CITIZENS COMMUNITY FOUNDATION INC: Form 990PF, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: CITIZENS COMMUNITY FOUNDATION INC (EIN 20-3537437)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-04-06
IRS object ID: 201640979349100804
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
Form 990-PF
Accounting Fees Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-04-06T15:49:09-05:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	611230372	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	MARK CLARK CPA PSC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 369	AddressLine1Txt
City	SOMERSET	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	425032700	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnTypeCd
Tax Period Begin	2015-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	203537437	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CITIZENS COMMUNITY FOUNDATION INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CITI	BusinessNameControlTxt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	145 WOODLAND DRIVE	AddressLine1Txt
City	SOMERSET	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	42501	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CLAY PARKER DAVIS	PersonNm
Person Title	DIRECTOR	PersonTitleTxt
Signature	2016-03-22	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MARK CLARK CPA	PreparerPersonNm
PTIN	P00055783	PTIN
Phone	6066784372	PhoneNum
Preparation	2016-03-22	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2016-09-27 15:27:22Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Organization501c3 Exempt PF	Yes (X)	Organization501c3ExemptPFInd
FMV Assets EOY	$374,326	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
Interest On Sav Rev And Expnss	$780	InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm	$780	InterestOnSavNetInvstIncmAmt
Interest On Savings Adj Net Incm	$780	InterestOnSavingsAdjNetIncmAmt
Total Rev And Expnss	$780	TotalRevAndExpnssAmt
Total Net Invst Incm	$780	TotalNetInvstIncmAmt
Total Adj Net Incm	$780	TotalAdjNetIncmAmt
Accounting Fees Rev And Expnss	$450	AccountingFeesRevAndExpnssAmt
Taxes Rev And Expnss	$15	TaxesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss	$465	TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm	$0	TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl	$0	TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss	$20,000	ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl	$20,000	ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss	$20,465	TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm	$0	TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl	$20,000	TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses	-$19,685	ExcessRevenueOverExpensesAmt
Net Investment Income	$780	NetInvestmentIncomeAmt
Adjusted Net Income	$780	AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Field	Value	IRS element (for citing)
Cash BOY	$394,012	CashBOYAmt
Cash EOY	$374,327	CashEOYAmt
Cash EOYFMV	$374,326	CashEOYFMVAmt
Total Assets BOY	$394,012	TotalAssetsBOYAmt
Total Assets EOY	$374,327	TotalAssetsEOYAmt
Total Assets EOYFMV	$374,326	TotalAssetsEOYFMVAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind
Unrestricted BOY	$394,012	UnrestrictedBOYAmt
Unrestricted EOY	$374,327	UnrestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY	$394,012	TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY	$374,327	TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY	$394,012	TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY	$374,327	TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Field	Value	IRS element (for citing)
Tot Net Ast Or Fund Balances BOY	$394,012	TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses	-$19,685	ExcessRevenueOverExpensesAmt
Subtotal	$374,327	SubtotalAmt
Tot Net Ast Or Fund Balances EOY	$374,327	TotNetAstOrFundBalancesEOYAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

Field	Value	IRS element (for citing)
Liable Section4942 Tax	false	LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1	$11,460	AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1	$285,434	NetVlNoncharitableAssetsYr1Amt
Distribution Yr1	0.040149	DistributionYr1Rt
Adjusted Qlfy Distri Yr2	$17,000	AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2	$296,207	NetVlNoncharitableAssetsYr2Amt
Distribution Yr2	0.057392	DistributionYr2Rt
Adjusted Qlfy Distri Yr3	$9,000	AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3	$304,857	NetVlNoncharitableAssetsYr3Amt
Distribution Yr3	0.029522	DistributionYr3Rt
Adjusted Qlfy Distri Yr4	$35,000	AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4	$322,855	NetVlNoncharitableAssetsYr4Amt
Distribution Yr4	0.108408	DistributionYr4Rt
Adjusted Qlfy Distri Yr5	$32,480	AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5	$360,000	NetVlNoncharitableAssetsYr5Amt
Distribution Yr5	0.090222	DistributionYr5Rt
Total Distribution	0.325693	TotalDistributionRt
Average Distribution	0.065139	AverageDistributionRt
Net Vl Noncharitable Assets	$383,594	NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets	$24,987	AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct	$8	NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct	$24,995	AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions	$20,000	QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

Field	Value	IRS element (for citing)
Investment Income Excise Tax	$16	InvestmentIncomeExciseTaxAmt
Subtotal	$16	SubtotalAmt
Tax Based On Investment Income	$16	TaxBasedOnInvestmentIncomeAmt
Tax Due	$16	TaxDueAmt

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	KY	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	CLAY PARKER DAVIS	IndividualWithBooksNm
Phone	6066799229	PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

Field	Value	IRS element (for citing)
Address Line1	145 WOODLAND DRIVE	AddressLine1Txt
City	SOMERSET	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	42501	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 (3 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
CLAY PARKER DAVIS
145 WOODLAND DRIVE	SOMERSET	KY	42501	DIRECTOR	1.00	$0	$0	$0
CY WADDLE
780 JARVIS AVENUE	SOMERSET	KY	42501	DIRECTOR	0.00	$0	$0	$0
HARRIS RAKESTRAW III
3593 HWY 39	SOMERSET	KY	42503	DIRECTOR	0.00	$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	$389,436	AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast	$0	FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets	$389,436	TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast	$389,436	AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable	$5,842	CashDeemedCharitableAmt
Net Vl Noncharitable Assets	$383,594	NetVlNoncharitableAssetsAmt
Minimum Investment Return	$19,180	MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
Minimum Investment Return	$19,180	MinimumInvestmentReturnAmt
Tax Based On Investment Income	$16	TaxBasedOnInvestmentIncomeAmt
Total Tax	$16	TotalTaxAmt
Distributable Before Adj	$19,164	DistributableBeforeAdjAmt
Distributable Before Ded	$19,164	DistributableBeforeDedAmt
Distributable As Adjusted	$19,164	DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

Field	Value	IRS element (for citing)
Expenses And Contributions	$20,000	ExpensesAndContributionsAmt
Qualifying Distributions	$20,000	QualifyingDistributionsAmt
Adjusted Qualifying Distri	$20,000	AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

Field	Value	IRS element (for citing)
Distributable As Adjusted	$19,164	DistributableAsAdjustedAmt
Excess Distribution Cyov Yr5	$24,206	ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4	$18,889	ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr2	$2,202	ExcessDistributionCyovYr2Amt
Total Excess Distribution Cyov	$45,297	TotalExcessDistributionCyovAmt
Qualifying Distributions	$20,000	QualifyingDistributionsAmt
Applied To Current Year	$19,164	AppliedToCurrentYearAmt
Remaining Distri From Corpus	$836	RemainingDistriFromCorpusAmt
Total Corpus	$46,133	TotalCorpusAmt
Undistributed Income CY	$0	UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5	$24,206	ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr	$21,927	ExcessDistriCyovToNextYrAmt
Excess From Year4	$18,889	ExcessFromYear4Amt
Excess From Year2	$2,202	ExcessFromYear2Amt
Excess From Current Year	$836	ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Field	Value	IRS element (for citing)
Only Contri To Preselected	Yes (X)	OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (5 entries)

Address Line1RecipientUSAddress/AddressLine1Txt	CityRecipientUSAddress/CityNm	State AbbreviationRecipientUSAddress/StateAbbreviationCd	ZIPRecipientUSAddress/ZIPCd	Recipient Foundation StatusRecipientFoundationStatusTxt	Grant Or Contribution PurposeGrantOrContributionPurposeTxt	AmtAmt
PULASKI HUMANE SOCIETY
PO BOX 448	SOMERSET	KY	42502	PC	DONEE'S GENERAL PURPOSE	$5,500
HOSPICE OF LAKE CUMBERLAND
100 PARKWAY DR	SOMERSET	KY	42503	PC	DONEE'S GENERAL PURPOSE	$2,000
GEORGETOWN COLLEGE
400 EAST COLLEGE STREET	GEORGETOWN	KY	40324	PC	DONEE'S GENERAL PURPOSE	$5,000
SOMERSET COMMUNITY COLLEGE
808 MONTICELLO ST	SOMERSET	KY	42501	PC	DONEE'S GENERAL PURPOSE	$5,000
FIRST BAPTIST CHURCH
128 NORTH MAIN STREET	SOMERSET	KY	42501	PC	DONEE'S GENERAL PURPOSE	$2,500

Field	Value	IRS element (for citing)
Total Grant Or Contri Pd Dur Yr	$20,000	TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

Field	Value	IRS element (for citing)
Exclusion	14	ExclusionCd
Exclusion	$780	ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

Field	Value	IRS element (for citing)
Exclusion	$780	ExclusionAmt

Field	Value	IRS element (for citing)
Total Income Producing Acty	$780	TotalIncomeProducingActyAmt

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Field	Value	IRS element (for citing)
Category	WILSON & CO	CategoryTxt
Amt	$450	Amt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

Field	Value	IRS element (for citing)
Category	KY STATE TREASURER	CategoryTxt
Amt	$15	Amt

CITIZENS COMMUNITY FOUNDATION INC: Form 990PF, tax year 2015

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

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 (3 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 (5 entries)

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

Comments