2012-11-14T07:58:50-06:00 2012-06-30 391173131 SCHENCK SC 200 E WASHINGTON ST PO BOX 1739 APPLETON WI 549121739 990 2011-07-01 396074258 MIELKE FAMILY FOUNDATION INC MIEL 9208301290 PO BOX 563 APPLETON WI 549120563 RICHARD CALDER 9208301290 2012-11-12 1 MIKE VANDEN HOGEN P00499282 9207318111 2011 2016-02-24 21:20:13Z RICHARD CALDER PO BOX 563 APPLETON WI 549120563 6428532 0 X N/A X 1963 WI PROVIDE GRANTS TO QUALIFIED CHARITABLE ORGANIZATIONS AS DETERMINED BY THE BOARD OF DIRECTORS. 11 11 0 19 0 0 1257 257089 0 0 604428 568942 0 0 605685 826031 458057 348169 0 0 0 0 0 0 0 163765 154559 621822 502728 -16137 323303 9345152 8977880 14406 11000 9330746 8966880 MAKING A DIFFERENCE BY GIVING TO OUR COMMUNITIES. 0 0 369585 348169 PROVIDED GRANTS TO 37 CHARITABLE ORGANIZATIONS. THE LARGEST GRANT RECIPIENT WAS THE FOX CITIES PERFORMING ARTS CENTER PRIMARILY FOR THE KEYSTONE CAMPAIGN. THE TRI-COUNTY COMMUNITY DENTAL CLINIC ALSO RECEIVED SIGNIFICANT SUPPORT, PRIMARILY FOR THE MOBILE DENTAL CLINIC. 369585 1 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 1 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X TERRI TOWLE 9208301290 4455 W LAWRENCE ST APPLETON WI 549120563 X RICHARD CALDER 1.50 X X 0 0 0 DOUG WILSON 0.30 X 0 0 0 JOHN MIELKE 1.00 X 0 0 0 ED GRYS 0.30 X 0 0 0 ANNE WEST 0.30 X 0 0 0 GARY WOLFMAN 0.30 X 0 0 0 JEFF RIESTER 0.30 X 0 0 0 KEVIN LOOMANS 0.50 X X 0 0 0 DOUG MIELKE 0.30 X 0 0 0 JANE GARTON 0.30 X 0 0 0 GREG CURRY 0.50 X X 0 0 0 RENEE ULMAN 0.30 X 0 0 0 0 0 0 0 0 0 0 0 257089 257089 150293 150293 6021150 5602501 418649 418649 418649 826031 0 0 568942 348169 348169 40594 20297 20297 110589 110589 1226 1226 846 440 406 351 183 168 825 429 396 MISCELLANEOUS 128 67 61 502728 369585 133143 0 602 729 194654 302922 9149896 8674229 9345152 8977880 14406 11000 14406 11000 X 9330746 8966880 9330746 8966880 9345152 8977880 X 323303 -687169 X 0 1 1 X 0 X X X 0 0 0 COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION INC 391548450 8 1 1 1 54068 1 54068 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19 1 257089 46805 301364 1315602 7651278 1 1 0 EQUITIES 4336084 F FIXED INCOME 2044421 F HEDGE FUNDS 1759869 F REAL ASSETS 357178 F PRIVATE EQUITY 92844 F REAL ESTATE 83833 F 8674229 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 1475410 0 0 0 0 0 0 1475410 0 1475410 0 0 0 0 1 0 METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: COLUMN F INCLUDES $1,460,376 OF BOOK VALUE OF INVESTMENTS AND $15,034 OF EXPENDITURES FOR INVESTMENT MANAGER FEES FOR THE CENTRAL AMERICA AND THE CARIBBEAN REGION. THE ORGANIZATION FOLLOWS THE ACCRUAL METHOD OF ACCOUNTING AND ITS INVESTMENTS ARE RECORDED AT FAIR MARKET VALUE. MIELKE FAMILY FOUNDATION IS A SUPPORTING ORGANIZATION OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION, INC. THE REPORTED AMOUNT OF INVESTMENTS AND FEES REPRESENTS MIELKE FAMILY FOUNDATION'S ALLOCATED PERCENTAGE OF THE INVESTMENTS THAT ARE LEGALLY OWNED BY THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION, INC. 1 APPLETON AREA SCHOOL DISTRICT PO BOX 2019 APPLETON WI 549132019 396000710 GOVERNMENT 8375 EDUCATION APPLETON EDUCATION FOUNDATION 122 E COLLEGE AVE STE 1B APPLETON WI 54911 391866090 501(C)3 19000 EDUCATION COMMUNITY CLOTHES CLOSET 1465-B OPPORTUNITY WAY MENASHA WI 54952 391394270 501(C)3 10000 HUMAN SERVICES COTS PO BOX 1645 APPLETON WI 549121645 391913179 501(C)3 15000 HOUSING & SHELTER FOX CITIES PERFORMING ARTS CENTER 400 W COLLEGE AVE APPLETON WI 54911 391977839 501(C)3 56000 ARTS, CULTURE & HUMANITIES FOX VALLEY TECHNICAL COLLEGE PO BOX 2277 APPLETON WI 549122277 391087276 GOVERNMENT 10000 EDUCATION FOX VALLEY TECHNICAL COLLEGE FOUNDATION PO BOX 2277 APPLETON WI 549122277 391264389 501(C)3 29885 EDUCATION GORDON BUBOLZ NATURE PRESERVE 4815 N LYNNDALE DRIVE GRAND CHUTE WI 54913 237120877 501(C)3 41000 ENVIRONMENT HARBOR HOUSE DOMESTIC ABUSE PROGRAM 720 WEST FIFTH STREET APPLETON WI 54914 391870927 501(C)3 10000 HUMAN SERVICES TRI-COUNTY COMMUNITY DENTAL CLINIC 9 TRI-PARK WAY APPLETON WI 54914 470862462 501(C)3 51000 HEALTH CARE UNIVERSITY OF WISCONSIN - FOX VALLEY FOUNDATION 1478 MIDWAY ROAD MENASHA WI 54952 391277701 501(C)3 10000 EDUCATION VALLEY PACKAGING INDUSTRIES 2730 NORTH ROEMER ROAD APPLETON WI 54911 390921632 501(C)3 8495 EMPLOYMENT COMMUNITY FOUNDTION FOR THE FOX VALLEY REGION PO BOX 563 APPLETON WI 549130563 391548450 501(C)3 13474 PHILANTHROPY, VOLUNTARISM 13 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANT RECIPIENTS ARE EXPECTED TO ABIDE BY THE TERMS AND CONDITIONS SET FORTH IN THE GRANT APPLICATION AND GRANT AGREEMENT, INCLUDING SUBMISSION OF PROGRESS OR FINAL REPORTS AS DEEMED APPROPRIATE BY INDIVIDUAL GRANTMAKING COMMITTEES. ELIGIBILITY FOR FUTURE FUNDING IS CONTINGENT UPON CHARITABLE ORGANIZATIONS' MEETING THESE TERMS AND CONDITIONS. FORM 990, PART VI, SECTION A, LINE 2 JOHN MIELKE AND DOUG MIELKE HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS CONSISTS OF TWO CLASSES: APPOINTED DIRECTORS AND ELECTED DIRECTORS. THE NUMBER OF APPOINTED DIRECTORS SHALL AT ALL TIMES BE AT LEAST ONE MORE THAN THE NUMBER OF ELECTED DIRECTORS. THE APPOINTED DIRECTORS ARE APPOINTED BY THE BOARD OF DIRECTORS OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION, INC. OR DULY-AUTHORIZED COMMITTEE OF THE COMMUNITY FOUNDATION. THE COMMUNITY FOUNDATION IS THE SUPPORTED ORGANIZATION OF THE MIELKE FAMILY FOUNDATION, INC. FORM 990, PART VI, SECTION B, LINE 11 THE FOUNDATION'S FORM 990 IS PREPARED BY THE CPA FIRM COMPLETING THE ANNUAL AUDIT OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION, INC. THE VICE PRESIDENT OF FINANCE AND ADMINISTRATION FOR THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION, INC. REVIEWS IT FOR REASONABLENESS. THE BOARD OF DIRECTORS WILL APPROVE THE FORM 990 FOR FILING AT A MEETING OR VIA EMAIL POLL BETWEEN NOVEMBER AND FEBRUARY OF EACH FISCAL YEAR. THE BOARD PRESIDENT OR ANOTHER OFFICER SIGNS THE FORM. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, DIRECTORS OF THE FOUNDATION ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT DESCRIBING THEIR RELATIONSHIPS AND THEIR FAMILY RELATIONSHIPS WITH OTHER ENTITIES DOING BUSINESS WITH THE FOUNDATION AND ALL RELATED ORGANIZATIONS. WHEN THE BOARD CONSIDERS A GRANT FOR APPROVAL, A DIRECTOR SHALL BE DEEMED TO HAVE ABSTAINED AS TO THAT PORTION OF THE GRANT REQUEST WHICH AFFECTS ANY ENTITY NOTED ON THAT DIRECTOR'S CONFLICT OF INTEREST STATEMENT. FORM 990, PART VI, SECTION C, LINE 19 REQUESTS FOR THE FOLLOWING DOCUMENTS CAN BE SENT TO: EXECUTIVE ASSISTANT COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION, INC. 4455 W. LAWRENCE ST. APPLETON, WI 54912-0563 -APPLICATION FOR RECOGNITION OF EXEMPTION UNDER SECTION 501(C)(3)(FORM 1023) -IRS DETERMINATION LETTER -ARTICLES AND BY-LAWS -CONFLICT OF INTEREST POLICY THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION INC. (SUPPORTED ORGANIZATION) PUBLISHES ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS, ANNUAL REPORT AND COMPETITIVE GRANT GUIDELINES, WHICH INCLUDES THE MIELKE FAMILY FOUNDATION INC., ON ITS WEBSITE AT WWW.CFFOXVALLEY.ORG. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -687,169. COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION INC PO BOX 563 APPLETON WI 549120563 391548450 SERVE A RANGE OF PHILANTHROPICAL INTEREST BENEFITING THE FV AREA WI 501(C)(3) 8 N/A 0 DOUG & CARLA SALMON FOUNDATION INC PO BOX 563 APPLETON WI 549120563 820566250 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 APPLETON EDUCATION FOUNDATION INC PO BOX 563 APPLETON WI 549120563 391866090 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 THE WILLIAM J AND BARBARA A SCHMIDT FAMILY FOUNDATION INC PO BOX 563 APPLETON WI 549120563 391869271 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 COMMUNITY REAL ESTATE AND PERSONAL PROPERTY FOUNDATION INC PO BOX 563 APPLETON WI 549120563 200875816 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 MYRA M AND ROBERT L VANDEHEY FOUNDATION LTD PO BOX 563 APPLETON WI 549120563 391649245 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 WOMEN'S FUND FOR THE FOX VALLEY REGION INC PO BOX 563 APPLETON WI 549120563 203096562 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 ROBERT AND PATRICIA ENDRIES FAMILY FOUNDATION LTD PO BOX 563 APPLETON WI 549120563 203896774 SUPPORT THE ACTIVITES OF THE COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION WI 501(C)(3) 11-1 CFFVR INC 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0