CAROLYN M AND LEARY E PETERSON FAMILY FOUNDATION INC: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CAROLYN M AND LEARY E PETERSON FAMILY FOUNDATION INC (EIN 39-1936484)
Tax period
2021-06-01 to 2022-05-31
Filed
2023-10-16
IRS object ID
202332899349101108
Schema version
2021v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-10-16T16:58:54-04:00ReturnTs
Tax Period End2022-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN391769340PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COLLINS & ASSOCIATES SCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 120AddressLine1Txt
CityPRAIRIE DU CHIENCityNm
State AbbreviationWIStateAbbreviationCd
ZIP538210120ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391936484EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CAROLYN M & LEARY E PETERSON FAMILYBusinessNameLine1Txt
Business Name Line2FOUNDATION INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCAROBusinessNameControlTxt
Phone6083266496PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 EAST HAYDN STAddressLine1Txt
CityPRAIRIE DU CHIENCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53821ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS F PETERSONPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone6083266496PhoneNum
Signature2023-01-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTHOMASPersonFirstNm
Person LastPETERSONPersonLastNm
FieldValueIRS element (for citing)
SSN888008888SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCOLLINS ASSOCIATES SCPreparerPersonNm
PTINP00146637PTIN
Phone6083266456PhoneNum
Preparation2023-01-27PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$1,029,619FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Dividends Rev And Expnss$27,040DividendsRevAndExpnssAmt
Dividends Net Invst Incm$27,040DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$1,755NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$32,358GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$1,755CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$134OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$134OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$28,929TotalRevAndExpnssAmt
Total Net Invst Incm$28,929TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$10,000CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$10,000CompOfcrDirTrstNetInvstIncmAmt
Legal Fees Rev And Expnss$25LegalFeesRevAndExpnssAmt
Accounting Fees Rev And Expnss$1,500AccountingFeesRevAndExpnssAmt
Taxes Rev And Expnss$267TaxesRevAndExpnssAmt
Other Expenses Rev And Expnss$76OtherExpensesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss$11,868TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$10,000TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$52,320ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$52,320ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$64,188TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$10,000TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$52,320TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$35,259ExcessRevenueOverExpensesAmt
Net Investment Income$18,929NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$4,614CashBOYAmt
Cash EOY$15CashEOYAmt
Cash EOYFMV$15CashEOYFMVAmt
Corporate Stock BOY$463,169CorporateStockBOYAmt
Corporate Stock EOY$432,558CorporateStockEOYAmt
Corporate Stock EOYFMV$977,452CorporateStockEOYFMVAmt
Other Investments BOY$59,166OtherInvestmentsBOYAmt
Other Investments EOY$59,117OtherInvestmentsEOYAmt
Other Investments EOYFMV$52,152OtherInvestmentsEOYFMVAmt
Total Assets BOY$526,949TotalAssetsBOYAmt
Total Assets EOY$491,690TotalAssetsEOYAmt
Total Assets EOYFMV$1,029,619TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Capital Stock BOY$526,949CapitalStockBOYAmt
Capital Stock EOY$491,690CapitalStockEOYAmt
Tot Net Ast Or Fund Balances BOY$526,949TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$491,690TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$526,949TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$491,690TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$526,949TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$35,259ExcessRevenueOverExpensesAmt
Subtotal$491,690SubtotalAmt
Tot Net Ast Or Fund Balances EOY$491,690TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (4 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
ORGANON & COP2009-10-022021-06-03$7$3$4$4
AT&TP2011-10-112022-05-23$25,012$26,749-$1,737-$1,737
ORGANON & COP2011-10-112022-05-23$4,383$1,832$2,551$2,551
VIATRIS INCP2011-10-112022-05-23$2,956$2,019$937$937
FieldValueIRS element (for citing)
Capital Gain Net Income$1,755CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$263InvestmentIncomeExciseTaxAmt
Subtotal$263SubtotalAmt
Tax Based On Investment Income$263TaxBasedOnInvestmentIncomeAmt
Tax Due$263TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateWIOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsfalseNewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksTHOMAS F PETERSONIndividualWithBooksNm
Phone6083266496PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1110 E HAYDN STAddressLine1Txt
CityPRAIRIE DU CHIENCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53821ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnfalseSaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnfalseBrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnfalseFurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnfalsePayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
CAROLE SAYER
20890 CHANNEL DREXCELSIORMN55331DIRECTOR000.00$2,000$0$0
JOE MULLEN
662 JENISA DRST CLOUDMN56301DIRECTOR000.00$2,000$0$0
THOMAS F PETERSON
110 E HAYDN STPRAIRIE DU CHIENWI53821DIRECTOR000.00$2,000$0$0
MARY JO RUHL
2740 NICHOLS LANEDAVENPORTIA52803DIRECTOR000.00$2,000$0$0
JOHN L PETERSON
4814 CHAMPIONS RUNMIDDLETONWI53562DIRECTOR000.00$2,000$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

FieldValueIRS element (for citing)
Description1THE FOUNDATION MAKES CHARITABLE CONTRIBUTIONS TO 501(C)(3) ORGANIZATIONS.Description1Txt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1N/ADescription1Txt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$1,051,731AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$15,795AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$1,067,526TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$1,067,526AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$16,013CashDeemedCharitableAmt
Net Vl Noncharitable Assets$1,051,513NetVlNoncharitableAssetsAmt
Minimum Investment Return$52,576MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$52,576MinimumInvestmentReturnAmt
Tax Based On Investment Income$263TaxBasedOnInvestmentIncomeAmt
Total Tax$263TotalTaxAmt
Distributable Before Adj$52,313DistributableBeforeAdjAmt
Distributable Before Ded$52,313DistributableBeforeDedAmt
Distributable As Adjusted$52,313DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$52,320ExpensesAndContributionsAmt
Qualifying Distributions$52,320QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$52,313DistributableAsAdjustedAmt
Undistributed Income PY$13,972UndistributedIncomePYAmt
Qualifying Distributions$52,320QualifyingDistributionsAmt
Applied To Year1$13,972AppliedToYear1Amt
Applied To Current Year$38,348AppliedToCurrentYearAmt
Undistributed Income CY$13,965UndistributedIncomeCYAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (12 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtAddress Line2RecipientUSAddress/AddressLine2Txt
WI WATERFOWL - PDC CHAPTER
38299 STUCKEY RDPRAIRIE DU CHIENWI53821GENERAL DONATION$1,000
HOLY FAMILY CATHOLIC SCHOOL
515 N BEAUMONT RDPRAIRIE DU CHIENWI53821GENERAL DONATION$10,464
CROSS PLAINS BASEBALL
2410 MARTIN STCROSS PLAINSWI53528GENERAL DONATION$1,000
ST MARY'S ELEMENTARY SCHOOL
823 1ST ST SST CLOUDMN56301GENERAL DONATION$5,232
FATHER FAGAN
PO BOX 157PRAIRIE DU CHIENWI53821GENERAL DONATION$2,464
PDC POLICE DEPT
228 N BEAUMONT RDPRAIRIE DU CHIENWI53821GENERAL DONATION$5,000
ST JOHN THE BAPTIST SCHOOL
114 E 3RD STWAUNAKEEWI53597GENERAL DONATION$10,464
ANNA MARIE'S SHELTER
505 10TH AVE NEST CLOUDMN56301GENERAL DONATION$5,232
NEIGHBORHOOD HEALTH CLINIC
120 GOODLETTE RD NNAPLESFL34102GENERAL DONATION$5,000
ST ALBERT CATHOLIC CHURCH
PO BOX 237LAND O LAKESWI54540GENERAL DONATION$2,464
MIDDLETON OUTREACH MINISTRY INC
3502 PARMENTER STMIDDLETONWI535621535GENERAL DONATION$1,000
WING'S FUND
3606 ENTERPIRSE AVENAPLESFL34104GENERAL DONATION$3,000SUITE 150
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$52,320TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$27,040ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$1,755ExclusionAmt

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Exclusion18ExclusionCd
Exclusion$134ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$28,929ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$28,929TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EOfalseTrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EOfalseTrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EOfalsePurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth AssetsfalseRentalOfFacilitiesOthAssetsInd
Reimbursement ArrangementsfalseReimbursementArrangementsInd
Loans Or Loan GuaranteesfalseLoansOrLoanGuaranteesInd
Performance Of Services EtcfalsePerformanceOfServicesEtcInd
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOfalseRelationshipsNonchrtblEOInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryINDIRECT ACCOUNTING FEESCategoryTxt
Amt$1,500Amt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (14 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
VIATRIS INC
AMAZON COM INC$60,023$69,088
APPLE INC$49,948$228,650
AT&T INC$8,646$8,346
CATERPILLAR, INC$20,933$54,285
CHEVRON CORP$55,561$88,783
COCA-COLA CO$26,897$45,341
INTEL CORP$40,433$74,354
JOHNSON & JOHNSON CO$21,833$61,571
MERCK & CO INC$36,630$111,882
PFIZER INC$36,913$113,750
PROCTER & GAMBLE CO$23,486$53,985
VERIZON COMMUNICATIONS$40,402$60,138
WARNER BROS DISCOVERY INC$10,853$7,279

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (2 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
FIRST TRUST INTERMEDIATEAT COST$24,726$19,910
ISHARES S&P US PFD STOCKAT COST$34,391$32,242

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryINDIRECT LEGAL FEESCategoryTxt
Legal Fees$25LegalFeesAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt
EXPENSES
MISC EXP$76

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Revenue And Expenses Per Books$134RevenueAndExpensesPerBooksAmt
Net Investment Income$134NetInvestmentIncomeAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryINDIRECT TAXES/LICENSESCategoryTxt
Amt$267Amt

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