2022-09-15T14:54:09-05:00 2021-12-31 FOUNDATION SOURCE ONE HOLLOW LN STE 212 LAKE SUCCESS NY 11042 990PF 2021-01-01 866320000 The Surplus Line Association of Arizona Foundation % Foundation Source SURP 8008391754 Foundation Source 501 Silverside Rd Wilmington DE 198091377 JON SCOTT WEDE TRUSTEE 8008391754 2022-08-31 true JON SCOTT WEDE 999009999 Jeffrey D Haskell P01345770 8008391754 2021 2023-04-26 12:10:37Z X 7396873 X 1200000 50 50 11178 11178 -878 55000 0 202930 202930 1413280 214158 0 550 32049 300 31749 32599 300 31749 1126000 1126000 1158599 300 1157749 254681 213858 809130 923088 923088 96905 34699 30849 326251 326251 338108 6093896 6296825 6104828 7326182 7580863 7396873 0 0 X 7326182 7580863 7326182 7580863 7326182 7580863 7326182 254681 7580863 7580863 Publicly-traded Securities 55000 55878 -878 -878 -878 2973 2973 2973 10 0 300 310 X 0 2663 false false false false false false false true true AZ true false false false false true Foundation Source 8008391754 501 Silverside Road Suite 123 Wilmington DE 198091377 false false false false false false false false false false false false false false false false false false false false false Marc Adler Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee, Sec, Treas 1.0 0 0 0 Timothy Downey Foundation Source 501 Silverside Rd Wilmington DE 198091377 Pres 1.0 0 0 0 Ed Dresselhuys Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee, Sec*, Treas*, VP 1.0 0 0 0 Lanny Hair Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee 1.0 0 0 0 Erick L Johnson CPCU Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee 1.0 0 0 0 Konnie Keaschall-Kiser Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee, VP*, Pres 1.0 0 0 0 James Mann Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee 1.0 0 0 0 Teresa Quale Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee 1.0 0 0 0 J Scott Wede Foundation Source 501 Silverside Rd Wilmington DE 198091377 Trustee, exec dir 1.0 0 0 0 401806 521541 6104828 7028175 0 7028175 105423 6922752 346138 346138 2973 2973 343165 343165 343165 1157749 0 0 0 0 1157749 343165 2019 2018 2017 435618 465417 465393 453604 864895 2684927 1157749 343165 814584 3499511 0 435618 3063893 465417 465393 453604 864895 814584 NONE X 100 CLUB OF ARIZONA 333 N 44TH ST STE 100 PHOENIX AZ 85008 N/A PC General & Unrestricted 20000 ABILITY360 INC 5025 EAST WASHINGTON ST NO 20 PHOENIX AZ 85034 N/A PC General & Unrestricted 5000 AID TO WOMEN CENTER 1328 E APACHE BLVD TEMPE AZ 85281 N/A PC General & Unrestricted 5000 AMERICAN CANCER SOCIETY - GREAT WEST DIVISION 6270 E HAWTHORNE ST TUCSON AZ 85711 N/A PC General & Unrestricted 5000 AMYOTROPHIC LATERAL SCLEROSIS ASSOCIATION 360 E CORONADO RD STE 140 PHOENIX AZ 85004 N/A PC General & Unrestricted 3000 ANDRE HOUSE OF ARIZONA INC PO BOX 2014 PHOENIX AZ 85001 N/A PC General & Unrestricted 65000 ARIZONA ART ALLIANCE 4327 E LEWIS AVE PHOENIX AZ 85008 N/A PC General & Unrestricted 10000 ARIZONA COMMUNITY FOUNDATION 2201 E CAMELBACK RD STE 405B PHOENIX AZ 85016 N/A PC General & Unrestricted 3000 ARIZONA DIABETES FOUNDATION INC GREENWAY PROFESSIONAL BLDG PHOENIX AZ 85032 N/A PC General & Unrestricted 5000 ARTHRITIS FOUNDATION INC - PHOENIX CHAPTER 5009 E WASHINGTON ST STE 125 PHOENIX AZ 85034 N/A PC General & Unrestricted 5000 AUTISM SOCIETY OF GREATER PHOENIX PO BOX 10543 PHOENIX AZ 85064 N/A PC General & Unrestricted 10000 BARROW NEUROLOGICAL FOUNDATION 2910 N 3RD AVE SUITE 450 PHOENIX AZ 85013 N/A PC General & Unrestricted 10000 BOY SCOUTS OF AMERICA 8840 E CHAPARRAL RD STE 200 SCOTTSDALE AZ 85250 N/A PC General & Unrestricted 10000 COMMUNITY FOOD BANK INC 3003 S COUNTRY CLUB RD TUCSON AZ 85713 N/A PC General & Unrestricted 65000 CYSTIC FIBROSIS FOUNDATION 2777 E CAMELBACK RD STE 330 PHOENIX AZ 85016 N/A PC General & Unrestricted 5000 GOMPERS 6601 N 27TH AVE PHOENIX AZ 85017 N/A PC General & Unrestricted 5000 HACIENDA SNF INC 1402 E S MOUNTAIN AVE PHOENIX AZ 85042 N/A PC General & Unrestricted 15000 HONORHEALTH FOUNDATION 8125 N HAYDEN RD SCOTTSDALE AZ 85258 N/A PC Desert Mission fund 40000 HONORHEALTH FOUNDATION 8125 N HAYDEN RD SCOTTSDALE AZ 85258 N/A PC General & Unrestricted 25000 INSURANCE TRAINING AND EDUCATION CENTER INC 333 E FLOWER ST PHOENIX AZ 85012 N/A PC General & Unrestricted 90000 JUVENILE DIABETES RESEARCH FOUNDATION INTERNATIONA 4343 E CAMELBACK ROAD STE 230 PHOENIX AZ 85018 N/A PC General & Unrestricted 5000 KITCHEN ON THE STREET INC 2650 E MOHAWK BLDG 3 PHOENIX AZ 85050 N/A PC General & Unrestricted 65000 MAKE A WISH FOUNDATION OF ARIZONA INC 2901 N 78TH ST SCOTTSDALE AZ 85251 N/A PC General & Unrestricted 10000 NEW CITY BARRIO NUEVO PHOENIX 2030 W BASELINE RD NO 182-212 PHOENIX AZ 85041 N/A PC General & Unrestricted 5000 ORAL EDUCATIONAL OPPORTUNITIES FOR THE HEARING IMP 3426 E SHEA BLVD PHOENIX AZ 85028 N/A PC General & Unrestricted 15000 PAZ DE CRISTO COMMUNITY CENTER 424 W BROADWAY RD MESA AZ 85210 N/A PC General & Unrestricted 65000 PLUS FOUNDATION 5353 WAYZATA BLVD STE 600 MINNEAPOLIS MN 55416 N/A SO I General & Unrestricted 15000 SHRINERS HOSPITALS FOR CHILDREN - SALT LAKE CITY FAIRFAX ROAD AT VIRGINIA ST SALT LAKE CITY UT 84103 N/A PC General & Unrestricted 5000 SOJOURNER CENTER PO BOX 20156 PHOENIX AZ 85036 N/A PC General & Unrestricted 15000 SOUTHWEST DISTRICT KIWANIS FOUNDATION 5318 KINGS ROW NE ALBUQUERQUE AZ 87109 N/A PC General & Unrestricted 15000 SOUTHWEST HUMAN DEVELOPMENT 2850 N 24TH ST PHOENIX AZ 85008 N/A PC General & Unrestricted 5000 ST MARYS FOOD BANK ALLIANCE 2831 N 31ST AVE PHOENIX AZ 85009 N/A PC General & Unrestricted 65000 THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER PO BOX 4486 HOUSTON TX 77210 N/A GOV General & Unrestricted 5000 THE WSIA EDUCATION FOUNDATION 4131 N MULBERRY DR STE 200 KANSAS CITY MO 64116 N/A PC General & Unrestricted 350000 UNITED SERVICE ORGANIZATIONS INC PO BOX 96860 WASHINGTON DC 20077 N/A PC General & Unrestricted 10000 WASTE NOT INC 1700 N GRANITE REEF RD SCOTTSDALE AZ 85257 N/A PC General & Unrestricted 65000 YOUTH RISING 6808 E INDIGOBAY DR GILBERT AZ 85234 N/A PC General & Unrestricted 10000 1126000 14 50 14 11178 18 -878 ANNUITY INCOME 14 202930 213280 213280 false false false false false false false false false false X X 1 The Surplus Line Association of Ari 15849 N 71st Street ste 100 Scottsdale AZ 85254 1200000 X Timothy Downey * deceased in 2021 Ed Dresselhuys * removed from positions in 2021 Konnie Keaschall-Kiser * removed from position in 2021 CATERPILLAR FINANCIAL SE MTN - 27118 28888 CITIGROUP INC - 5.500% - 09/13 28857 28283 CITIGROUP INC SUB NT - 3.500% 24065 25846 GE CAPITAL CORP - 4.500% - 11/ 27075 26863 GENERAL ELECTRIC CAPITAL CORP 25722 26369 GENERAL ELECTRIC CO - 5.000% - 55230 55451 GOLDMAN SACHS GP INC - 5.950% 32164 35382 GOLDMAN SACHS GROUP INC - 3.50 11770 12837 GOLDMAN SACHS GRP INC MTN BE - 25249 25770 HANCOCK JOHN LIFE INS CO - 5.0 17689 18458 JPMORGAN CHASE & CO - 4.125% - 25267 27590 STATOIL ASA NT - 3.700% - 03/0 26045 26371 34699 30849 COLUMBUS LIFE # CM5064902A 168045 168045 COLUMBUS LIFE # CM5108868A 1745181 1666647 INTEGRITY LIFE INSURANCE # 210 1117798 1073831 JACKSON NATIONAL LIFE # 100355 336965 336965 JACKSON NATIONAL LIFE # 100471 423479 423479 JACKSON NATIONAL LIFE # 100498 407897 407897 NEW YORK LIFE # 52132702 292458 292458 NORTH AMERICAN LIFE 8000460723 665463 643096 PRINCIPAL # 8944779 429695 407705 PRINCIPAL # 8951445 315789 300603 UNITED OF OMAHA # U01139674 394055 384102 Administrative Fees 31749 31749 Bank Charges 300 300 Annuity Income 202930 202930 990-PF Extension for 2020 550