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        <BusinessNameLine1Txt>William J Jernick Memorial Fund Inc</BusinessNameLine1Txt>
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      <InCareOfNm>% Carl Robinson</InCareOfNm>
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      <PhoneNum>3017419979</PhoneNum>
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      <PersonNm>Carl Robinson</PersonNm>
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      <PreparerPersonNm>Patti Gray</PreparerPersonNm>
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        <InvestmentIncomeExciseTaxAmt>544</InvestmentIncomeExciseTaxAmt>
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        <LegislativePoliticalActyInd>false</LegislativePoliticalActyInd>
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        <IndividualWithBooksNm>Carl A Robinson</IndividualWithBooksNm>
        <PhoneNum>3017419979</PhoneNum>
        <LocationOfBooksUSAddress>
          <AddressLine1Txt>1021 8th Street</AddressLine1Txt>
          <CityNm>Laurel</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20707</ZIPCd>
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        <UncorrectedPYJeopardyInvstInd>false</UncorrectedPYJeopardyInvstInd>
        <InfluenceLegislationInd>false</InfluenceLegislationInd>
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        <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
        <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
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        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>William H Buttrill</PersonNm>
          <USAddress>
            <AddressLine1Txt>3490 State Street</AddressLine1Txt>
            <CityNm>Crisfield</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21817</ZIPCd>
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          <TitleTxt>Board Member</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>002.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
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        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>Ronald T Lamot</PersonNm>
          <USAddress>
            <AddressLine1Txt>8304 Oliver Street</AddressLine1Txt>
            <CityNm>New Carrollton</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>20784</ZIPCd>
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          <TitleTxt>Board Member</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>002.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
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        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>Sandra C Brantner</PersonNm>
          <USAddress>
            <AddressLine1Txt>1157 Old Crellin Road</AddressLine1Txt>
            <CityNm>Oakland</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21550</ZIPCd>
          </USAddress>
          <TitleTxt>Chairman</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>002.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>Connie DeYoung</PersonNm>
          <USAddress>
            <AddressLine1Txt>1 Patriot Drive</AddressLine1Txt>
            <CityNm>Dover</CityNm>
            <StateAbbreviationCd>DE</StateAbbreviationCd>
            <ZIPCd>19904</ZIPCd>
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          <TitleTxt>Board Member</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>002.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
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        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>Carl A Robinson</PersonNm>
          <USAddress>
            <AddressLine1Txt>12021 8th Street</AddressLine1Txt>
            <CityNm>Laurel</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>20707</ZIPCd>
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          <TitleTxt>Secretary/Treasurer</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>004.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
        </OfficerDirTrstKeyEmplGrp>
        <CompOfHghstPdEmplOrNONETxt>NONE</CompOfHghstPdEmplOrNONETxt>
        <CompOfHghstPdCntrctOrNONETxt>NONE</CompOfHghstPdCntrctOrNONETxt>
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      <SummaryOfDirectChrtblActyGrp>
        <Description1Txt>Direct assistance to families of youth suffering from medical conditions 7 recipients this fiscal year</Description1Txt>
        <Expenses1Amt>12700</Expenses1Amt>
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        <ExpensesAndContributionsAmt referenceDocumentId="990PF:151">12700</ExpensesAndContributionsAmt>
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        <DistributableAsAdjustedAmt>0</DistributableAsAdjustedAmt>
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          <TotalAmt>0</TotalAmt>
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          <CurrentYearAmt>12700</CurrentYearAmt>
          <Year1Amt>20500</Year1Amt>
          <Year2Amt>55000</Year2Amt>
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          <TotalAmt>101061</TotalAmt>
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          <CurrentYearAmt>12700</CurrentYearAmt>
          <Year1Amt>20500</Year1Amt>
          <Year2Amt>55000</Year2Amt>
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          <TotalAmt>101061</TotalAmt>
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          <TotalAmt>11530</TotalAmt>
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        <ShareholderManagerNm>None</ShareholderManagerNm>
        <ApplicationSubmissionInfoGrp>
          <RecipientPersonNm>William J Jernick Memorial Fund</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>Various local Elks Lodges</AddressLine1Txt>
            <CityNm>Various</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21236</ZIPCd>
          </RecipientUSAddress>
          <RecipientPhoneNum>4102569691</RecipientPhoneNum>
          <FormAndInfoAndMaterialsTxt>Requests must be submitted through local Elks Lodges</FormAndInfoAndMaterialsTxt>
          <SubmissionDeadlinesTxt>None</SubmissionDeadlinesTxt>
          <RestrictionsOnAwardsTxt>Only for families with sick or handicapped children under the age of 21</RestrictionsOnAwardsTxt>
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        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>Carmen V Kemper for Sage R Kemper</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>13 McCoy Street</AddressLine1Txt>
            <CityNm>Milford</CityNm>
            <StateAbbreviationCd>DE</StateAbbreviationCd>
            <ZIPCd>19963</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Purchase of special glasses to child with tumor of the optic nerve</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>Severna Park Elks Lodge for Elliot</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>147 Moore Road</AddressLine1Txt>
            <CityNm>Arnold</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21012</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Assist with purchase of adapted bicycle for child with a neurological condition</GrantOrContributionPurposeTxt>
          <Amt>1500</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>Jessica Rice for Jordan Rice</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>554 Aiken Avenue</AddressLine1Txt>
            <CityNm>Perryville</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21903</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Assistance for a teen who is paralyzed from the neck down due to an injury</GrantOrContributionPurposeTxt>
          <Amt>2000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>Westminster Lodge for Hank Shockley</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>3939 Rhinehna Road</AddressLine1Txt>
            <CityNm>Westminster</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21158</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Assistance for family with baby who has end stage renal failure</GrantOrContributionPurposeTxt>
          <Amt>2000</Amt>
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        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>Carlos DiLaudo for Fabrizzio DiLaud</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>11902 Frost Valley Way</AddressLine1Txt>
            <CityNm>Potomac</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>20854</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Down payment for new hearing aids for 10 year old child</GrantOrContributionPurposeTxt>
          <Amt>2200</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>James Aumiller for Madison Moore</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>538 Gorsuch Road</AddressLine1Txt>
            <CityNm>Westminster</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21157</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Financial assistance for family of sick child</GrantOrContributionPurposeTxt>
          <Amt>2000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>Milford Elks Lodge for Alyssa Wolfe</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>PO Box 63</AddressLine1Txt>
            <CityNm>Milford</CityNm>
            <StateAbbreviationCd>DE</StateAbbreviationCd>
            <ZIPCd>19963</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>None</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>I</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>Assist with funds for family to purchase a wheelchair accessible van</GrantOrContributionPurposeTxt>
          <Amt>2000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <TotalGrantOrContriPdDurYrAmt>12700</TotalGrantOrContriPdDurYrAmt>
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        <DividendsAndInterestFromSecDtl>
          <RelatedOrExemptFunctionIncmAmt>39134</RelatedOrExemptFunctionIncmAmt>
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        <OtherRevenueDescribedGrp>
          <Desc>Miscellaneous Income</Desc>
          <RelatedOrExemptFunctionIncmAmt>2094</RelatedOrExemptFunctionIncmAmt>
        </OtherRevenueDescribedGrp>
        <SubtotalsIncmProducingActyGrp>
          <RelatedOrExemptFunctionIncmAmt>41228</RelatedOrExemptFunctionIncmAmt>
        </SubtotalsIncmProducingActyGrp>
        <TotalIncomeProducingActyAmt>41228</TotalIncomeProducingActyAmt>
      </AnalysisIncomeProducingActyGrp>
      <RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>4</LineNumberTxt>
          <RelationshipStatementTxt>The total income derived from investments is available for use. This income is used to assist families with</RelationshipStatementTxt>
        </RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>4</LineNumberTxt>
          <RelationshipStatementTxt>children under the age of 21 who have serious medical problems, and to assist Elks Camp Barrett a camp for</RelationshipStatementTxt>
        </RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>4</LineNumberTxt>
          <RelationshipStatementTxt>youth operations.</RelationshipStatementTxt>
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        <TrnsfrOtherAssetNonchrtblEOInd>false</TrnsfrOtherAssetNonchrtblEOInd>
        <SalesOrExchangesOfAssetsInd>false</SalesOrExchangesOfAssetsInd>
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        <RentalOfFacilitiesOthAssetsInd>false</RentalOfFacilitiesOthAssetsInd>
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          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33733</ZIPCd>
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      <OtherIncomeDetail>
        <Desc>Checks voided from prior years</Desc>
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