PETERSON FAMILY FOUNDATION: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: PETERSON FAMILY FOUNDATION (EIN 91-1746622)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-07-08
IRS object ID: 202231899349100313
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
Form 990-PF
Accounting Fees Schedule
Other Decreases Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-07-08T12:44:19-05:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	912016086	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	VIERCK & RAKOSKI CPAS PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	606 SE 117TH AVENUE SUITE 100	AddressLine1Txt
City	VANCOUVER	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98683	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	911746622	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE PETERSON FAMILY FOUNDATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	PETE	BusinessNameControlTxt
Phone	3608161840	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2401 NW WALDEN DRIVE	AddressLine1Txt
City	CAMAS	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98607	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KENNETH D PETERSON JR	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	3608821052	PhoneNum
Signature	2022-06-20	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	KENNETH D	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	JOSEPH G RAKOSKI	PreparerPersonNm
PTIN	P00168178	PTIN
Phone	3603563805	PhoneNum
Preparation	2022-06-20	PreparationDt

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	$6,874	FMVAssetsEOYAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Schedule B Not Required	Yes (X)	ScheduleBNotRequiredInd
Total Rev And Expnss	$0	TotalRevAndExpnssAmt
Total Net Invst Incm	$0	TotalNetInvstIncmAmt
Accounting Fees Rev And Expnss	$1,180	AccountingFeesRevAndExpnssAmt
Accounting Fees Chrtbl Prps	$1,180	AccountingFeesChrtblPrpsAmt
Taxes Rev And Expnss	$35	TaxesRevAndExpnssAmt
Taxes Dsbrs Chrtbl	$35	TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss	$1,215	TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm	$0	TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl	$1,215	TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss	$125,970	ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl	$125,970	ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss	$127,185	TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm	$0	TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl	$127,185	TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses	-$127,185	ExcessRevenueOverExpensesAmt
Net Investment Income	$0	NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Field	Value	IRS element (for citing)
Cash BOY	$134,159	CashBOYAmt
Cash EOY	$6,874	CashEOYAmt
Cash EOYFMV	$6,874	CashEOYFMVAmt
Total Assets BOY	$134,159	TotalAssetsBOYAmt
Total Assets EOY	$6,874	TotalAssetsEOYAmt
Total Assets EOYFMV	$6,874	TotalAssetsEOYFMVAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117	Yes (X)	OrgDoesNotFollowFASB117Ind
Retained Earning BOY	$134,159	RetainedEarningBOYAmt
Retained Earning EOY	$6,874	RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY	$134,159	TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY	$6,874	TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY	$134,159	TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY	$6,874	TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Field	Value	IRS element (for citing)
Tot Net Ast Or Fund Balances BOY	$134,159	TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses	-$127,185	ExcessRevenueOverExpensesAmt
Subtotal	$6,974	SubtotalAmt
Other Decreases	$100	OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY	$6,874	TotNetAstOrFundBalancesEOYAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

Field	Value	IRS element (for citing)
Investment Income Excise Tax	$0	InvestmentIncomeExciseTaxAmt

Statements Regarding Acty StatementsRegardingActyGrp

Field	Value	IRS element (for citing)
Legislative Political Acty	false	LegislativePoliticalActyInd
More Than100 Spent	false	MoreThan100SpentInd
Form1120 POL Filed	false	Form1120POLFiledInd
Activities Not Previously Rpt	false	ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws	false	ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc	false	OrganizationDissolvedEtcInd
Section508e Rqr Satisfied	Yes (true)	Section508eRqrSatisfiedInd
At Least5000 In Assets	Yes (true)	AtLeast5000InAssetsInd
Org Report Or Register State	WA	OrgReportOrRegisterStateCd
Form990 PF Filed With Atty Gen	Yes (true)	Form990PFFiledWithAttyGenInd
Private Operating Foundation	false	PrivateOperatingFoundationInd
New Substantial Contributors	false	NewSubstantialContributorsInd
Own Controlled Entity	false	OwnControlledEntityInd
Donor Advised Fund	false	DonorAdvisedFundInd
Comply With Public Insp Rqr	Yes (true)	ComplyWithPublicInspRqrInd
Website Address	N/A	WebsiteAddressTxt
Individual With Books	CLAUDIA J PETERSON	IndividualWithBooksNm
Phone	3608161840	PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

Field	Value	IRS element (for citing)
Address Line1	2401 NW WALDEN DRIVE	AddressLine1Txt
City	CAMAS	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98607	ZIPCd

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

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

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

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 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
KENNETH D PETERSON JR
2401 NW WALDEN DRIVE	CAMAS	WA	98607	PRESIDENT	1.00	$0	$0	$0
CLAUDIA J PETERSON
2401 NW WALDEN DRIVE	CAMAS	WA	98607	SEC/TREAS	1.00	$0	$0	$0

Field	Value	IRS element (for citing)
Comp Of Hghst Pd Empl Or NONE	NONE	CompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONE	NONE	CompOfHghstPdCntrctOrNONETxt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

Field	Value	IRS element (for citing)
Description1	N/A	Description1Txt

Minimum Investment Return MinimumInvestmentReturnGrp

Field	Value	IRS element (for citing)
Average Monthly FMV Of Sec	$0	AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances	$98,823	AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast	$0	FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets	$98,823	TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast	$98,823	AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable	$1,482	CashDeemedCharitableAmt
Net Vl Noncharitable Assets	$97,341	NetVlNoncharitableAssetsAmt
Minimum Investment Return	$4,867	MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
Minimum Investment Return	$4,867	MinimumInvestmentReturnAmt
Distributable Before Adj	$4,867	DistributableBeforeAdjAmt
Distributable Before Ded	$4,867	DistributableBeforeDedAmt
Distributable As Adjusted	$4,867	DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

Field	Value	IRS element (for citing)
Expenses And Contributions	$127,185	ExpensesAndContributionsAmt
Qualifying Distributions	$127,185	QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

Field	Value	IRS element (for citing)
Distributable As Adjusted	$4,867	DistributableAsAdjustedAmt
Excess Distribution Cyov Yr5	$5,107	ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4	$434,048	ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3	$378,811	ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2	$235,936	ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1	$167,615	ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov	$1,221,517	TotalExcessDistributionCyovAmt
Qualifying Distributions	$127,185	QualifyingDistributionsAmt
Applied To Current Year	$4,867	AppliedToCurrentYearAmt
Remaining Distri From Corpus	$122,318	RemainingDistriFromCorpusAmt
Total Corpus	$1,343,835	TotalCorpusAmt
Undistributed Income CY	$0	UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5	$5,107	ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr	$1,338,728	ExcessDistriCyovToNextYrAmt
Excess From Year4	$434,048	ExcessFromYear4Amt
Excess From Year3	$378,811	ExcessFromYear3Amt
Excess From Year2	$235,936	ExcessFromYear2Amt
Excess From Year1	$167,615	ExcessFromYear1Amt
Excess From Current Year	$122,318	ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (23 entries)

Address Line1RecipientUSAddress/AddressLine1Txt	CityRecipientUSAddress/CityNm	State AbbreviationRecipientUSAddress/StateAbbreviationCd	ZIPRecipientUSAddress/ZIPCd	Recipient RelationshipRecipientRelationshipTxt	Recipient Foundation StatusRecipientFoundationStatusTxt	Grant Or Contribution PurposeGrantOrContributionPurposeTxt	AmtAmt	Address Line2RecipientUSAddress/AddressLine2Txt
ACHON UGANDA CHILDREN'S FUND
13645 NW LARIAT CT	PORTLAND	OR	97229	ON FILE	EXEMPT	GENERAL FUND	$1,000
ADVENTIST FORUM
PO BOX 619047	ROSEVILLE	CA	95661	ON FILE	EXEMPT	GENERAL FUND	$5,000
CASCADE POLICY INSTITUTE
4850 SW SCHOLLS FERRY RD	PORTLAND	OR	97225	ON FILE	EXEMPT	GENERAL FUND	$1,000
CATO INSTITUTE
1000 MASSACHUSETTS AVE NW	WASHINGTON	DC	20001	ON FILE	EXEMPT	GENERAL FUND	$1,000
CHILDREN'S YOUTH THEATRE
1545 PIONEER WAY	EL CAJON	CA	92020	ONFILE	EXEMPT	GENERAL FUND	$1,000
CLARK COUNTY FOOD BANK
6502 NE 47TH AVE	VANCOUVER	WA	98661	ON FILE	EXEMPT	GENERAL FUND	$1,000
DISCOVERY INSTITUTE
208 COLUMBIA STREET	SEATTLE	WA	98104	ON FILE	EXEMPT	GENERAL FUND	$5,000
FRANKLIN NEWS FOUNDATION
200 W MADISON STREET	CHICAGO	IL	60606	ON FILE	EXEMPT	GENERAL FUND	$500	SUITE 2100
FREE THE PEOPLE FOUNDATION
611 PENNSYLVANIA AVE SE	WASHINGTON	DC	20003	ON FILE	EXEMPT	GENERAL FUND	$5,000
INDEPENDENT INSTITUTE
100 SWAN WAY	OAKLAND	CA	94621	ON FILE	EXEMPT	GENERAL FUND	$1,000
INTERNATIONAL CHILDREN'S CARE
PO BOX 820610	VANCOUVER	WA	98682	ON FILE	EXEMPT	GENERAL FUND	$1,000
INTL HYPERBARICS ASSOCIATION
15810 EAST GALE AVENUE	HACIENDA HEIGHTS	CA	91745	ON FILE	EXEMPT	GENERAL FUND	$250	SUITE 178
LOMA LINDA UNIVERSITY
PO BOX 2000	LOMA LINDA	CA	92354	ON FILE	EXEMPT	GENERAL FUND	$50,000
OURGANDA
PO BOX 874205	VANCOUVER	WA	98687	ON FILE	EXEMPT	GENERAL FUND	$15,000
PACIFIC LEGAL FOUNDATION
930 G STREET	SACRAMENTO	CA	95814	ON FILE	EXEMPT	GENERAL FUND	$1,000
PORTLAND CITY CENTER ADVENTIST GRP
0435 SW IOWA STREET	PORTLAND	OR	97239	ON FILE	EXEMPT	GENERAL FUND	$10,000
REASON FOUNDATION
5737 MESMER AVE	LOS ANGELES	CA	90230	ON FILE	EXEMPT	GENERAL FUND	$1,000
RHEMATA
258 N GREEN GABLES LOOP	RIDGEFIELD	WA	98642	ON FILE	EXEMPT	GENERAL FUND	$5,000
THE SALVATION ARMY
PO BOX 60117	CITY OF INDUSTRY	CA	917160117	ON FILE	EXEMPT	GENERAL FUND	$1,000
UNION GOSPEL MISSION
3 NW THIRD AVE	PORTLAND	OR	97209	ON FILE	EXEMPT	GENERAL FUND	$500
VAN CITY CHURCH
1812 MAIN ST	VANCOUVER	WA	98660	ON FILE	EXEMPT	GENERAL FUND	$8,000
WASHINGTON POLICY CENTER
PO BOX 3643	SEATTLE	WA	98124	ON FILE	EXEMPT	GENERAL FUND	$5,000
YOUNG AMERICANS FOR LIBERTY
500 N CAPITAL OF TEXAS HW	AUSTIN	TX	78746	ON FILE	EXEMPT	GENERAL FUND	$6,720	BLDG 5

Field	Value	IRS element (for citing)
Total Grant Or Contri Pd Dur Yr	$125,970	TotalGrantOrContriPdDurYrAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Field	Value	IRS element (for citing)
Category	ACCOUNTING FEES	CategoryTxt
Amt	$1,180	Amt
Disbursements Charitable Prps	$1,180	DisbursementsCharitablePrpsAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

Field	Value	IRS element (for citing)
Desc	REMOVED CONTRIBUTION HFFH	Desc
Amt	$100	Amt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxt	AmtAmt	Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt
STATE FEES-SOS	$10	$10
STATE FEES-SOS CHARITABLE TRUST	$25	$25

PETERSON FAMILY FOUNDATION: 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

Form 990-PF IRS990PF

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

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 (2 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 (23 entries)

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

Comments