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CITIZENS COMMUNITY FOUNDATION INC: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CITIZENS COMMUNITY FOUNDATION INC (EIN 20-3537437)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-02-21
IRS object ID
201730529349100708
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)
Return2017-02-21T16:40:04-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN611230372PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MARK CLARK CPA PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1POBOX 369AddressLine1Txt
CitySOMERSETCityNm
State AbbreviationKYStateAbbreviationCd
ZIP425022700ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203537437EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CITIZENS COMMUNITY FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCITIBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1145 WOODLAND DRIVEAddressLine1Txt
CitySOMERSETCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42501ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCLAY PARKER DAVISPersonNm
Person TitleDIRECTORPersonTitleTxt
Signature2017-02-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARK CLARK CPAPreparerPersonNm
PTINP00055783PTIN
Phone6066784372PhoneNum
Preparation2017-02-07PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device Id2D426263845748513852DCBD2BD9A71A3091F1FAAtSubmissionCreationDeviceId
At Submission Filing Device Id3572BEBB2CE418BF6DE9908884FB162166186B54AtSubmissionFilingDeviceId
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$0FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$751InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$751InterestOnSavNetInvstIncmAmt
Interest On Savings Adj Net Incm$751InterestOnSavingsAdjNetIncmAmt
Total Rev And Expnss$751TotalRevAndExpnssAmt
Total Net Invst Incm$751TotalNetInvstIncmAmt
Total Adj Net Incm$751TotalAdjNetIncmAmt
Accounting Fees Rev And Expnss$450AccountingFeesRevAndExpnssAmt
Taxes Rev And Expnss$31TaxesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss$481TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$0TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$17,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$17,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$17,481TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$0TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$17,000TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$16,730ExcessRevenueOverExpensesAmt
Net Investment Income$751NetInvestmentIncomeAmt
Adjusted Net Income$751AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$374,327CashBOYAmt
Cash EOY$357,597CashEOYAmt
Total Assets BOY$374,327TotalAssetsBOYAmt
Total Assets EOY$357,597TotalAssetsEOYAmt
Total Assets EOYFMV$0TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind
Unrestricted BOY$374,327UnrestrictedBOYAmt
Unrestricted EOY$357,597UnrestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY$374,327TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$357,597TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$374,327TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$357,597TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$374,327TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$16,730ExcessRevenueOverExpensesAmt
Subtotal$357,597SubtotalAmt
Tot Net Ast Or Fund Balances EOY$357,597TotNetAstOrFundBalancesEOYAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$20,000AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$383,594NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.052138DistributionYr1Rt
Adjusted Qlfy Distri Yr2$11,460AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$285,434NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.040149DistributionYr2Rt
Adjusted Qlfy Distri Yr3$17,000AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$296,207NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.057392DistributionYr3Rt
Adjusted Qlfy Distri Yr4$9,000AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$304,857NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.029522DistributionYr4Rt
Adjusted Qlfy Distri Yr5$35,000AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$322,855NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.108408DistributionYr5Rt
Total Distribution0.287609TotalDistributionRt
Average Distribution0.057522AverageDistributionRt
Net Vl Noncharitable Assets$376,098NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$21,634AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$8NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$21,642AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$17,000QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$15InvestmentIncomeExciseTaxAmt
Subtotal$15SubtotalAmt
Tax Based On Investment Income$15TaxBasedOnInvestmentIncomeAmt
Tax Due$15TaxDueAmt

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 StateKYOrgReportOrRegisterStateCd
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 BooksCLAY PARKER DAVISIndividualWithBooksNm
Phone6066799229PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1145 WOODLAND DRIVEAddressLine1Txt
CitySOMERSETCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42501ZIPCd
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
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
CLAY PARKER DAVIS
145 WOODLAND DRIVESOMERSETKY42501DIRECTOR000.00$0$0$0
CY WADDLE
780 JARVIS AVENUESOMERSETKY42501DIRECTOR000.00$0$0$0
HARRIS RAKESTRAW III
3593 HWY 39SOMERSETKY42503DIRECTOR000.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

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$0AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$381,825AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$381,825TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$381,825AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$5,727CashDeemedCharitableAmt
Net Vl Noncharitable Assets$376,098NetVlNoncharitableAssetsAmt
Minimum Investment Return$18,805MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$18,805MinimumInvestmentReturnAmt
Tax Based On Investment Income$15TaxBasedOnInvestmentIncomeAmt
Total Tax$15TotalTaxAmt
Distributable Before Adj$18,790DistributableBeforeAdjAmt
Distributable Before Ded$18,790DistributableBeforeDedAmt
Distributable As Adjusted$18,790DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$17,000ExpensesAndContributionsAmt
Qualifying Distributions$17,000QualifyingDistributionsAmt
Adjusted Qualifying Distri$17,000AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$18,790DistributableAsAdjustedAmt
Excess Distribution Cyov Yr5$18,889ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr3$2,202ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr1$836ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$21,927TotalExcessDistributionCyovAmt
Qualifying Distributions$17,000QualifyingDistributionsAmt
Applied To Current Year$17,000AppliedToCurrentYearAmt
Excess Distri Cyov App CY Corpus$1,790ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$1,790ExcessDistributionCyovAppCYAmt
Total Corpus$20,137TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5$17,099ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$3,038ExcessDistriCyovToNextYrAmt
Excess From Year3$2,202ExcessFromYear3Amt
Excess From Year1$836ExcessFromYear1Amt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (7 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
SCC FOUNDATION
808 MONTICELLO STREETSOMERSETKY42502PCDONEE'S GENERAL PURPOSE$2,000
HOSPICE OF LAKE CUMBERLAND
100 PARKWAY DRSOMERSETKY42503PCDONEE'S GENERAL PURPOSE$2,500
GEORGETOWN COLLEGE
400 EAST COLLEGE STREETGEORGETOWNKY40324PCDONEE'S GENERAL PURPOSE$5,000
FIRST BAPTIST CHURCH
128 NORTH MAIN STREETSOMERSETKY42501PCDONEE'S GENERAL PURPOSE$2,500
AIM
111 S CHURCH STREETSOMERSETKY42501PCDONEE'S GENERAL PURPOSE$1,000
ROGER'S SCHOLAR
808 MONTICELLO STREETSOMERSETKY42501PCDONEE'S GENERAL PURPOSE$1,500
GOD'S FOOD PANTRY
119 S CENTRAL AVESOMERSETKY42501PCDONEE'S GENERAL PURPOSE$2,500
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$17,000TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$751ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$751ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$751TotalIncomeProducingActyAmt

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)
CategoryACCOUNTING FEECategoryTxt
Amt$450Amt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmt
KY STATE TREASURER$15
FEDERAL EXCISE TAX$16

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