PETERSON FAMILY FOUNDATION: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: PETERSON FAMILY FOUNDATION (EIN 91-1746622)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-05-03
IRS object ID: 201721239349100427
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
Form 990-PF
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-03T10:08:41-07:00	ReturnTs
Tax Period End	2016-12-31	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	2016-01-01	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	2017-04-28	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JOSEPH G RAKOSKI	PreparerPersonNm
PTIN	P00168178	PTIN
Phone	3603563805	PhoneNum
Preparation	2017-04-28	PreparationDt

Filing Security Information FilingSecurityInformation

Field	Value	IRS element (for citing)
At Submission Creation Device Id	1A3678D535FD2DFA2FDA5E188A264B178A761E60	AtSubmissionCreationDeviceId
At Submission Filing Device Id	AE14AE924843CE9E0375EB026BFE4F68DBD124CD	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Organization501c3 Exempt PF	Yes (X)	Organization501c3ExemptPFInd
FMV Assets EOY	$14,071	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
Taxes Rev And Expnss	$35	TaxesRevAndExpnssAmt
Taxes Dsbrs Chrtbl	$35	TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss	$35	TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm	$0	TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl	$35	TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss	$6,000	ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl	$6,000	ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss	$6,035	TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm	$0	TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl	$6,035	TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses	-$6,035	ExcessRevenueOverExpensesAmt
Net Investment Income	$0	NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Field	Value	IRS element (for citing)
Cash BOY	$20,106	CashBOYAmt
Cash EOY	$14,071	CashEOYAmt
Cash EOYFMV	$14,071	CashEOYFMVAmt
Total Assets BOY	$20,106	TotalAssetsBOYAmt
Total Assets EOY	$14,071	TotalAssetsEOYAmt
Total Assets EOYFMV	$14,071	TotalAssetsEOYFMVAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117	Yes (X)	OrgDoesNotFollowSFAS117Ind
Retained Earning BOY	$20,106	RetainedEarningBOYAmt
Retained Earning EOY	$14,071	RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY	$20,106	TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY	$14,071	TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY	$20,106	TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY	$14,071	TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Field	Value	IRS element (for citing)
Tot Net Ast Or Fund Balances BOY	$20,106	TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses	-$6,035	ExcessRevenueOverExpensesAmt
Subtotal	$14,071	SubtotalAmt
Tot Net Ast Or Fund Balances EOY	$14,071	TotNetAstOrFundBalancesEOYAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

Field	Value	IRS element (for citing)
Liable Section4942 Tax	false	LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1	$991	AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1	$20,490	NetVlNoncharitableAssetsYr1Amt
Distribution Yr1	0.048365	DistributionYr1Rt
Adjusted Qlfy Distri Yr2	$1,064	AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2	$20,245	NetVlNoncharitableAssetsYr2Amt
Distribution Yr2	0.052556	DistributionYr2Rt
Adjusted Qlfy Distri Yr3	$84,389	AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3	$63,103	NetVlNoncharitableAssetsYr3Amt
Distribution Yr3	1.337322	DistributionYr3Rt
Adjusted Qlfy Distri Yr4	$214,300	AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4	$35,361	NetVlNoncharitableAssetsYr4Amt
Distribution Yr4	6.060349	DistributionYr4Rt
Adjusted Qlfy Distri Yr5	$158,247	AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5	$147,080	NetVlNoncharitableAssetsYr5Amt
Distribution Yr5	1.075925	DistributionYr5Rt
Total Distribution	8.574517	TotalDistributionRt
Average Distribution	1.714903	AverageDistributionRt
Net Vl Noncharitable Assets	$18,557	NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets	$31,823	AdjNetVlNoncharitableAssetsAmt
Adj Nonchrtbl Net Invst Incm Pct	$31,823	AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions	$6,035	QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

Field	Value	IRS element (for citing)
Investment Income Excise Tax	$0	InvestmentIncomeExciseTaxAmt
Estimated Plus Ovpmt Incm Tx	$121	EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits	$121	TotalPaymentsAndCreditsAmt
Overpayment	$121	OverpaymentAmt
Applied To ES Tax	$121	AppliedToESTaxAmt

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	KENNETH D PETERSON JR	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

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	000.00	$0	$0	$0
CLAUDIA J PETERSON
2401 NW WALDEN DRIVE	CAMAS	WA	98607	SEC/TREAS	000.00	$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	$18,840	AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast	$0	FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets	$18,840	TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast	$18,840	AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable	$283	CashDeemedCharitableAmt
Net Vl Noncharitable Assets	$18,557	NetVlNoncharitableAssetsAmt
Minimum Investment Return	$928	MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
Minimum Investment Return	$928	MinimumInvestmentReturnAmt
Distributable Before Adj	$928	DistributableBeforeAdjAmt
Distributable Before Ded	$928	DistributableBeforeDedAmt
Distributable As Adjusted	$928	DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

Field	Value	IRS element (for citing)
Expenses And Contributions	$6,035	ExpensesAndContributionsAmt
Qualifying Distributions	$6,035	QualifyingDistributionsAmt
Adjusted Qualifying Distri	$6,035	AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

Field	Value	IRS element (for citing)
Distributable As Adjusted	$928	DistributableAsAdjustedAmt
Excess Distribution Cyov Yr5	$150,893	ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4	$212,532	ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3	$81,234	ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2	$52	ExcessDistributionCyovYr2Amt
Total Excess Distribution Cyov	$444,711	TotalExcessDistributionCyovAmt
Qualifying Distributions	$6,035	QualifyingDistributionsAmt
Applied To Current Year	$928	AppliedToCurrentYearAmt
Remaining Distri From Corpus	$5,107	RemainingDistriFromCorpusAmt
Total Corpus	$449,818	TotalCorpusAmt
Undistributed Income CY	$0	UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5	$150,893	ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr	$298,925	ExcessDistriCyovToNextYrAmt
Excess From Year4	$212,532	ExcessFromYear4Amt
Excess From Year3	$81,234	ExcessFromYear3Amt
Excess From Year2	$52	ExcessFromYear2Amt
Excess From Current Year	$5,107	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

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SPECTRUM ADVENTIST FORUM	BusinessNameLine1Txt

Recipient US Address RecipientUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 619047	AddressLine1Txt
City	ROSEVILLE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	956619047	ZIPCd

Field	Value	IRS element (for citing)
Recipient Relationship	ON FILE	RecipientRelationshipTxt
Recipient Foundation Status	EXEMPT	RecipientFoundationStatusTxt
Grant Or Contribution Purpose	GENERAL FUND	GrantOrContributionPurposeTxt
Amt	$6,000	Amt

Field	Value	IRS element (for citing)
Total Grant Or Contri Pd Dur Yr	$6,000	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

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

Field	Value	IRS element (for citing)
Category	STATE FEES	CategoryTxt
Amt	$35	Amt
Disbursements Charitable Prps	$35	DisbursementsCharitablePrpsAmt

PETERSON FAMILY FOUNDATION: Form 990PF, tax year 2016

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

Preparer Person PreparerPersonGrp

Filing Security Information FilingSecurityInformation

Form 990-PF IRS990PF

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

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

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

Undistributed Income UndistributedIncomeGrp

Supplementary Information SupplementaryInformationGrp

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp

Recipient Business Name RecipientBusinessName

Recipient US Address RecipientUSAddress

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

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