RACCOON VALLEY BANK CHARITABLE FOUNDATION: Form 990PF, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- RACCOON VALLEY BANK CHARITABLE FOUNDATION (EIN 42-1347634)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-05-20
- IRS object ID
- 201901409349100420
- Schema version
- 2018v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-20T13:36:17-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 666 WALNUT ST STE 1450 | AddressLine1Txt |
| City | DES MOINES | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 503093918 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421347634 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RACCOON VALLEY BANK | BusinessNameLine1Txt |
| Business Name Line2 | CHARITABLE FOUNDATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RACC | BusinessNameControlTxt |
| Phone | 5154653521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1202 2ND ST | AddressLine1Txt |
| City | PERRY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 502200129 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERRY NIELSEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5154653521 | PhoneNum |
| Signature | 2019-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY MERFELD | PreparerPersonNm |
| PTIN | P00454267 | PTIN |
| Phone | 5152440266 | PhoneNum |
| Preparation | 2019-05-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 199.247.42.211 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-10 | IPDt |
| IP Tm | 09:04:30 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 2EB51E1F06D4FB4132B6CCC0E368D668E07215B8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E0A0657C97B5EE00B718E4344F3003D65DEFD85B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $66,480 | 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 | $74,000 | ContriRcvdRevAndExpnssAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $74,000 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $0 | 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 | $350 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $175 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $175 | AccountingFeesChrtblPrpsAmt |
| Tot Opr Expenses Rev And Expnss | $350 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $175 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $175 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $88,781 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $88,781 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $89,131 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $175 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $88,956 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$15,131 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $76,611 | CashBOYAmt |
| Cash EOY | $61,480 | CashEOYAmt |
| Cash EOYFMV | $61,480 | CashEOYFMVAmt |
| Other Investments BOY | $5,000 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $5,000 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $5,000 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $81,611 | TotalAssetsBOYAmt |
| Total Assets EOY | $66,480 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $66,480 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| 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 | $81,611 | RetainedEarningBOYAmt |
| Retained Earning EOY | $66,480 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $81,611 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $66,480 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $81,611 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $66,480 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $81,611 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$15,131 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $66,480 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $66,480 | TotNetAstOrFundBalancesEOYAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $67,870 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $87,218 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.778165 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $61,850 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $98,087 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.630563 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $58,070 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $104,278 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.556877 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $24,060 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $91,844 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.261966 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $45,541 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $73,093 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.623056 | DistributionYr5Rt |
| Total Distribution | 2.850627 | TotalDistributionRt |
| Average Distribution | 0.570125 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $45,162 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $25,748 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $0 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $25,748 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $88,956 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | Yes (X) | DomesticOrgMeetingSect4940eInd |
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $0 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $0 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $0 | 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 | IA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | 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 | TERRY NIELSEN | IndividualWithBooksNm |
| Phone | 5154653521 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 129 1202 SECOND | AddressLine1Txt |
| City | PERRY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50220 | 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 | Yes (1) | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | 0 | ActsFailToQlfyAsExceptionsInd |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|
| TERRY NIELSEN | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | PRESIDENT & DIRECTOR | 1.00 | $0 | $0 | $0 |
| KENDALL RATHJE | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | ID | 50220 | SECRETARY/TREASURER | 1.00 | $0 | $0 | $0 |
| SALLY HAERR | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| ELIZABETH GARST | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| SARAH GARST | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| H T HOLCOMB | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| JON PETERS | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| DOUG MCDERMOTT | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $0 | $0 | $0 |
| DAN WILHELMI | ||||||||
| 1202 SECOND AVENUE P O BOX 129 | PERRY | IA | 50220 | DIRECTOR | 0.10 | $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) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $40,850 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $5,000 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $45,850 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $45,850 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $688 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $45,162 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $2,258 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $2,258 | MinimumInvestmentReturnAmt |
| Total Tax | $0 | TotalTaxAmt |
| Distributable Before Adj | $2,258 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $2,258 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $2,258 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $88,956 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $88,956 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $88,956 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $2,258 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $41,886 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $19,468 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $52,856 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $56,946 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $63,509 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $234,665 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $88,956 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $2,258 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $86,698 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $321,363 | 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 | $41,886 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $279,477 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $19,468 | ExcessFromYear4Amt |
| Excess From Year3 | $52,856 | ExcessFromYear3Amt |
| Excess From Year2 | $56,946 | ExcessFromYear2Amt |
| Excess From Year1 | $63,509 | ExcessFromYear1Amt |
| Excess From Current Year | $86,698 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | TERRY NIELSEN | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RACCOON VALLEY BANK | AddressLine1Txt |
| City | PERRY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 5154653521 | RecipientPhoneNum |
| Form And Info And Materials | IN WRITING, WITH A BRIEF EXPLANATION AS TO THE CHARITABLE OR OTHER NEED. | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | NONE. | SubmissionDeadlinesTxt |
| Restrictions On Awards | MUST BE TO CHARITABLE, RELIGIOUS, LITERARY, EDUCATIONAL OR OTHER WORTHY INSTITUTIONS OR ORGANIZATIONS. | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (38 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ACLU FOUNDATION | |||||||
| 505 FIFTH AVENUE SUITE 901 | DES MOINES | IA | 50309 | NONE | PC | GENERAL FUND | $1,000 |
| ADM SCHOLARSHIP FOUNDATION | |||||||
| 215 NORTH 11TH ST | ADEL | IA | 50003 | NONE | PC | GENERAL FUND | $25 |
| ART ON THE PRAIRIE | |||||||
| 1215 WARFORD ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $1,000 |
| CENTRAL COLLEGE | |||||||
| 812 UNIVERSITY ST | PELLA | IA | 50219 | NONE | PC | GENERAL FUND | $50 |
| DALLAS COUNTY CONSERVATION FOUNDATION | |||||||
| 14581 K AVE | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $175 |
| DALLAS COUNTY FOUNDATION | |||||||
| PO BOX 46 | ADEL | IA | 50003 | NONE | PC | GENERAL FUND | $20,000 |
| DALLAS COUNTY HOSPITAL FOUNDATION | |||||||
| 610 10TH ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $2,760 |
| FAITH LUTHERAN CHURCH | |||||||
| 602 S 14TH ST | ADEL | IA | 50003 | NONE | PC | GENERAL FUND | $500 |
| FIRST ASSEMBLY | |||||||
| 2725 MERLE HAY RD | DES MOINES | IA | 50310 | NONE | PC | GENERAL FUND | $200 |
| GREATER DALLAS COUNTY DEVELOPMENT ALLIANCE | |||||||
| 9325 UNIVERSITY AVE STE 125 | WEST DES MOINES | IA | 50266 | NONE | PC | GENERAL FUND | $5,000 |
| IOWA LEGAL AID FOUNDATION | |||||||
| 1111 9TH ST STE 230 | DES MOINES | IA | 50314 | NONE | PC | GENERAL FUND | $1,000 |
| IOWA PUBLIC TELEVISION | |||||||
| 6450 CORPORATE DR | JOHNSTON | IA | 50131 | NONE | PC | GENERAL FUND | $60 |
| LIFEHOUSE COMMUNITY CHURCH | |||||||
| 4095 NW URBANDALE DR | URBANDALE | IA | 50322 | NONE | PC | GENERAL FUND | $500 |
| MT OLIVET LUTHERAN CHURCH | |||||||
| 920 15TH ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $850 |
| SCIENCE CENTER OF IOWA | |||||||
| 401 MARTIN LUTHER KING JR PKWY | DES MOINES | IA | 50309 | NONE | PC | GENERAL FUND | $500 |
| ST JOHN'S CATHOLIC CHURCH | |||||||
| 24043 302ND PL | ADEL | IA | 50003 | NONE | PC | GENERAL FUND | $500 |
| ST JOSEPHS CHURCH | |||||||
| 503 N CHESTNUT ST | JEFFERSON | IA | 50129 | NONE | PC | GENERAL FUND | $500 |
| ST PATRICK'S CHURCH | |||||||
| 1312 3RD ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $1,180 |
| TRINITY LUTHERAN CHURCH | |||||||
| 2174 B AVE | COON RAPIDS | IA | 50058 | NONE | PC | GENERAL FUND | $500 |
| WHITEROCK CONSERVANCY | |||||||
| 1390 HIGHWAY 141 | COON RAPIDS | IA | 50058 | NONE | PC | GENERAL FUND | $275 |
| LION OF JUDAH PENTECOASTAL CHURCH | |||||||
| 2611 OTLEY AVE | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $500 |
| FIRST BAPTIST CHURCH | |||||||
| 1220 4TH ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $500 |
| SIEDA | |||||||
| 201 S 23RD ST | FAIRFIELD | IA | 52556 | NONE | PC | GENERAL FUND | $500 |
| THE BRENTON ARBORETUM | |||||||
| 25141 260TH ST | DALLAS CENTER | IA | 50063 | NONE | PC | GENERAL FUND | $500 |
| AMERICAN CANCER SOCIETY | |||||||
| 250 WILLIAMS ST | ATLANTA | GA | 73123 | NONE | PC | GENERAL FUND | $250 |
| DALLAS COUNTY SHERIFFS OFFICE | |||||||
| 201 NILE KINNICK DR | ADEL | IA | 50003 | NONE | GOV | GENERAL FUND | $2,500 |
| FRIENDS OF KINNICK-FELLER PARK | |||||||
| 61 N 12TH ST | ADEL | IA | 50003 | NONE | PC | GENERAL FUND | $4,636 |
| IOWA ENVIROMENTAL COUNCIL | |||||||
| 505 5TH AVE | DES MOINES | IA | 50309 | NONE | PC | GENERAL FUND | $1,000 |
| IOWA NATURAL HERITAGE FOUNDATION | |||||||
| 505 5TH AVE | DES MOINES | IA | 50309 | NONE | PC | GENERAL FUND | $300 |
| LIFEGATE CHURCH - OMAHA | |||||||
| 15555 W DODGE ROAD | OMAHA | NE | 68154 | NONE | PC | GENERAL FUND | $150 |
| PERRY ALONA CLUB | |||||||
| 1211 LUCINDA ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $420 |
| PERRY AREA SWIM TEAM | |||||||
| 802 15TH ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $300 |
| PERRY COMMUNITY SCHOOL FOUNDATION | |||||||
| 1200 18TH ST | PERRY | IA | 50220 | NONE | PC | GENERAL FUND | $25,000 |
| SPURGEON MANOR | |||||||
| 1204 LINDEN | DALLAS CENTER | IA | 50063 | NONE | PC | GENERAL FUND | $5,500 |
| THE HUNGER FREE DALLAS COUNTY ENDOW IOWA FUND | |||||||
| 451 NILE KINNICK DR | ADEL | IA | 50003 | NONE | PC | GENERAL FUND | $10,000 |
| TORI'S ANGELS FOUNDATION | |||||||
| 4677 PANORAMA DR | PANORA | IA | 50216 | NONE | PC | GENERAL FUND | $100 |
| UNIVERSITY OF NEBRASKA AT OMAHA FOUNDATION | |||||||
| PO BOX 3465 | OMAHA | NE | 68103 | NONE | PC | GENERAL FUND | $25 |
| WAYPOINT CHURCH - OMAHA | |||||||
| PO BOX 31249 | OMAHA | IA | 68131 | NONE | PC | GENERAL FUND | $25 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $88,781 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $0 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RACCOON VALLEY BANK | BusinessNameLine1Txt |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 129 | AddressLine1Txt |
| City | PERRY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $74,000 | TotalContributionsAmt |
| Person Contribution | Yes (X) | PersonContributionInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $350 | Amt |
| Net Investment Income | $175 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $175 | DisbursementsCharitablePrpsAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | STAMOS TAPESTRY | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $5,000 | BookValueAmt |
| EOYFMV | $5,000 | EOYFMVAmt |
Comments