CAROLYN M AND LEARY E PETERSON FAMILY FOUNDATION INC: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CAROLYN M AND LEARY E PETERSON FAMILY FOUNDATION INC (EIN 39-1936484)
Tax period
2016-06-01 to 2017-05-31
Filed
2017-09-20
IRS object ID
201712639349100101
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-09-20T09:39:28-05:00ReturnTs
Tax Period End2017-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN391769340PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 120AddressLine1Txt
CityPRAIRIE DU CHIENCityNm
State AbbreviationWIStateAbbreviationCd
ZIP538210120ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391936484EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS F PETERSONPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone6083266496PhoneNum
Signature2017-09-18SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCOLLINS ASSOCIATES SCPreparerPersonNm
PTINP00146637PTIN
Phone6083266456PhoneNum
Preparation2017-09-18PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device IdA2B937FF85B3C8DCF3CCCBC0187101360FC73A00AtSubmissionCreationDeviceId
At Submission Filing Device IdB5EECDB6DE34AA27E0313E8E90DB780454FC1A65AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$357,038FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Dividends Rev And Expnss$12,569DividendsRevAndExpnssAmt
Dividends Net Invst Incm$12,569DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$7,511NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$15,837GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$7,511CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$20,080TotalRevAndExpnssAmt
Total Net Invst Incm$20,080TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$7,500CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$7,500CompOfcrDirTrstNetInvstIncmAmt
Accounting Fees Rev And Expnss$1,400AccountingFeesRevAndExpnssAmt
Taxes Rev And Expnss$206TaxesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss$9,106TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$7,500TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$21,042ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$21,042ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$30,148TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$7,500TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$21,042TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$10,068ExcessRevenueOverExpensesAmt
Net Investment Income$12,580NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$868CashBOYAmt
Cash EOY-$873CashEOYAmt
Cash EOYFMV-$873CashEOYFMVAmt
Corporate Stock BOY$239,165CorporateStockBOYAmt
Corporate Stock EOY$230,838CorporateStockEOYAmt
Corporate Stock EOYFMV$357,911CorporateStockEOYFMVAmt
Total Assets BOY$240,033TotalAssetsBOYAmt
Total Assets EOY$229,965TotalAssetsEOYAmt
Total Assets EOYFMV$357,038TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$240,033CapitalStockBOYAmt
Capital Stock EOY$229,965CapitalStockEOYAmt
Tot Net Ast Or Fund Balances BOY$240,033TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$229,965TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$240,033TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$229,965TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$240,033TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$10,068ExcessRevenueOverExpensesAmt
Subtotal$229,965SubtotalAmt
Tot Net Ast Or Fund Balances EOY$229,965TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
E I DU PONT DE NEMOURS & COP2011-10-112017-05-12$7,742$4,088$3,654$3,654
JOHNSON & JOHNSONP2011-10-112017-05-12$8,095$4,238$3,857$3,857
FieldValueIRS element (for citing)
Capital Gain Net Income$7,511CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$16,396AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$347,349NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.047203DistributionYr1Rt
Adjusted Qlfy Distri Yr2$16,695AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$362,147NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.046100DistributionYr2Rt
Adjusted Qlfy Distri Yr3$21,013AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$356,255NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.058983DistributionYr3Rt
Adjusted Qlfy Distri Yr4$14,413AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$295,009NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.048856DistributionYr4Rt
Adjusted Qlfy Distri Yr5$11,254AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$301,531NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.037323DistributionYr5Rt
Total Distribution0.238465TotalDistributionRt
Average Distribution0.047693AverageDistributionRt
Net Vl Noncharitable Assets$383,442NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$18,287AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$126NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$18,413AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$21,042QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$126InvestmentIncomeExciseTaxAmt
Subtotal$126SubtotalAmt
Tax Based On Investment Income$126TaxBasedOnInvestmentIncomeAmt
Tax Due$126TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

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

Location Of Books US Address LocationOfBooksUSAddress

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

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

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

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
CAROLE SAYER
20890 CHANNEL DREXCELSIORMN55331DIRECTOR000.00$1,500$0$0
JOE MULLEN
662 JENISA DRST CLOUDMN56301DIRECTOR000.00$1,500$0$0
THOMAS F PETERSON
110 E HAYDN STPRAIRIE DU CHIENWI53821DIRECTOR000.00$1,500$0$0
MARY JO RUHL
2740 NICHOLS LANEDAVENPORTIA52803DIRECTOR000.00$1,500$0$0
JOHN L PETERSON
4814 CHAMPIONS RUNMIDDLETONWI53562DIRECTOR000.00$1,500$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

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

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1N/ADescription1Txt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$383,613AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$5,668AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$389,281TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$389,281AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$5,839CashDeemedCharitableAmt
Net Vl Noncharitable Assets$383,442NetVlNoncharitableAssetsAmt
Minimum Investment Return$19,172MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$19,172MinimumInvestmentReturnAmt
Tax Based On Investment Income$126TaxBasedOnInvestmentIncomeAmt
Total Tax$126TotalTaxAmt
Distributable Before Adj$19,046DistributableBeforeAdjAmt
Distributable Before Ded$19,046DistributableBeforeDedAmt
Distributable As Adjusted$19,046DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$21,042ExpensesAndContributionsAmt
Qualifying Distributions$21,042QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$126PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$20,916AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$19,046DistributableAsAdjustedAmt
Undistributed Income PY$16,662UndistributedIncomePYAmt
Qualifying Distributions$21,042QualifyingDistributionsAmt
Applied To Year1$16,662AppliedToYear1Amt
Applied To Current Year$4,380AppliedToCurrentYearAmt
Undistributed Income CY$14,666UndistributedIncomeCYAmt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (10 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
WI WATERFOWL - PDC CHAPTER
38299 STUCKEY RDPRAIRIE DU CHIENWI53821GENERAL DONATION$708
CROSSING RIVERS HEALTH
37868 US 18PRAIRIE DU CHIENWI53821GENERAL DONATION$2,000
PRAIRIE CATHOLIC SCHOOL
515 N BEAUMONT RDPRAIRIE DU CHIENWI53821SCHOLARSHIPS$7,617
ST MARY'S CATHOLIC SCHOOL
312 SENECA STSTORM LAKEIA50588GENERAL DONATION$3,809
ST PETER'S ON CAPITOL HILL
313 2ND STREET SEWASHINGTONDC20003GENERAL DONATION$500
CROSS PLAINS BASEBALL
2410 MARTIN STCROSS PLAINSWI53528GENERAL DONATION$600
ROADS TO LIFE TANZANIA INC
PO BOX 157PRAIRIE DU CHIENWI53821GENERAL DONATION$2,000
LYMPHOMA RESEARCH FDN
191 WAUKEGAN RD STE 105NORTHFIELDIL60093GENERAL DONATION$1,000
ST WILLIAMS CATHOLIC CHURCH
601 SEAGATE DRNAPLESFL34108GENERAL DONATION$1,000
DANI HAGMANN FUND
18190 OLD BAY SHORE RDNORTH FT MYERSFL33917GENERAL DONATION$1,808
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$21,042TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$12,569ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$7,511ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$20,080ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$20,080TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryINDIRECT ACCOUNTING FEESCategoryTxt
Amt$1,400Amt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (10 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
GENERAL ELECTRIC$23,417$37,579
VERIZON COMMUNICATIONS$19,585$27,283
PFIZER INC DEL PV$20,829$35,675
MERCK & CO INC$22,473$45,574
PROCTER & GAMBLE CO$25,372$34,725
AT&T INC$25,617$33,889
CHEVRON CORP$26,909$27,751
E I DU PONT DE NEMOURS & CO$15,858$29,894
JOHNSON & JOHNSON CO$21,833$43,153
INTEL CORP$28,945$42,388

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryINDIRECT TAXES/LICENSESCategoryTxt
Amt$206Amt

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.