CAROLYN M AND LEARY E PETERSON FAMILY FOUNDATION INC: Form 990PF, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
CAROLYN M AND LEARY E PETERSON FAMILY FOUNDATION INC (EIN 39-1936484)
Tax period
2015-06-01 to 2016-05-31
Filed
2016-10-11
IRS object ID
201622859349100512
Schema version
2015v2.1
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

FieldValueIRS element (for citing)
Return2016-10-11T13:29:01-05:00ReturnTs
Tax Period End2016-05-31TaxPeriodEndDt

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 Begin2015-06-01TaxPeriodBeginDt

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
Signature2016-08-25SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCOLLINS ASSOCIATES SCPreparerPersonNm
PTINP00146637PTIN
Phone6083266456PhoneNum
Preparation2016-10-04PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$359,997FMVAssetsEOYAmt
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$12,452DividendsRevAndExpnssAmt
Dividends Net Invst Incm$12,452DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$2,869NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$9,072GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$2,869CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$110OtherIncomeRevAndExpnssAmt
Total Rev And Expnss$15,431TotalRevAndExpnssAmt
Total Net Invst Incm$15,321TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$5,000CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$5,000CompOfcrDirTrstNetInvstIncmAmt
Taxes Rev And Expnss$104TaxesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss$5,104TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$5,000TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$16,396ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$16,396ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$21,500TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$5,000TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$16,396TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$6,069ExcessRevenueOverExpensesAmt
Net Investment Income$10,321NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$735CashBOYAmt
Cash EOY$868CashEOYAmt
Cash EOYFMV$868CashEOYFMVAmt
Corporate Stock BOY$245,367CorporateStockBOYAmt
Corporate Stock EOY$239,165CorporateStockEOYAmt
Corporate Stock EOYFMV$359,129CorporateStockEOYFMVAmt
Total Assets BOY$246,102TotalAssetsBOYAmt
Total Assets EOY$240,033TotalAssetsEOYAmt
Total Assets EOYFMV$359,997TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$246,102CapitalStockBOYAmt
Capital Stock EOY$240,033CapitalStockEOYAmt
Tot Net Ast Or Fund Balances BOY$246,102TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$240,033TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$246,102TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$240,033TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$246,102TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$6,069ExcessRevenueOverExpensesAmt
Subtotal$240,033SubtotalAmt
Tot Net Ast Or Fund Balances EOY$240,033TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
CHEMOURS COP2011-10-112016-05-25$1,077$1,328-$251-$251
E I DU PONT DE NEMOURS & COP2011-10-112016-05-25$7,992$4,873$3,119$3,119
CHEMOURS COP2011-10-112015-07-01$3$2$1$1
FieldValueIRS element (for citing)
Capital Gain Net Income$2,869CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$16,695AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$362,147NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.046100DistributionYr1Rt
Adjusted Qlfy Distri Yr2$21,013AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$356,255NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.058983DistributionYr2Rt
Adjusted Qlfy Distri Yr3$14,413AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$295,009NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.048856DistributionYr3Rt
Adjusted Qlfy Distri Yr4$11,254AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$301,531NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.037323DistributionYr4Rt
Adjusted Qlfy Distri Yr5$13,322AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$299,240NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.044519DistributionYr5Rt
Total Distribution0.235781TotalDistributionRt
Average Distribution0.047156AverageDistributionRt
Net Vl Noncharitable Assets$347,349NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$16,380AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$103NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$16,483AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$16,396QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$206InvestmentIncomeExciseTaxAmt
Subtotal$206SubtotalAmt
Tax Based On Investment Income$206TaxBasedOnInvestmentIncomeAmt
Tax Due$206TaxDueAmt

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 DREXCELSIORMN55331DIRECTOR1.00$1,000$0$0
JANE L MULLEN
662 JENISA DRST CLOUDMN56301DIRECTOR1.00$1,000$0$0
THOMAS F PETERSON
110 E HAYDN STPRAIRIE DU CHIENWI53821DIRECTOR1.00$1,000$0$0
MARY JO RUHL
2740 NICHOLS LANEDAVENPORTIA52803DIRECTOR1.00$1,000$0$0
JOHN L PETERSON
4814 CHAMPIONS RUNMIDDLETONWI53562DIRECTOR1.00$1,000$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$345,022AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$7,617AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$352,639TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$352,639AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$5,290CashDeemedCharitableAmt
Net Vl Noncharitable Assets$347,349NetVlNoncharitableAssetsAmt
Minimum Investment Return$17,367MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$17,367MinimumInvestmentReturnAmt
Tax Based On Investment Income$206TaxBasedOnInvestmentIncomeAmt
Total Tax$206TotalTaxAmt
Distributable Before Adj$17,161DistributableBeforeAdjAmt
Distributable Before Ded$17,161DistributableBeforeDedAmt
Distributable As Adjusted$17,161DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$16,396ExpensesAndContributionsAmt
Qualifying Distributions$16,396QualifyingDistributionsAmt
Adjusted Qualifying Distri$16,396AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$17,161DistributableAsAdjustedAmt
Undistributed Income PY$15,897UndistributedIncomePYAmt
Qualifying Distributions$16,396QualifyingDistributionsAmt
Applied To Year1$15,897AppliedToYear1Amt
Applied To Current Year$499AppliedToCurrentYearAmt
Undistributed Income CY$16,662UndistributedIncomeCYAmt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (8 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
WI WATERFOWL - PDC CHAPTER
38299 STUCKEY RDPRAIRIE DU CHIENWI53821GENERAL DONATION$1,250
CROSSING RIVERS HEALTH
37868 US 18PRAIRIE DU CHIENWI53821GENERAL DONATION$2,000
PRAIRIE CATHOLIC SCHOOL
515 N BEAUMONT RDPRAIRIE DU CHIENWI53821SCHOLARSHIPS$5,838
ST MARY'S CATHOLIC SCHOOL
312 SENECA STSTORM LAKEIA50588GENERAL DONATION$2,779
NAPLES COMMUNITY HEALTH CLINIC
121 GOODLET RD NNAPLESFL34102GENERAL DONATION$2,500
ST PETER'S ON CAPITOL HILL
313 2ND STREET SEWASHINGTONDC20003GENERAL DONATION$750
PETE'S PALS
19377 WEST PETERSON RDLIBERTYVILLEIL60048GENERAL DONATION$679
CROSS PLAINS BASEBALL
2410 MARTIN STCROSS PLAINSWI53528GENERAL DONATION$600
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$16,396TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$12,452ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$2,869ExclusionAmt

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescTAX REFUNDDesc
Related Or Exempt Function Incm$110RelatedOrExemptFunctionIncmAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$15,321ExclusionAmt
Related Or Exempt Function Incm$110RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$15,431TotalIncomeProducingActyAmt

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

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (10 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
GENERAL ELECTRIC$23,417$41,234
VERIZON COMMUNICATIONS$19,585$30,473
PFIZER INC DEL PV$20,829$38,417
MERCK & CO INC$22,473$39,649
PROCTER & GAMBLE CO$25,372$32,409
AT&T INC$25,617$34,662
CHEVRON CORP$26,909$27,035
E I DU PONT DE NEMOURS & CO$19,947$32,443
JOHNSON & JOHNSON CO$26,071$45,902
INTEL CORP$28,945$36,905

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescTAX REFUNDDesc
Revenue And Expenses Per Books$110RevenueAndExpensesPerBooksAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
Amt$104Amt

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