HUGH E & MARJORIE S PETERSEN FOUNDATION INC: Form 990PF, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
HUGH E & MARJORIE S PETERSEN FOUNDATION INC (EIN 20-3757530)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-07-17
IRS object ID
201831989349100023
Schema version
2017v2.3
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)
Return2018-07-17T14:34:03-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Foundation SourceBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1One Hollow Ln Ste 212AddressLine1Txt
CityLake SuccessCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11042ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203757530EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hugh E & Marjorie S Petersen FoundationBusinessNameLine1Txt
Business Name Line2IncBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% Foundation SourceInCareOfNm
Business Name ControlHUGHBusinessNameControlTxt
Phone8008391754PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Foundation Source 501 Silverside RdAddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLYNNE M TAHMISIANPersonNm
Person TitlepresidentPersonTitleTxt
Phone8008391754PhoneNum
Signature2018-06-26SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJeffrey D HaskellPreparerPersonNm
PTINP01345770PTIN
Phone8008391754PhoneNum
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$432,545FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$1,530,000ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$837InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$837InterestOnSavNetInvstIncmAmt
Cap Gain Net Incm Net Invst Incm$0CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$471OtherIncomeRevAndExpnssAmt
Total Rev And Expnss$1,531,308TotalRevAndExpnssAmt
Total Net Invst Incm$837TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Other Expenses Rev And Expnss$5,025OtherExpensesRevAndExpnssAmt
Other Expenses Dsbrs Chrtbl$5,025OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$5,025TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$0TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$5,025TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$1,129,500ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$1,129,500ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$1,134,525TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$0TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$1,134,525TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$396,783ExcessRevenueOverExpensesAmt
Net Investment Income$837NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$35,762SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$432,545SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$432,545SavAndTempCashInvstEOYFMVAmt
Total Assets BOY$35,762TotalAssetsBOYAmt
Total Assets EOY$432,545TotalAssetsEOYAmt
Total Assets EOYFMV$432,545TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Retained Earning BOY$35,762RetainedEarningBOYAmt
Retained Earning EOY$432,545RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$35,762TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$432,545TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$35,762TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$432,545TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$35,762TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$396,783ExcessRevenueOverExpensesAmt
Subtotal$432,545SubtotalAmt
Tot Net Ast Or Fund Balances EOY$432,545TotNetAstOrFundBalancesEOYAmt
FieldValueIRS element (for citing)
Cap Gains Loss Tx Invst Incm DetailCapGainsLossTxInvstIncmDetail

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$640,521AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$81,430NetVlNoncharitableAssetsYr1Amt
Distribution Yr17.865909DistributionYr1Rt
Adjusted Qlfy Distri Yr2$892,700AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$189,220NetVlNoncharitableAssetsYr2Amt
Distribution Yr24.717789DistributionYr2Rt
Adjusted Qlfy Distri Yr3$365,471AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$188,732NetVlNoncharitableAssetsYr3Amt
Distribution Yr31.936455DistributionYr3Rt
Adjusted Qlfy Distri Yr4$394,871AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$135,425NetVlNoncharitableAssetsYr4Amt
Distribution Yr42.915791DistributionYr4Rt
Adjusted Qlfy Distri Yr5$413,820AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$211,214NetVlNoncharitableAssetsYr5Amt
Distribution Yr51.959245DistributionYr5Rt
Total Distribution19.395189TotalDistributionRt
Average Distribution3.879038AverageDistributionRt
Net Vl Noncharitable Assets$145,654NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$564,997AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$8NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$565,005AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$1,134,525QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$8InvestmentIncomeExciseTaxAmt
Subtotal$8SubtotalAmt
Tax Based On Investment Income$8TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$100EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$100TotalPaymentsAndCreditsAmt
Overpayment$92OverpaymentAmt
Applied To ES Tax$92AppliedToESTaxAmt

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 EtcYes (true)OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateDEOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsYes (true)NewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1Foundation SourceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8008391754PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1501 Silverside Road Suite 123AddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd
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

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
Ruth Kovacs
Foundation Source 501 Silverside RdWilmingtonDE198091377Dir, Sec, VP1.0$0$0$0
Sharon Peck
Foundation Source 501 Silverside RdWilmingtonDE198091377Dir, VP1.0$0$0$0
Lynne Tahmisian
Foundation Source 501 Silverside RdWilmingtonDE198091377Dir, Pres1.0$0$0$0
FieldValueIRS element (for citing)
Summary Of Direct Chrtbl ActySummaryOfDirectChrtblActyGrp
Sum Of Program Related InvstSumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$0AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$147,872AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$147,872TotalFMVOfUnusedAssetsAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$147,872AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$2,218CashDeemedCharitableAmt
Net Vl Noncharitable Assets$145,654NetVlNoncharitableAssetsAmt
Minimum Investment Return$7,283MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$7,283MinimumInvestmentReturnAmt
Tax Based On Investment Income$8TaxBasedOnInvestmentIncomeAmt
Total Tax$8TotalTaxAmt
Distributable Before Adj$7,275DistributableBeforeAdjAmt
Distributable Before Ded$7,275DistributableBeforeDedAmt
Distributable As Adjusted$7,275DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$1,134,525ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$1,134,525QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$8PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$1,134,517AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$7,275DistributableAsAdjustedAmt
Prior Year12015PriorYear1Yr
Prior Year22014PriorYear2Yr
Prior Year32013PriorYear3Yr
Excess Distribution Cyov Yr5$403,269ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$392,652ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$364,642ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$890,889ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$636,457ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$2,687,909TotalExcessDistributionCyovAmt
Qualifying Distributions$1,134,525QualifyingDistributionsAmt
Applied To Current Year$7,275AppliedToCurrentYearAmt
Remaining Distri From Corpus$1,127,250RemainingDistriFromCorpusAmt
Total Corpus$3,815,159TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5$403,269ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$3,411,890ExcessDistriCyovToNextYrAmt
Excess From Year4$392,652ExcessFromYear4Amt
Excess From Year3$364,642ExcessFromYear3Amt
Excess From Year2$890,889ExcessFromYear2Amt
Excess From Year1$636,457ExcessFromYear1Amt
Excess From Current Year$1,127,250ExcessFromCurrentYearAmt
FieldValueIRS element (for citing)
Private Operating FoundationsPrivateOperatingFoundationsGrp

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (31 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
CAMPUS CRUSADE FOR CHRIST INTERNATIONAL
100 LAKE HART DRORLANDOFL32832N/APCDidier and Donna Heslon Project$3,750
CAMPUS CRUSADE FOR CHRIST INTERNATIONAL
100 LAKE HART DRORLANDOFL32832N/APCDidier and Donna Heslon Project$1,250
CANCER SUPPORT COMMUNITY VALLEY- VENTURA-SANTA BAR
530 HAMPSHIRE RDWESTLAKE VLGCA91361N/APCGeneral & Unrestricted$50,000
FAMILY CARE NETWORK INC
1255 KENDALL RDSAN LUIS OBISPOCA93401N/APCGeneral & Unrestricted$20,000
FAMILY CARE NETWORK INC
1255 KENDALL RDSAN LUIS OBISPOCA93401N/APCCharitable Event$10,000
GRACE COMMUNITY CHURCH
13248 ROSCOE BLVDSUN VALLEYCA91352N/APCGeneral & Unrestricted$10,000
GRACE COMMUNITY CHURCH
13248 ROSCOE BLVDSUN VALLEYCA91352N/APCBryan and Alex Tahmisian Fund$10,000
HAGGAI INTERNATIONAL INSTITUTE FOR ADVANCED LEADER
4725 PEACHTREE CORNERS CIR STE 1NORCROSSGA30092N/APCGeneral & Unrestricted$52,000
INTERVARSITY CHRISTIAN FELLOWSHIP- USA
PO BOX 7895MADISONWI53707N/APCCampus ministry program led by Charles Barker$6,000
JODI HOUSE INC
625 CHAPALA STSANTA BARBARACA93101N/APCGeneral & Unrestricted$500
JUBILEE ECONOMICS MINISTRIES
3295 MEADE AVESAN DIEGOCA92116N/APCGeneral & Unrestricted$6,000
LANGHAM PARTNERSHIP USA INC NFP
580A VALLEY WAYMILPITASCA95035N/APCGeneral & Unrestricted$30,000
MONTECITO COVENANT CHURCH SANTA BARBARA CA
671 COLD SPRINGS RDSANTA BARBARACA93108N/APCGeneral & Unrestricted$60,000
MONTECITO COVENANT CHURCH SANTA BARBARA CA
671 COLD SPRINGS RDSANTA BARBARACA93108N/APCParsonage Renovation Fund$100,000
OPPORTUNITY INTERNATIONAL INC
550 W VAN BUREN STE 200CHICAGOIL60607N/APCColombia Fund$10,000
OPPORTUNITY INTERNATIONAL INC
550 W VAN BUREN STE 200CHICAGOIL60607N/APCColumbia Fund$25,000
PRISON FELLOWSHIP MINISTRIES
44180 RIVERSIDE PKWYLANSDOWNEVA20176N/APCGeneral & Unrestricted$1,000
PROVIDENCE SBCS INC
3723 MODOC RDSANTA BARBARACA93105N/APCCampaign for Providence$250,000
SANTA BARBARA RESCUE MISSION
535 E YANONALI STSANTA BARBARACA93103N/APCGeneral & Unrestricted$30,000
SANTA BARBARA RESCUE MISSION
535 E YANONALI STSANTA BARBARACA93103N/APCMission of Hope Campaign$70,000
WESTMONT COLLEGE
955 LA PAZ RDSANTA BARBARACA93108N/APCGlobal Learning Center and MCC Intern Fund$185,000
WYCLIFFE BIBLE TRANSLATORS INC
PO BOX 628200ORLANDOFL32862N/APCMary and Waller Tabb Fund$10,000
WYCLIFFE BIBLE TRANSLATORS INC
PO BOX 628200ORLANDOFL32862N/APCWaller and Mary Tabb Fund$10,000
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCGold Coast, CA Division$5,000
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCSanta Barbara, CA 50 Division$18,000
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCWomen's Philanthropy Mission led by Jamie Lisea$50,000
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCGold Coast Region AF56 Fund$50,000
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCJaime Lisea AF56 Fund$4,500
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCJaime Lisea AF56 Fund$500
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCWomen's Philanthropy Mission led by Jamie Lisea$1,000
YOUNG LIFE
PO BOX 70065PRESCOTTAZ86304N/APCCaperneum Training Program$50,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$1,129,500TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

FieldValueIRS element (for citing)
Fees Contracts From Govt AgFeesContractsFromGovtAgGrp
Membership Dues And AssmntMembershipDuesAndAssmntGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$837ExclusionAmt
FieldValueIRS element (for citing)
Div And Int From Sec Part VIIDivAndIntFromSecPartVIIGrp
Net Rntl Incm Re Debt Fincd PropNetRntlIncmReDebtFincdPropGrp
Net Rntl Incm Re Not Debt Fincd PropNetRntlIncmReNotDebtFincdProp
Net Rental Income Personal PropNetRentalIncomePersonalPropGrp
Other Investment Incm Part VIIOtherInvestmentIncmPartVIIGrp
Gain Sales Ast Oth Than InvntryGainSalesAstOthThanInvntryGrp
Net Income Loss From Special EvtNetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of InvntryGrossProfitLossSlsOfInvntryGrp

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescFederal Tax RefundDesc
Exclusion01ExclusionCd
Exclusion$471ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$1,308ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$1,308TotalIncomeProducingActyAmt

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

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Contributor PersonMarjorie S Petersen Admin Tr Ua 11ContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line11114 State Street Suite 243AddressLine1Txt
CitySanta BarbaraCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93101ZIPCd
FieldValueIRS element (for citing)
Total Contributions$1,530,000TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Depreciation Schedule DepreciationSchedule

Liquidation Explanation Stmt LiquidationExplanationStmt

FieldValueIRS element (for citing)
ExplanationAs explained below, the Foundation has no plans for dissolution. This statement is submitted to report the distribution of certain assets during the year. The distributions resulted in a substantial contraction of assets. The following information is submitted in accordance with Treasury Regulation Section 1.6043-3(a)(1) and the Form 990-PF instructions: During the taxable year ending December 31, 2017, the Foundation made distributions from assets from sources other than current income. Collectively, the distributions in excess of current income totaled $1,129,500. This amount represents over 25% of the Foundation's net assets of $35,762 (as measured by fair market value) at the beginning of the Foundation's taxable year ending December 31, 2017. Although the Foundation technically experienced a substantial contraction, it will continue in existence and has no plans for dissolution. The Foundation made distributions of cash to the grantees listed in the attachment to Part XV, Line 3a; each such grant was made solely for the charitable purpose specified therein.ExplanationTxt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
Administrative Fees$5,000$5,000
State or Local Filing Fees$25$25

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescFederal Tax RefundDesc
Revenue And Expenses Per Books$471RevenueAndExpensesPerBooksAmt

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail

FieldValueIRS element (for citing)
PersonMarjorie S Petersen Admin Tr Ua 11PersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11114 State Street Suite 243AddressLine1Txt
CitySanta BarbaraCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93101ZIPCd

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