Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
right arrow Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
right arrow Attach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
OHIO BUSINESS ROUNDTABLE
 
Employer identification number

31-1359114
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... right arrow$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ right arrow$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
(1) PATRICK J TIBERI PRESIDENT & CEO SPLIT DOLLAR LIFE INSURANCE PLAN   X 76,000 325,403   No Yes   Yes  
Total ...............right arrow $ 325,403
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2022
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Schedule L (Form 990) 2022
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Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
PART II, LINE 1 AS PART OF A SPLIT DOLLAR LIFE INSURANCE POLICY FOR THE BENEFIT OF PATRICK J. TIBERI, PATRICK WILL OWE THE ORGANIZATION THE AMOUNT OF PREMIUMS PAID ON HIS BEHALF IF HE TERMINATES THE POLICY, OR THE AMOUNTS WILL BE PAID OUT OF THE LIFE INSURANCE BENEFIT. SINCE THE FINANCIAL STATEMENTS ARE ON A MODIFIED CASH BASIS OF ACCOUNTING, THIS RECEIVABLE IS NOT ON THE BALANCE SHEET. AS OF 12/31/22, THE BALANCE DUE IS $325,405
Schedule L (Form 990) 2022


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