,298
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	7,135,945	6,380,520	10,647,114
	17	Accounts payable and accrued expenses..........	27,919	108,256
	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 )	List of Attached Documents: // Content 131,350	List of Attached Documents: // Content 132,375
	23	Total liabilities (add lines 17 through 22).........	159,269	240,631
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........	6,976,676	6,139,889
	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
	29	Total net assets or fund balances (see instructions).....	6,976,676	6,139,889
	30	Total liabilities and net assets/fund balances (see instructions).	7,135,945	6,380,520

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

6,976,676

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

-836,787

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

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

6,139,889

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 .

6,139,889

Form 990-PF (2023)

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.)
1 a	MORGAN STANLEY	P	2012-01-01	2023-12-31
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	834,925	788,219	46,706
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			46,706
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	46,706
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	0

Part V

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 and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)	1	9,585
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	0
3	Add lines 1 and 2...........................	3	9,585
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	9,585
6	Credits/Payments:

a	2023 estimated tax payments and 2022 overpayment credited to 2023	6a	12,000
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	0
d	Backup withholding erroneously withheld ..........	6d	0

7	Total credits and payments. Add lines 6a through 6d..............		7	12,000
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.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	2,415
11	Enter the amount of line 10 to be: Credited to 2024 estimated tax2,415	Refunded	11	0

Form 990-PF (2023)

Page 4

Part VI-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:

(1) On the foundation. right arrow

$ 0(2) On foundation managers. right arrow

$ 0

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. right arrow

$ 0

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?.........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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? ................

Yes

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 XIV..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 2023 or the taxable year beginning in 2023? See the instructions for Part XIII.

If "Yes," complete Part XIII .............................

Yes

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address right arrow

HTTPS://RETIRENEWHARMONY.COM/

The books are in care of right arrow

AMY KOCH Telephone no. right arrow

(812) 682-4675

Located at right arrow

920 S MAIN STNEW HARMONYIN ZIP+4 right arrow

47631

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here ......... right arrow

and enter the amount of tax-exempt interest received or accrued during the year ........ right arrow

16 At any time during calendar year 2023, 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 right arrow

Form 990-PF (2023)

Page 5

Part VI-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

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? ...........

1a(1)

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? ..............................

1a(2)

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........

1a(3)

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............

1a(4)

(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)? ......................

1a(5)

(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.) ...............

1a(6)

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 ..........

Organizations relying on a current notice regarding disaster assistance check here ........ right arrow

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 2023? .............

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)):

At the end of tax year 2023, did the foundation have any undistributed income (Part XII, lines 6d

and 6e) for tax year(s) beginning before 2023?....................

If "Yes," list the years right arrow

20, 20, 20, 20

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

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year? ..............................

If "Yes," did it have excess business holdings in 2023 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 2023.) .....................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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 2023? ..

Form 990-PF (2023)

Page 6

Part VI-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........

5a(1)

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive? ....................

5a(2)

(3) Provide a grant to an individual for travel, study, or other similar purposes? .............

5a(3)

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions ........................

5a(4)

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals? .............

5a(5)

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 ........

Organizations relying on a current notice regarding disaster assistance check ......... right arrow

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).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? .............................

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....

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 VII

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
VICKI CAMPBELL	VICE PRESIDENT 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	VICE PRESIDENT 2.00	0	0
KAREN WALKER	SECRETARY 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	SECRETARY 2.00	0	0
LISA CASTLEBURY	TREASURER 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	TREASURER 2.00	0	0
NATHAN MAUDLIN	PRESIDENT 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	PRESIDENT 2.00	0	0
DR KATIE ELMAN	DIRECTOR 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	DIRECTOR 2.00	0	0
TOM STAHL	DIRECTOR 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	DIRECTOR 2.00	0	0
WILL TANK	DIRECTOR 2.00	0	0
920 S MAIN ST NEW HARMONY,IN47631	DIRECTOR 2.00	0	0
AMY KOCH	EXECUTIVE DIRECTOR 40.00	147,259	4,418
920 S MAIN ST NEW HARMONY,IN47631	EXECUTIVE DIRECTOR 40.00	147,259	4,418

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...................				0

Form 990-PF (2023)

Page 7

Part VII

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............. right arrow

Part VIII-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	THE CORPORATION OPERATE AN ASSISTED LIVING FACILITY	2,664,076
2


3


4

Part VIII-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......................... right arrow

Form 990-PF (2023)

Page 8

Part IX

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

8,988,885

Average of monthly cash balances.......................

227,832

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

9,216,717

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

9,216,717

Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see

instructions) .............................

138,251

Net value of noncharitable-use assets. Subtract line 4 from line 3. ............

9,078,466

Minimum investment return. Enter 5% (0.05) of line 5................

453,923

Part X

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.)

Minimum investment return from Part IX, line 6..................

Tax on investment income for 2022 from Part V, line 5.......

Income tax for 2022. (This does not include the tax from Part V.) ...

Add lines 2a and 2b............................

Distributable amount before adjustments. Subtract line 2c from line 1............

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...

Part XI

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

2,680,570

Program-related investments—total from Part VIII-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

104,531

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4. .......

2,785,101

Form 990-PF (2023)

Page 9

Part XII

Undistributed Income (see instructions)

		(a) Corpus	(b) Years prior to 2022	(c) 2022	(d) 2023
1 Distributable amount for 2023 from Part X, line 7
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......
b From 2019......
c From 2020......
d From 2021......
e From 2022......
f Total of lines 3a through e ........
4Qualifying distributions for 2023 from Part
XI, line 4: $
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.....
e Remaining amount distributed out of corpus
5 Excess distributions carryover applied to 2023.
(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 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 ..........
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) ...
9 Excess distributions carryover to 2024. Subtract lines 7 and 8 from line 6a ......
10 Analysis of line 9:
a Excess from 2019....
b Excess from 2020....
c Excess from 2021....
d Excess from 2022....
e Excess from 2023....

Form 990-PF (2023)

Page 10

Part XIII

Private Operating Foundations (see instructions and Part VI-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 2023, enter the date of the ruling ...... right arrow

2012-10-01

b Check box to indicate whether the organization is a private operating foundation described in section 4942(j)(3) or4942(j)(5)

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
	453,923	461,583	486,116	441,243	1,842,865
b 85% (0.85) of line 2a .........	385,835	392,346	413,199	375,057	1,566,435
c Qualifying distributions from Part XI, line 4 for each year listed .....	2,785,101	1,957,837	1,826,482	1,805,667	8,375,087
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 ....	2,785,101	1,957,837	1,826,482	1,805,667	8,375,087
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 IX, line 6 for each year listed ..	302,615	307,722	324,077	294,162	1,228,576
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 XIV

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 right arrow

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions

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 (2023)

Page 11

Part XIV

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year

Total ................................. 3a				0

bApproved for future payment

Total ................................. 3b				0

Form 990-PF (2023)

Page 12

Part XV-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	(e) Related or exempt function income (See instructions.)
aBREWERY STREET RENT			16	8,000
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	43,657
4 Dividends and interest from securities ....			14	210,955
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 .....			15	437,616
8 Gain or (loss) from sales of assets other than inventory ............					46,706
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: aINCOME - NEW RESIDENTS					899,733
bLAUNDRY INCOME					22,774
cINCOME BEAUTY SALON					1,025
dPHARMACY CONSULT INCOME					1,510
eINCONTINENT SUPPLY SERVICE					9,598
fIN ROOM TELEPHONES					750
gMISCELLANEOUS					2,569
hSERVICE INCOME LEVEL					140,744
12 Subtotal. Add columns (b), (d), and (e) ..		0		700,228	1,125,409

13Total. Add line 12, columns (b), (d), and (e)..................

1,825,637

(See worksheet in line 13 instructions to verify calculations.)

Part XV-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See instructions.)
11B	AMOUNT CONTRIBUTED BY THE RESIDENTS TO THE HOME TO MAINTAIN THE HOME AND PROVIDE FOOD AND SHELTER FOR THE RESIDENTS AMORTIZATION OF THE ASSETS GIVEN TO THE HOME BY THE RESIDENTS UPON ENTRANCE TO THE HOME. IT IS AMORTIZED OVER THE LIFE EXPECTANCY OF EACH OF THE RESIDENTS. THIS INCOME IS USED TO PROVIDE FOOD AND SHELTER TO THE RESIDENTS. CHANGE IN THE LIABILITY TO PROVIDE FOOD, SHELTER, AND MEDICAL CARE FOR THE REMAINING LIFETIME CARE RESIDENTS

Form 990-PF (2023)

Page 13

Part XVI

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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? ...........Yes No

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.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

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.

Form 990-PF (2023)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2023 AccountingFeesSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
ACCOUNTING FEES	14,775	7,388	7,387	0

- TIN:

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

TY 2023 DepreciationSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Description of Property	Date Acquired	Cost or Other Basis	Prior Years' Depreciation	Computation Method	Rate / Life (# of years)	Current Year's Depreciation Expense	Adjusted Net Income
ORIGINAL	1954-10-01	8,000	8,000	SL	50.000000000000	0	0
ADDITIONS	1955-01-01	68,217	68,217	SL	50.000000000000	0	0
ADDITIONS	1956-01-01	31,285	31,285	SL	50.000000000000	0	0
ADDITIONS	1957-01-01	4,678	4,678	SL	50.000000000000	0	0
ADDITIONS	1959-01-01	105	105	SL	50.000000000000	0	0
ADDITIONS	1962-01-01	1,459	1,459	SL	20.000000000000	0	0
ADDITIONS	1962-01-01	95	95	SL	20.000000000000	0	0
ADDITIONS	1964-01-01	279	279	SL	20.000000000000	0	0
DRIVEWAY	1969-01-01	703	703	SL	20.000000000000	0	0
ADDITION TO HOME	1972-01-01	251,742	251,742	SL	40.000000000000	0	0
DRIVEWAY	1972-01-01	9,500	9,500	SL	10.000000000000	0	0
PAVING	1973-01-01	3,042	3,042	SL	10.000000000000	0	0
COMPLETION OF ADDITION	1973-01-01	16,391	16,391	SL	40.000000000000	0	0
DOORS	1977-04-01	7,417	7,417	SL	20.000000000000	0	0
HANDRAILS	1978-06-01	1,459	1,459	SL	20.000000000000	0	0
NEW WING	1979-12-07	78,842	78,842	SL	20.000000000000	0	0
NEW WING-1980	1980-12-01	154,178	154,178	SL	20.000000000000	0	0
NEW WING	1980-12-01	30,957		SL	5.000000000000	0	0
STAINED GLASS WINDOWS-SUNROOM	1985-06-01	2,682	2,682	SL	20.000000000000	0	0
BUILDING IMPROVEMENTS WALK IN	2003-05-07	4,884	4,803	SL	20.000000000000	81	81
BUILDING IMPROVEMENTS	2003-05-13	1,057	1,040	SL	20.000000000000	17	17
HANDICAP RAMP	2003-07-19	2,237	2,172	SL	20.000000000000	65	65
CULVERT AT BACK ENTRANCE	2003-09-10	16,994	16,428	SL	20.000000000000	566	566
ELECTRICALLY WORK - ADDITION	2004-07-11	1,097	1,014	SL	20.000000000000	55	55
GUTTERING AND FASCIA	2004-07-29	1,500	1,381	SL	20.000000000000	75	75
STORAGE BUILDING	2004-12-31	32,501	11,700	SL	50.000000000000	650	650
ADD'I COST IN STORAGE BUILDING	2005-02-21	306	109	SL	50.000000000000	6	6
FRONT ENTRY DOOR	2006-11-01	5,147	2,080	SL	40.000000000000	129	129
AUTOMATIC DOOR	2009-06-17	2,613	2,373	SL	15.000000000000	174	174
ROOF	2009-10-07	104,651	68,677	SL	20.000000000000	5,233	5,233
GABEL REPAIRS & SCREENED	2010-06-25	10,285	3,297	SL	39.000000000000	264	264
SUNROOM KEYPAD	2010-07-21	3,181	769	SL	10.000000000000	318	318
CARPET ROOM 119	2013-01-21	534	508	SL	10.000000000000	26	4
WALLS IN KITCHEN	2013-02-18	2,445	604	SL	39.000000000000	63	63
REFRIGERATOR	2013-07-29	3,184	3,025	SL	10.000000000000	159	159
GOLF CAR	2013-09-23	4,795	4,555	SL	5.000000000000	240	240
2014 BUILDING REMODEL	2014-12-01	139,479	28,041	SL	39.000000000000	3,576	3,576
SPRINKLER SYSTEM	2014-12-08	57,510	57,510	SL	7.000000000000	0	0
SPRINKLER SYSTEM	2015-04-23	32,965	32,965	SL	7.000000000000	0	0
BUILDING IMPROVEMENTS	2015-12-15	139,019	25,249	SL	39.000000000000	3,565	3,565
2 AIR CONDITIONERS	2015-12-15	9,671	1,756	SL	39.000000000000	248	248
MAIN HALL A/C	2016-11-07	2,977	471	SL	39.000000000000	76	76
WATER HEATER	2016-12-15	4,223	2,710	SL	10.000000000000	422	422
BUILDING IMPROVEMENTS	2017-11-20	80,876	12,615	SL	39.000000000000	2,074	2,074
BUILDING IMPROVEMENTS	2017-11-20	86,536	11,279	SL	39.000000000000	2,219	2,219
FIRE ALARM PANEL	2017-12-15	4,812	4,812	SL	5.000000000000	0	0
WATER HEATER	2017-12-15	2,868	1,458	SL	10.000000000000	287	287
PTAC	2018-02-27	630	609	SL	5.000000000000	21	21
NURSE COMPUTER LE COMPUTER	2018-03-01	3,023	2,922	SL	5.000000000000	101	101
DRYER	2018-03-19	582	553	SL	5.000000000000	29	29
BEAUTY SHOP CHAIR	2018-04-23	1,069	998	SL	5.000000000000	71	71
CHAIRS	2018-07-15	8,718	7,846	SL	5.000000000000	872	872
TV REFRIGERATORS	2018-07-17	2,520	2,226	SL	5.000000000000	294	294
ADMISSIONS	2018-08-16	1,506	1,304	SL	5.000000000000	202	202
WI-FI & EXTENDERS	2018-09-18	1,290	1,096	SL	5.000000000000	194	194
TV DVD SHELF CABLES	2018-10-22	535	446	SL	5.000000000000	89	89
PAPER SHREDDER	2018-10-22	621	517	SL	5.000000000000	104	104
PTAC	2018-10-30	710	592	SL	5.000000000000	118	118
PTAC	2018-11-15	881	734	SL	5.000000000000	147	147
CARDIAC MONITOR STAND	2018-11-19	2,045	1,670	SL	10.000000000000	205	205
IMPROVEMENTS	2018-12-31	86,991	8,922	SL	39.000000000000	2,231	2,231
TIME CLOCK	2018-12-31	510	408	SL	5.000000000000	102	102
RESIDENT REFRIGERATORS	2019-07-02	1,025	350	SL	10.000000000000	103	103
2 PTCAC UNITS	2019-07-22	3,075	1,051	SL	10.000000000000	308	308
PTAC UNIT 7000 BTU	2019-08-22	1,467	489	SL	5.000000000000	293	293
COMPUTERS	2019-08-27	5,713	3,809	SL	5.000000000000	1,143	1,143
HOME FURNISHING	2019-12-26	62,777	18,833	SL	10.000000000000	6,278	6,278
KORESEN FIRE AND SECURITY	2019-12-31	1,532	118	SL	39.000000000000	39	39
MASH WORKS	2019-12-31	2,414	186	SL	39.000000000000	62	62
IMPROVEMENTS	2019-12-31	196,021	15,079	SL	39.000000000000	5,026	5,026
HOME IMPROVEMENTS	2019-12-31	60,075	4,621	SL	39.000000000000	1,540	1,540
MEDLINE	2019-12-31	6,717	2,015	SL	10.000000000000	672	672
DECORATIONS	2020-03-09	3,000	850	SL	10.000000000000	300	300
IPAD	2020-04-06	7,520	4,136	SL	5.000000000000	1,504	1,504
PTAC UNIT	2020-04-06	768	211	SL	10.000000000000	77	77
TOUCHSCREEN LAPTOP	2020-04-14	1,192	655	SL	5.000000000000	238	238
ROCKER RECLINER	2020-05-05	659	176	SL	10.000000000000	66	66
SURFACE BOOKS OFFICE PRO	2020-05-12	4,235	2,259	SL	5.000000000000	847	847
CUB CADET ZERO TURN	2020-06-01	2,199	1,136	SL	5.000000000000	440	440
ARTWORK	2020-08-25	8,726	2,036	SL	10.000000000000	873	873
ELECTRONIC SCALE	2020-08-25	691	161	SL	10.000000000000	69	69
CAMERA	2020-09-08	3,910	1,825	SL	5.000000000000	782	782
PTAC	2020-09-28	1,039	234	SL	10.000000000000	104	104
WASHING MACHINE	2020-10-01	981	221	SL	10.000000000000	98	98
WASH DRYER REFRIGERATOR	2020-10-04	1,890	472	SL	5.000000000000	378	378
PATIO HEATERS	2020-10-09	1,437	623	SL	10.000000000000	144	144
ART & BLINDS	2020-11-19	1,160	242	SL	10.000000000000	116	116
PTAC	2020-12-14	694	145	SL	5.000000000000	139	139
IMPROVEMENTS	2020-12-31	61,783	3,168	SL	39.000000000000	1,584	1,584
SURFACE BOOKS OFFICE PRO	2021-01-18	1,262	484	SL	5.000000000000	252	252
RECUMBENT CROSS TRAINER	2021-05-03	4,390	1,463	SL	5.000000000000	878	878
SURFACE PROBOOK'S	2021-05-03	1,855	618	SL	5.000000000000	371	371
SALON EQUIPMENT	2021-05-04	4,708	1,569	SL	10.000000000000	471	471
SPEED QUEEN WASHING MACHINE	2021-07-26	1,120	159	SL	10.000000000000	112	112
PREP TABLE	2021-08-11	2,722	386	SL	10.000000000000	272	272
WATER HEATER	2021-08-20	4,447	593	SL	10.000000000000	445	445
3 IPADS	2021-10-15	1,110	277	SL	5.000000000000	222	222
TABLES	2021-11-15	1,049	122	SL	10.000000000000	105	105
POPCORN MACHINE	2021-12-31	1,108	222	SL	5.000000000000	222	222
DRYER I	2022-01-09	1,350	23	SL	10.000000000000	135	135
SPLIT SYSTEM IN GARAGE OFFICE I	2022-01-10	4,859	81	SL	10.000000000000	486	486
STORAGE CABINET FOR SALON	2022-02-21	676	56	SL	10.000000000000	68	68
COMPUTER	2022-02-21	555	92	SL	5.000000000000	111	111
ART	2022-03-21	1,500	113	SL	10.000000000000	150	150
PCC GO BOOK	2022-03-21	765	115	SL	5.000000000000	153	153
FIRE ALARM PANEL	2022-04-19	3,919	261	SL	10.000000000000	392	392
CARPET - ROOM 112	2022-05-02	550	37	SL	10.000000000000	55	55
RECEPTACLES YEAR REC LIGHTS	2022-05-02	910	61	SL	10.000000000000	91	91
BIDET TOILET SCATS	2022-05-02	7,865	1,049	SL	5.000000000000	1,573	1,573
CANOPY TENTS	2022-05-17	1,680	196	SL	5.000000000000	336	336
WATER 1 819 BREWERY	2022-06-01	1,923	112	SL	10.000000000000	192	192
BIDET RECEPTACLES	2022-06-13	2,028	118	SL	10.000000000000	203	203
PORTABLE AIR CONDITIONERS	2022-06-13	1,441	22	SL	39.000000000000	37	37
CARPET- 819 BREWERY	2022-06-13	2,502	125	SL	10.000000000000	250	250
GALAXY BOOK GO	2022-07-18	857	71	SL	5.000000000000	171	171
PHONE SYSTEM/NURSE CALL SYSTEM	2022-08-09	11,709	488	SL	10.000000000000	1,171	1,171
MIRROR	2022-08-17	550	18	SL	10.000000000000	55	55
ROOM 106 REMODEL	2022-11-01	25,339	108	SL	39.000000000000	650	650
CARPET - ROOM 103	2022-11-21	1,391	12	SL	10.000000000000	139	139
WIRELESS ACCESS POINTS	2022-12-12	2,870	24	SL	10.000000000000	287	287
CARPET - ROOM ID2	2022-12-21	1,450		SL	10.000000000000	145	145
KITCHEN HOT WATER HEATER	2022-12-31	3,095		SL	10.000000000000	310	310
ELECTRIC HEATER	2022-12-31	556		SL	10.000000000000	56	56
FURNACE MAIN HALL	2022-12-31	3,500		SL	10.000000000000	350	350
PHONE SYSTEM	2023-02-27	12,788		SL	10.000000000000	1,172	1,172
ROOM 1066 REMODEL	2023-03-20	9,610		SL	39.000000000000	205	205
DISHES SILVERWARE BUS TUBS	2023-03-29	1,431		SL	5.000000000000	238	238
N HALL AC UNIT	2023-07-31	9,250		SL	10.000000000000	463	385
NEW LAPTOP DOCKING STATIONS	2023-09-01	16,845		SL	5.000000000000	1,123	1,123
FURNITURE FOR CARMI OFFICE	2023-09-27	3,000		SL	7.000000000000	143	143
S W HALL DOOR	2023-11-13	1,200		SL	10.000000000000	20	20
STAINLESS STEEL TABLES	2023-11-21	10,068		SL	10.000000000000	168	168
KITCHEN REMODEL	2023-12-11	34,839		SL	39.000000000000	74	74
DEMO FLOORING PAINTING QTR RND	2023-12-31	5,500		SL	39.000000000000	12	12

- TIN:

TY 2023 InvestmentsCorpStockSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Name of Stock	End of Year Book Value	End of Year Fair Market Value
MUTUAL FUNDS	1,204,356	1,204,356
STOCK	968,684	3,260,669

- TIN:

TY 2023 InvestmentsGovtObligationsSch

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

US Government Securities - End of Year Book Value:

399,901

US Government Securities - End of Year Fair Market Value:

396,840

State & Local Government Securities - End of Year Book Value:

State & Local Government Securities - End of Year Fair Market Value:

- TIN:

TY 2023 InvestmentsOtherSchedule2

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
CASH EQUIVALENT	AT COST	21,116	21,116
EXCHANGE TRADED FUNDS	AT COST	1,585,841	3,575,091
OTHER	AT COST	121,971	121,972
CERTIFICATES OF DEPOSITS	AT COST	550,000	547,021

- TIN:

TY 2023 LandEtcSchedule2

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Category / Item	Cost / Other Basis	Accumulated Depreciation	Book Value
ORIGINAL	8,000	8,000	0
ADDITIONS	68,217	68,217	0
ADDITIONS	31,285	31,285	0
ADDITIONS	4,678	4,678	0
ADDITIONS	105	105	0
ADDITIONS	1,459	1,459	0
ADDITIONS	95	95	0
ADDITIONS	279	279	0
DRIVEWAY	703	703	0
ADDITION TO HOME	251,742	251,742	0
DRIVEWAY	9,500	9,500	0
PAVING	3,042	3,042	0
COMPLETION OF ADDITION	16,391	16,391	0
DOORS	7,417	7,417	0
HANDRAILS	1,459	1,459	0
NEW WING	78,842	78,842	0
NEW WING-1980	154,178	154,178	0
NEW WING	30,957	0	30,957
STAINED GLASS WINDOWS-SUNROOM	2,682	2,682	0
BUILDING IMPROVEMENTS WALK IN	4,884	4,884	0
BUILDING IMPROVEMENTS	1,057	1,057	0
HANDICAP RAMP	2,237	2,237	0
CULVERT AT BACK ENTRANCE	16,994	16,994	0
ELECTRICALLY WORK - ADDITION	1,097	1,069	28
GUTTERING AND FASCIA	1,500	1,456	44
STORAGE BUILDING	32,501	12,350	20,151
ADD'I COST IN STORAGE BUILDING	306	115	191
FRONT ENTRY DOOR	5,147	2,209	2,938
AUTOMATIC DOOR	2,613	2,547	66
ROOF	104,651	73,910	30,741
GABEL REPAIRS & SCREENED	10,285	3,561	6,724
SUNROOM KEYPAD	3,181	1,087	2,094
CARPET ROOM 119	534	534	0
WALLS IN KITCHEN	2,445	667	1,778
REFRIGERATOR	3,184	3,184	0
GOLF CAR	4,795	4,795	0
2014 BUILDING REMODEL	139,479	31,617	107,862
SPRINKLER SYSTEM	57,510	57,510	0
SPRINKLER SYSTEM	32,965	32,965	0
BUILDING IMPROVEMENTS	139,019	28,814	110,205
2 AIR CONDITIONERS	9,671	2,004	7,667
MAIN HALL A/C	2,977	547	2,430
WATER HEATER	4,223	3,132	1,091
BUILDING IMPROVEMENTS	80,876	14,689	66,187
BUILDING IMPROVEMENTS	86,536	13,498	73,038
FIRE ALARM PANEL	4,812	4,812	0
WATER HEATER	2,868	1,745	1,123
PTAC	630	630	0
NURSE COMPUTER LE COMPUTER	3,023	3,023	0
DRYER	582	582	0
BEAUTY SHOP CHAIR	1,069	1,069	0
CHAIRS	8,718	8,718	0
TV REFRIGERATORS	2,520	2,520	0
ADMISSIONS	1,506	1,506	0
WI-FI & EXTENDERS	1,290	1,290	0
TV DVD SHELF CABLES	535	535	0
PAPER SHREDDER	621	621	0
PTAC	710	710	0
PTAC	881	881	0
CARDIAC MONITOR STAND	2,045	1,875	170
IMPROVEMENTS	86,991	11,153	75,838
TIME CLOCK	510	510	0
RESIDENT REFRIGERATORS	1,025	453	572
2 PTCAC UNITS	3,075	1,359	1,716
PTAC UNIT 7000 BTU	1,467	782	685
COMPUTERS	5,713	4,952	761
HOME FURNISHING	62,777	25,111	37,666
KORESEN FIRE AND SECURITY	1,532	157	1,375
MASH WORKS	2,414	248	2,166
IMPROVEMENTS	196,021	20,105	175,916
HOME IMPROVEMENTS	60,075	6,161	53,914
MEDLINE	6,717	2,687	4,030
DECORATIONS	3,000	1,150	1,850
IPAD	7,520	5,640	1,880
PTAC UNIT	768	288	480
TOUCHSCREEN LAPTOP	1,192	893	299
ROCKER RECLINER	659	242	417
SURFACE BOOKS OFFICE PRO	4,235	3,106	1,129
CUB CADET ZERO TURN	2,199	1,576	623
ARTWORK	8,726	2,909	5,817
ELECTRONIC SCALE	691	230	461
CAMERA	3,910	2,607	1,303
PTAC	1,039	338	701
WASHING MACHINE	981	319	662
WASH DRYER REFRIGERATOR	1,890	850	1,040
PATIO HEATERS	1,437	767	670
ART & BLINDS	1,160	358	802
PTAC	694	284	410
IMPROVEMENTS	61,783	4,752	57,031
SURFACE BOOKS OFFICE PRO	1,262	736	526
RECUMBENT CROSS TRAINER	4,390	2,341	2,049
SURFACE PROBOOK'S	1,855	989	866
SALON EQUIPMENT	4,708	2,040	2,668
SPEED QUEEN WASHING MACHINE	1,120	271	849
PREP TABLE	2,722	658	2,064
WATER HEATER	4,447	1,038	3,409
3 IPADS	1,110	499	611
TABLES	1,049	227	822
POPCORN MACHINE	1,108	444	664
DRYER I	1,350	158	1,192
SPLIT SYSTEM IN GARAGE OFFICE I	4,859	567	4,292
STORAGE CABINET FOR SALON	676	124	552
COMPUTER	555	203	352
ART	1,500	263	1,237
PCC GO BOOK	765	268	497
FIRE ALARM PANEL	3,919	653	3,266
CARPET - ROOM 112	550	92	458
RECEPTACLES YEAR REC LIGHTS	910	152	758
BIDET TOILET SCATS	7,865	2,622	5,243
CANOPY TENTS	1,680	532	1,148
WATER 1 819 BREWERY	1,923	304	1,619
BIDET RECEPTACLES	2,028	321	1,707
PORTABLE AIR CONDITIONERS	1,441	59	1,382
CARPET- 819 BREWERY	2,502	375	2,127
GALAXY BOOK GO	857	242	615
PHONE SYSTEM/NURSE CALL SYSTEM	11,709	1,659	10,050
MIRROR	550	73	477
ROOM 106 REMODEL	25,339	758	24,581
CARPET - ROOM 103	1,391	151	1,240
WIRELESS ACCESS POINTS	2,870	311	2,559
CARPET - ROOM ID2	1,450	145	1,305
KITCHEN HOT WATER HEATER	3,095	310	2,785
ELECTRIC HEATER	556	56	500
FURNACE MAIN HALL	3,500	350	3,150
PHONE SYSTEM	12,788	1,172	11,616
ROOM 1066 REMODEL	9,610	205	9,405
DISHES SILVERWARE BUS TUBS	1,431	238	1,193
N HALL AC UNIT	9,250	463	8,787
NEW LAPTOP DOCKING STATIONS	16,845	1,123	15,722
FURNITURE FOR CARMI OFFICE	3,000	143	2,857
S W HALL DOOR	1,200	20	1,180
STAINLESS STEEL TABLES	10,068	168	9,900
KITCHEN REMODEL	34,839	74	34,765
DEMO FLOORING PAINTING QTR RND	5,500	12	5,488

- TIN:

TY 2023 LegalFeesSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
LEGAL FEES	3,473	1,737	1,736	0

- TIN:

TY 2023 OtherAssetsSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
POSEY COUNTY F.B. STOCK	91	91	91
OIL RECEIVABLE	19,730	18,207	18,207

- TIN:

TY 2023 OtherExpensesSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Description	Revenue and Expenses per Books	Net Investment Income	Disbursements for Charitable Purposes
SPECIAL EVENTS	12,432	0	12,432
ADVERTISING	37,388	0	37,388
PAPER SUPPLIES - NURSING	2,351	0	2,351
EDUCATION	10,936	0	10,936
SMALL KITCHEN EQUIPMENT	3,515	0	3,515
PROFESSIONAL DUES	2,304	0	2,304
GENERATOR	700	0	700
CLEANING SUPPLIES	1,189	0	1,189
IT CONSULTANT	26,268	0	26,268
IT SUPPLIES	28,932	0	28,932
GASOLINE - VANS	2,386	0	2,386
VAN LEASE	13,598	0	13,598
YARD MAINTENANCE	12,953	0	12,953
GARDEN	1,429	0	1,429
PUBLIC RELATIONS	5,943	0	5,943
BEAUTICIAN PAYMENTS	87	0	87
HELP WANTED	3,160	0	3,160
CARPENTY ROOFING CONTRACTORS	3,399	0	3,399
PERSONAL PROTECTIVE EQUIPMENT	1,127	0	1,127
401K FEES	1,950	0	1,950
CONCESSION INCOME	1,770	0	1,770
COST OF GOODS SOLD	1,626	0	1,626
PAPER SUPPLIES - OTHER	0	0	0
SPA TUB SUPPLIES	954	0	954
MEDICAL EDUCATION & SEMINARS	3,050	0	3,050
INCONTINENCE SUPPLIES	2,634	0	2,634
PROFESSIONAL CLEANING	530	0	530
PENALTIES	398	0	398
FOOD	124,946	0	124,946
PAPER SUPPLIES - HOUSE KEEPING	6,118	0	6,118
PAPER SUPPLIES - DIETARY	9,371	0	9,371
SUNDRY SUPPLIES	2,615	0	2,615
LINENS - HOUSEKEEPING	4,274	0	4,274
MISCELLANEOUS HOME SUPPLIES	11,661	0	11,661
LAUNDRY INCOME	1,544	0	1,544
INSURANCE - HOME	69,848	0	69,848
INSURANCE EMPLOYEE	108,680	0	108,680
WATER SOFTNERS	3,197	0	3,197
REPAIR & MAINTENANCE	600	0	600
CASUAL LABOR	81,019	0	81,019
FIRE/SAFETY CONTRACTORS	12,533	0	12,533
OUTSIDE EQUIPMENT MAINTENANCE	0	0	0
INSIDE EQUIPMENT MAINTENANCE	4,507	0	4,507
MAINTENANCE - SUPPLIES	24,254	0	24,254
CONSULTATIONS	164,134	0	164,134
DIETARY CONSULTANT	833	0	833
MEDICAL SUPPLIES	12,150	0	12,150
EMPLOYEE EXPENSE	24,345	0	24,345
DOCTOR & HOSPITALS	525	0	525
OFFICE SUPPLIES	12,464	0	12,464
POSTAGE	1,004	0	1,004
VEHICLE REPAIR AND MAINTENANCE	601	0	601
MISCELLANEOUS EXPENSE	4,970	0	4,970
MAGAZINES & SUBSCRIPTIONS	1,367	0	1,367
BANK FEES - GENERAL FUND	30,445	30,445	0
BANK FEES - CHECKING ACCT	27	0	27
EQUIPMENT RENTAL	2,653	0	2,653
DISHWASHER RENTAL	975	0	975
COPIER EXPENSE	7,801	0	7,801
HOUSEKEEPING	4,356	0	4,356
KITCHEN CLEANING SUPPLIES	3,600	0	3,600
LIFE ENRICHMENT DIRECTOR	13,967	0	13,967
MARKETING	54,292	0	54,292

- TIN:

TY 2023 OtherIncomeSchedule2

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
ROYALTY INCOME OIL	437,616	437,616	437,616
BREWERY STREET RENT	8,000		8,000
INCOME - NEW RESIDENTS	899,733		899,733
LAUNDRY INCOME	22,774		22,774
INCOME BEAUTY SALON	1,025		1,025
PHARMACY CONSULT INCOME	1,510		1,510
INCONTINENT SUPPLY SERVICE	9,598		9,598
IN ROOM TELEPHONES	750		750
MISCELLANEOUS	2,569		2,569
SERVICE INCOME LEVEL	140,744		140,744

- TIN:

TY 2023 OtherLiabilitiesSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Description	Beginning of Year - Book Value	End of Year - Book Value
SECURITY DEPOSITS	82,045	61,331
ACCRUED PAYROLL	37,116	60,495
STATE/COUNTY WITHHOLDINGS	3,983	5,692
UNEMPLOYMENT TAXES	133	269
ACCRUED PAYROLL TAXES	2,839	4,588
ACCURED EXCISE TAXES	5,234	0

- TIN:

TY 2023 TaxesSchedule

Name:

THE CHARLES FORD MEMORIAL HOME INC

EIN:

45-5388556

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
FICA EXPENSE	99,560	0	0	99,560
UNEMPLOYMENT TAXES	2,641	0	0	2,641
TAXES-OIL	9,804	9,804	0	0
INCOME TAXES	9,323	0	9,323	0