MARK & MARY PETERSON FAMILY FOUNDATION INC: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: MARK & MARY PETERSON FAMILY FOUNDATION INC (EIN 27-1561402)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-05-11
IRS object ID: 202221319349105762
Schema version: 2021v4.2
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
Form 990-PF
Schedule B
Accounting Fees Schedule
Investments Corp Stock Schedule
Other Assets Schedule
Other Decreases Schedule
Other Expenses Schedule
Substantial Contributors Sch
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-05-11T16:48:23-05:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	391731751	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	GERALD C CONDON JR AND ASSOCIATES	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	200 SO WASHINGTON ST STE 301	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543014200	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	271561402	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARK & MARY PETERSON FAMILY FOUNDATION	BusinessNameLine1Txt
Business Name Line2	INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	MARK	BusinessNameControlTxt
Phone	9205449384	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 COUNTRY CLUB ROAD	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54313	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MARK PETERSON	PersonNm
Person Title	VICE-PRESIDENT	PersonTitleTxt
Phone	9205449384	PhoneNum
Signature	2022-04-27	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	MARK	PersonFirstNm
Person Last	PETERSON	PersonLastNm

Field	Value	IRS element (for citing)
SSN	XXX-XX-XXXX	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DIANE M LOTTO	PreparerPersonNm
PTIN	P00229043	PTIN
Phone	9204326466	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Organization501c3 Exempt PF	Yes (X)	Organization501c3ExemptPFInd
FMV Assets EOY	$2,649,163	FMVAssetsEOYAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Contri Rcvd Rev And Expnss	$1,008,344	ContriRcvdRevAndExpnssAmt
Dividends Rev And Expnss	$30,711	DividendsRevAndExpnssAmt
Dividends Net Invst Incm	$30,711	DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss	$239,318	NetGainSaleAstRevAndExpnssAmt
Gross Sales Price	$1,315,190	GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm	$674,549	CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss	$1,278,373	TotalRevAndExpnssAmt
Total Net Invst Incm	$705,260	TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss	$0	CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm	$0	CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl	$0	CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss	$4,277	AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm	$0	AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps	$0	AccountingFeesChrtblPrpsAmt
Taxes Rev And Expnss	$409	TaxesRevAndExpnssAmt
Taxes Net Invst Incm	$0	TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl	$0	TaxesDsbrsChrtblAmt
Other Expenses Rev And Expnss	$11,807	OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm	$11,647	OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl	$0	OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss	$16,493	TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm	$11,647	TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl	$0	TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss	$127,730	ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl	$127,730	ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss	$144,223	TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm	$11,647	TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl	$127,730	TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses	$1,134,150	ExcessRevenueOverExpensesAmt
Net Investment Income	$693,613	NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Field	Value	IRS element (for citing)
Sav And Temp Cash Invst BOY	$13,244	SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY	$98,245	SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV	$98,245	SavAndTempCashInvstEOYFMVAmt
Corporate Stock BOY	$1,070,765	CorporateStockBOYAmt
Corporate Stock EOY	$2,054,783	CorporateStockEOYAmt
Corporate Stock EOYFMV	$2,550,918	CorporateStockEOYFMVAmt
Other Assets BOY	$192,091	OtherAssetsBOYAmt
Other Assets EOY	$256,982	OtherAssetsEOYAmt
Other Assets EOYFMV	$0	OtherAssetsEOYFMVAmt
Total Assets BOY	$1,276,100	TotalAssetsBOYAmt
Total Assets EOY	$2,410,010	TotalAssetsEOYAmt
Total Assets EOYFMV	$2,649,163	TotalAssetsEOYFMVAmt
Total Liabilities BOY	$0	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117	Yes (X)	OrgDoesNotFollowFASB117Ind
Capital Stock BOY	$0	CapitalStockBOYAmt
Capital Stock EOY	$0	CapitalStockEOYAmt
Additional Paid In Capital BOY	$0	AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY	$0	AdditionalPaidInCapitalEOYAmt
Retained Earning BOY	$1,276,100	RetainedEarningBOYAmt
Retained Earning EOY	$2,410,010	RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY	$1,276,100	TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY	$2,410,010	TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY	$1,276,100	TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY	$2,410,010	TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Field	Value	IRS element (for citing)
Tot Net Ast Or Fund Balances BOY	$1,276,100	TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses	$1,134,150	ExcessRevenueOverExpensesAmt
Other Increases	$0	OtherIncreasesAmt
Subtotal	$2,410,250	SubtotalAmt
Other Decreases	$240	OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY	$2,410,010	TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (4 entries)

PropertyPropertyDesc	How AcquiredHowAcquiredCd	AcquiredAcquiredDt	SoldSoldDt	Gross Sales PriceGrossSalesPriceAmt	Cost Or Other BasisCostOrOtherBasisAmt	Gain Or LossGainOrLossAmt	Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
SCH 1 - MORGAN STANLEY 7542	P	2021-01-01	2021-12-31	$110,720	$114,077	-$3,357	-$3,357
SCH 2 - MORGAN STANLEY 7542	P	2020-01-01	2021-12-31	$548,531	$353,888	$194,643	$194,643
SCH 3 - MORGAN STANLEY 7542	P	2020-01-01	2021-12-31	$585,667	$172,676	$412,991	$412,991
CAPITAL GAINS DIVIDENDS	P			$70,272		$70,272	$70,272

Field	Value	IRS element (for citing)
Capital Gain Net Income	$674,549	CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

Field	Value	IRS element (for citing)
Investment Income Excise Tax	$9,641	InvestmentIncomeExciseTaxAmt
Tax Under Section511	$0	TaxUnderSection511Amt
Subtotal	$9,641	SubtotalAmt
Subtitle A Tax	$0	SubtitleATaxAmt
Tax Based On Investment Income	$9,641	TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx	$1,519	EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce	$0	ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid	$0	ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld	$0	BackupWithholdingWithheldAmt
Total Payments And Credits	$1,519	TotalPaymentsAndCreditsAmt
Es Penalty	$0	EsPenaltyAmt
Tax Due	$8,122	TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

Field	Value	IRS element (for citing)
Legislative Political Acty	0	LegislativePoliticalActyInd
More Than100 Spent	0	MoreThan100SpentInd
Form1120 POL Filed	0	Form1120POLFiledInd
Section4955 Organization Tax	$0	Section4955OrganizationTaxAmt
Section4955 Managers Tax	$0	Section4955ManagersTaxAmt
Tax Reimbursed	$0	TaxReimbursedAmt
Activities Not Previously Rpt	0	ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws	0	ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc	0	OrganizationDissolvedEtcInd
Section508e Rqr Satisfied	Yes (1)	Section508eRqrSatisfiedInd
At Least5000 In Assets	Yes (1)	AtLeast5000InAssetsInd
Org Report Or Register State	WI	OrgReportOrRegisterStateCd
Form990 PF Filed With Atty Gen	Yes (1)	Form990PFFiledWithAttyGenInd
Private Operating Foundation	0	PrivateOperatingFoundationInd
New Substantial Contributors	Yes (1)	NewSubstantialContributorsInd
Own Controlled Entity	0	OwnControlledEntityInd
Donor Advised Fund	0	DonorAdvisedFundInd
Comply With Public Insp Rqr	Yes (1)	ComplyWithPublicInspRqrInd
Website Address	N/A	WebsiteAddressTxt
Individual With Books	MARK PETERSON	IndividualWithBooksNm
Phone	9205449384	PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

Field	Value	IRS element (for citing)
Address Line1	100 COUNTRY CLUB RD	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54313	ZIPCd

Field	Value	IRS element (for citing)
Foreign Accounts Question	0	ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

Field	Value	IRS element (for citing)
Sale Or Exch Disqualified Prsn	0	SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn	0	BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn	0	FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn	0	PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn	0	TransferAstDisqualifiedPrsnInd
Payment To Government Official	0	PaymentToGovernmentOfficialInd
Uncorrected Prior Acts	0	UncorrectedPriorActsInd
Undistributed Income PY	0	UndistributedIncomePYInd
Business Holdings	0	BusinessHoldingsInd
Jeopardy Investments	0	JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst	0	UncorrectedPYJeopardyInvstInd
Influence Legislation	0	InfluenceLegislationInd
Influence Election	0	InfluenceElectionInd
Grants To Individuals	0	GrantsToIndividualsInd
Grants To Organizations	0	GrantsToOrganizationsInd
Noncharitable Purpose	0	NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	TitleTitleTxt	Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt	CompensationCompensationAmt	Employee Benefit ProgramEmployeeBenefitProgramAmt	Expense Account Other AllwncExpenseAccountOtherAllwncAmt
MARK PETERSON
100 COUNTRY CLUB ROAD	GREEN BAY	WI	54313	TREASURER/VICE PRESIDENT	0.00	$0	$0	$0
MARY PETERSON
100 COUNTRY CLUB ROAD	GREEN BAY	WI	54313	PRESIDENT	0.00	$0	$0	$0
BRAD PETERSON
100 COUNTRY CLUB ROAD	GREEN BAY	WI	54313	SECRETARY	0.00	$0	$0	$0

Field	Value	IRS element (for citing)
Comp Of Hghst Pd Empl Or NONE	NONE	CompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k	0	OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONE	NONE	CompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k	0	ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

Field	Value	IRS element (for citing)
Description1	NONE	Description1Txt
Expenses1	$0	Expenses1Amt
Total	$0	TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

Field	Value	IRS element (for citing)
Average Monthly FMV Of Sec	$2,078,289	AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances	$33,620	AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast	$0	FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets	$2,111,909	TotalFMVOfUnusedAssetsAmt
Reduction Claimed	$0	ReductionClaimedAmt
Acquisition Indebtedness	$0	AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast	$2,111,909	AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable	$31,679	CashDeemedCharitableAmt
Net Vl Noncharitable Assets	$2,080,230	NetVlNoncharitableAssetsAmt
Minimum Investment Return	$104,012	MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
Minimum Investment Return	$104,012	MinimumInvestmentReturnAmt
Tax Based On Investment Income	$9,641	TaxBasedOnInvestmentIncomeAmt
Total Tax	$9,641	TotalTaxAmt
Distributable Before Adj	$94,371	DistributableBeforeAdjAmt
Recoveries Qualfied Distri	$0	RecoveriesQualfiedDistriAmt
Distributable Before Ded	$94,371	DistributableBeforeDedAmt
Deduction From Distributable	$0	DeductionFromDistributableAmt
Distributable As Adjusted	$94,371	DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

Field	Value	IRS element (for citing)
Expenses And Contributions	$127,730	ExpensesAndContributionsAmt
Program Related Invst Total	$0	ProgramRelatedInvstTotalAmt
Qualifying Distributions	$127,730	QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

Field	Value	IRS element (for citing)
Distributable As Adjusted	$94,371	DistributableAsAdjustedAmt
Undistributed Income PY	$2,089	UndistributedIncomePYAmt
Total For Prior Years	$0	TotalForPriorYearsAmt
Total Excess Distribution Cyov	$0	TotalExcessDistributionCyovAmt
Qualifying Distributions	$127,730	QualifyingDistributionsAmt
Applied To Year1	$2,089	AppliedToYear1Amt
Applied To Prior Years	$0	AppliedToPriorYearsAmt
Treated As Distri From Corpus	$0	TreatedAsDistriFromCorpusAmt
Applied To Current Year	$94,371	AppliedToCurrentYearAmt
Remaining Distri From Corpus	$31,270	RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus	$0	ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY	$0	ExcessDistributionCyovAppCYAmt
Total Corpus	$31,270	TotalCorpusAmt
Prior Year Undistributed Incm	$0	PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax	$0	PriorYearDeficiencyOrTaxAmt
Taxable1	$0	Taxable1Amt
Taxable2	$0	Taxable2Amt
Undistributed Income CY	$0	UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3	$0	CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5	$0	ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr	$31,270	ExcessDistriCyovToNextYrAmt
Excess From Current Year	$31,270	ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Field	Value	IRS element (for citing)
Contributing Manager	MARK PETERSON	ContributingManagerNm
Contributing Manager	MARY PETERSON	ContributingManagerNm
Only Contri To Preselected	Yes (X)	OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (43 entries)

Address Line1RecipientUSAddress/AddressLine1Txt	CityRecipientUSAddress/CityNm	State AbbreviationRecipientUSAddress/StateAbbreviationCd	ZIPRecipientUSAddress/ZIPCd	Recipient RelationshipRecipientRelationshipTxt	Recipient Foundation StatusRecipientFoundationStatusTxt	Grant Or Contribution PurposeGrantOrContributionPurposeTxt	AmtAmt
AMAZING GRACE EQUINE SANCTUARY
W4985 CTY RD FF	ELKHART LAKE	WI	53020	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVENUE	DALLAS	TX	75231	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$300
AMERICAN RED CROSS
431 18TH STREET NW	WASHINGTON	DC	20006	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
BOYS AND GIRLS CLUB OF GREEN BAY
311 SOUTH ONEIDA STREET	GREEN BAY	WI	54303	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
BROWN COUNTY SHERIFF'S BENEVOLENT ASSOCIATION
PO BOX 1612	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$20
BROWN COUNTY UNITED WAY
PO BOX 1593	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITYSUPPORT CHARITABLE ACTIVITY	$1,000
CASA OF BROWN COUNTY INC
414 E WALNUT ST STE 170	GREEN BAY	WI	54301	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$2,000
CATHOLIC FOUNDATION
PO BOX 22128	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	BISHOPS APPEAL	$21,000
CEREBRAL PALSY INC
2801 SO WEBSTER AVENUE	GREEN BAY	WI	54301	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$15,000
CURATIVE CONNECTION
2900 CURRY LANE	GREEN BAY	WI	54308	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$40,000
DISABLED AMERICAN VETERANS
PO BOX 14301	CINCINNATI	OH	45250	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
FAMILY SERVICES
300 CROOKS STREET	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,500
FOUNDATIONS HEALTH & WELLNESS
1061 W MASON STREET	GREEN BAY	WI	54303	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
FREEDOM HOUSE MINISTRIES INC
2997 ST ANTHONY DRIVE	GREEN BAY	WI	54311	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
HABITAT FOR HUMANITY
1967 ALLOUEZ AVENUE	GREEN BAY	WI	54311	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
HOUSE OF HOPE
1660 CHRISTIANA STREET	GREEN BAY	WI	54303	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
HOWE COMMUNITY RESOURCE CENTER
526 S MONROE AVENUE	GREEN BAY	WI	54301	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
NWTC EDUCATIONAL FOUNDATION
PO BOX 19042	GREEN BAY	WI	54307	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$5,110
PAUL'S PANTRY
1529 LEO FRIGO WAY	GREEN BAY	WI	54302	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$5,000
SALVATION ARMY
626 UNION COURT	GREEN BAY	WI	54303	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,100
SPECIAL OLYMPICS - WISCONSIN
2310 CROSSROADS DR STE 1000	MADISON	WI	53718	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
ST JOHN THE EVANGELIST HOMELESS SHELTER
PO BOX 1743	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,500
ST JUDE CHILDREN'S HOSPITAL
501 ST JUDE PLACE	MEMPHIS	TN	38105	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,200
YMCA
235 N JEFFERSON STREET	GREEN BAY	WI	54301	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$2,000
ST JOHN THE BAPTIST PARISH
2597 GLENDALE AVENUE	GREEN BAY	WI	54313	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$3,500
GREATER GREEN BAY COMMUNITY FOUNDATION
320 N BROADWAY STE 260	GREEN BAY	WI	54303	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,500
PAWS CHICAGO
1997 N CLYBOURN AVENUE	CHICAGO	IL	60614	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
FELINE & CANINES
6379 N PAULINA STREET	CHICAGO	IL	60660	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
CHICAGO RUN
3611 N KEDZIE AVENUE	CHICAGO	IL	60618	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
GREATER CHICAGO FOOD
4100 WEST ANN LURIE PLACE	CHICAGO	IL	60632	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,500
UNIVERSITY OF CHICAGO - CHILD LIFE SPECIAL PROJECTS
5235 S HARPER COURT STE 450	CHICAGO	IL	60615	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
CHICAGO CARES
641 W LAKE ST STE 200	CHICAGO	IL	60661	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
FRIENDS OF PBS WISCONSIN
821 UNIVERSITY AVENUE	MADISON	WI	53706	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
BIG BROTHERS BIG SISTERS OF NORTHEAST WISCONSIN
520 N BROADWAY STE 220	GREEN BAY	WI	54303	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
COMPRESS & SCHOCK FOUNDATION
PO BOX 4282	ROANOKE	VA	24015	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
WILLOW TREE CORNERSTONE CHILD ADVOCACY CENTER
503 S MONROE AVENUE	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
ENCOMPASS EARLY EDUCATION AND CARE INC
PO BOX 1627	GREEN BAY	WI	54305	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$500
BEAMING INC
2692 COUNTY ROAD GG	NEENAH	WI	54956	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
EXCEPTIONAL EQUESTRIANS
1130 ORLANDO DRIVE	DE PERE	WI	54115	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
SYBLE HOPP SCHOOL
755 SCHEURING ROAD	DE PERE	WI	54115	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$2,000
BONDUEL SCHOOL DISTRICT
400 W GREEN BAY STREET	BONDUEL	WI	54107	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$2,000
WESTWOOD ELEMENTARY SCHOOL
1155 WESTWOOD DRIVE	DE PERE	WI	54115	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000
FEEDING AMERICA EASTERN WISCONSIN
1700 W FOND DU LAC AVENUE	MILWAUKEE	WI	53205	NONE	PUBLIC CHARITY	SUPPORT CHARITABLE ACTIVITY	$1,000

Field	Value	IRS element (for citing)
Total Grant Or Contri Pd Dur Yr	$127,730	TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut	$0	TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

Field	Value	IRS element (for citing)
Exclusion	14	ExclusionCd
Exclusion	$30,711	ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

Field	Value	IRS element (for citing)
Exclusion	18	ExclusionCd
Exclusion	$239,318	ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

Field	Value	IRS element (for citing)
Unrelated Business Taxbl Incm	$0	UnrelatedBusinessTaxblIncmAmt
Exclusion	$270,029	ExclusionAmt
Related Or Exempt Function Incm	$0	RelatedOrExemptFunctionIncmAmt

Field	Value	IRS element (for citing)
Total Income Producing Acty	$270,029	TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

Field	Value	IRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO	0	TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO	0	TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets	0	SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO	0	PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets	0	RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements	0	ReimbursementArrangementsInd
Loans Or Loan Guarantees	0	LoansOrLoanGuaranteesInd
Performance Of Services Etc	0	PerformanceOfServicesEtcInd
Sharing Of Facilities Etc	0	SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO	0	RelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

Field	Value	IRS element (for citing)
Organization501c3 Exempt PF	Yes (X)	Organization501c3ExemptPFInd
General Rule	Yes (X)	GeneralRuleInd

Contributor Information ContributorInformationGrp (2 entries)

ContributorContributorNum	Address Line1ContributorUSAddress/AddressLine1Txt	CityContributorUSAddress/CityNm	State AbbreviationContributorUSAddress/StateAbbreviationCd	ZIPContributorUSAddress/ZIPCd	Total ContributionsTotalContributionsAmt	Person ContributionPersonContributionInd
MARK PETERSON
1	100 COUNTRY CLUB RD	GREEN BAY	WI	54313	$504,172	Yes (X)
MARY PETERSON
2	100 COUNTRY CLUB RD	GREEN BAY	WI	54313	$504,172	Yes (X)

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Field	Value	IRS element (for citing)
Category	GERALD C. CONDON, JR & ASSOC	CategoryTxt
Amt	$4,277	Amt
Net Investment Income	$0	NetInvestmentIncomeAmt
Disbursements Charitable Prps	$0	DisbursementsCharitablePrpsAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)

StockStockNm	EOY Book ValueEOYBookValueAmt	EOYFMVEOYFMVAmt
MORGAN STANLEY SB EQUITY FUND	$665,819	$1,046,116
MORGAN STANLEY SB MUTUAL FUND	$1,388,964	$1,504,802

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (8 entries)

DescDesc	BOY Book ValueBOYBookValueAmt	EOY Book ValueEOYBookValueAmt
ACCRUED INCOME	$396	$1,354
2016 BASIS ADJ - DONATED 28 SH S&P 500 INDEX	$3,527	$0
2016 BASIS ADJ - DONATED 130 SH S&P 500 INDEX	$15,400	$0
2018 BASIS ADJ - DONATED 396 SH VANGUARD SM CAP	$33,880	$0
2018 BASIS ADJ - DONATED 76 SH VANGUARD SM CAP	$6,357	$0
2020 BASIS ADJ - DONATED 1445 SH VANGUARD MID CAP	$132,531	$49,344
2021 BASIS ADJ - DONATED 845 SH ISHARE CORE S&P	$0	$163,243
2021 BASIS ADJ - DONATED 609 SH VANGUARD SMALL CAP	$0	$43,041

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

Field	Value	IRS element (for citing)
Desc	NON-DEDUCTIBLE CONTRIBUTION TO NWTC EDUCATIONAL FND	Desc
Amt	$240	Amt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (4 entries)

DescDesc	Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt	Net Investment IncomeNetInvestmentIncomeAmt	Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt
MORGAN STANLEY SB FEE	$11,238	$11,238	$0
PROMOTIONAL EXPENSE	$150	$0	$0
MISCELLANEOUS INVESTMENT EXPENSE	$409	$409	$0
ANNUAL REPORT FEE	$10	$0	$0

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd
MARK PETERSON
100 COUNTRY CLUB ROAD	GREEN BAY	WI	54313
MARY PETERSON
100 COUNTRY CLUB ROAD	GREEN BAY	WI	54313

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

Field	Value	IRS element (for citing)
Category	FOREIGN TAX WITHHELD #7542	CategoryTxt
Amt	$409	Amt
Net Investment Income	$0	NetInvestmentIncomeAmt
Disbursements Charitable Prps	$0	DisbursementsCharitablePrpsAmt

MARK & MARY PETERSON FAMILY FOUNDATION INC: Form 990PF, tax year 2021

Return header ReturnHeader

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Preparer US Address PreparerUSAddress

Filer Filer

Business Name BusinessName

US Address USAddress

Business Officer BusinessOfficerGrp

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Preparer Person PreparerPersonGrp

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Form 990-PF IRS990PF

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (4 entries)

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

Statements Regarding Acty StatementsRegardingActyGrp

Location Of Books US Address LocationOfBooksUSAddress

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (3 entries)

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

Distributable Amount DistributableAmountGrp

PF Qualifying Distributions PFQualifyingDistributionsGrp

Undistributed Income UndistributedIncomeGrp

Supplementary Information SupplementaryInformationGrp

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (43 entries)

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp (2 entries)

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (8 entries)

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (4 entries)

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail (2 entries)

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

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