Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletInformation about Form 990-PF and its instructions is at www.irs.gov/form990pf.
OMB No. 1545-0052
2014
Open to Public Inspection
For calendar year 2014, or tax year beginning 2014, and ending , 20
Name of foundation
CLARENCE KELLER SCHOLARSHIP TR 000010367500
 

Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 2043   Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MILWAUKEE, WI532012043
A Employer identification number

39-6500681
B Telephone number (see instructions)

(920) 457-8505
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$461,674
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach
schedule)..............  
2 Check bullet
Sch. B ...............
3 Interest on savings and temporary cash investments 1 1  
4 Dividends and interest from securities...... 11,423 11,665  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 11,683
b Gross sales price for all assets on line 6a 135,311
7 Capital gain net income (from Part IV, line 2)... 11,762
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances 0
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule)..... 0  
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 23,107 23,428  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 4,774 4,296   477
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... 750 0 0 750
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... 28 178   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 5,552 4,474 0 1,227
25 Contributions, gifts, grants paid........ 23,766 23,766
26 Total expenses and disbursements. Add lines 24 and 25 29,318 4,474 0 24,993
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -6,211
b Net investment income (if negative, enter -0-) 18,954
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2014)
Form 990-PF (2014)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............... 1,417 1,331 1,331
2 Savings and temporary cash investments..........      
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........      
c Investments—corporate bonds (attach schedule)........      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 464,339 Click to see attachment458,226 460,343
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 465,756 459,557 461,674
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable..................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)..........   0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted...................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds......... 465,756 459,557
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see instructions)...... 465,756 459,557
31 Total liabilities and net assets/fund balances (see instructions).. 465,756 459,557
Part III Analysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree
with end-of-year figure reported on prior year’s return)............... 1 465,756
2 Enter amount from Part I, line 27a..................... 2 -6,211
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 12
4 Add lines 1, 2, and 3.......................... 4 459,557
5 Decreases not included in line 2 (itemize) bullet 5 0
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 459,557
Form 990-PF (2014)
Form 990-PF (2014)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b) How acquired
P—Purchase
D—Donation
(c) Date acquired
(mo., day, yr.)
(d) Date sold
(mo., day, yr.)
1 a 117.964 LOOMIS SAYLES STRATEGIC ALPHA FUND Y   2014-03-10 2014-08-12
b 15.403 NUVEEN HIGH INCOME BOND FD CL I   2013-12-03 2014-08-12
c 70.342 NUVEEN HIGH INCOME BOND FD CL I   2012-12-07 2014-08-12
d 45.24 NUVEEN HIGH INCOME BOND FD CL I   2013-01-23 2014-08-12
e 18.59638 P I M C O FDS TOTAL RETURN FD   2012-09-06 2014-08-12
109.94362 P I M C O FDS TOTAL RETURN FD   2012-09-06 2014-08-12
11.53394 MORGAN DEMPSEY SMALL MICRO CAP VALUE   2013-12-03 2014-08-12
90.27106 MORGAN DEMPSEY SMALL MICRO CAP VALUE   2013-12-03 2014-08-12
13.307 ABERDEEN FDS EMRGN   2012-04-23 2014-08-27
178.945 ABERDEEN FDS EMRGN   2011-12-07 2014-08-27
86.801 CAMBIAR INTL EQUITY FUND INS   2014-03-10 2014-08-27
21.0663 FEDERATED INST HI YLD BD FD   2014-03-10 2014-08-27
119.3757 FEDERATED INST HI YLD BD FD   2014-03-10 2014-08-27
221.483 NUVEEN INTERMEDIATE GOVT BD FD CL I   2014-03-10 2014-08-27
21.526 T ROWE PRICE GROWTH STOCK #40   2014-03-10 2014-08-27
9.15 VANGUARD 500 INDEX FUND   2013-12-03 2014-08-27
1302.049 BAIRD AGGREGATE BOND FD INSTL   2014-03-10 2014-11-18
1396.446 GOLDMAN SACHS COMM STRAT INS   2013-12-03 2014-11-18
124.21 JOHN HANCOCK FDS III DISCPLN V I   2014-03-10 2014-11-18
1319.525 NUVEEN INTERMEDIATE GOVT BD FD CL I   2014-03-10 2014-11-18
607.631 P I M C O FDS TOTAL RETURN FD   2012-09-06 2014-11-18
24.52 T ROWE PRICE GROWTH STOCK #40   2014-03-10 2014-11-18
15.012 T ROWE PRICE MID CAP GROWTH FD #64   2013-12-03 2014-11-18
1602.882 T ROWE PRICE INTL BOND FUND   2014-05-02 2014-11-18
395.366 T ROWE PRICE INTL GR&INC FD   2014-03-10 2014-11-18
95.294 SCOUT INTERNATIONAL FUND   2013-12-03 2014-11-18
219.98 SCOUT INTERNATIONAL FUND   2012-04-23 2014-11-18
598.537 SCOUT INTERNATIONAL FUND   2011-06-23 2014-11-18
986.91 MORGAN DEMPSEY SMALL MICRO CAP VALUE   2013-11-18 2014-11-18
8.118 VANGUARD 500 IDX ADML   2013-12-03 2014-11-18
CAPITAL GAIN DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
a 1,199   1,191 8
b 141   142 -1
c 644   638 6
d 414   420 -6
e 204   213 -9
1,205   1,262 -57
156   160 -4
1,220   1,248 -28
215   190 25
2,886   2,416 470
2,177   2,162 15
218   218  
1,233   1,234 -1
1,956   1,947 9
1,204   1,176 28
1,399   1,255 144
14,036   13,737 299
6,577   7,890 -1,313
2,449   2,276 173
11,665   11,599 66
6,647   6,868 -221
1,410   1,340 70
1,218   1,117 101
14,650   15,756 -1,106
6,041   6,239 -198
3,421   3,464 -43
7,897   7,140 757
21,487   19,494 1,993
13,234   13,715 -481
1,541   1,348 193
      10,780
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69
(k) Excess of col. (i)
over col. (j), if any
a       8
b       -1
c       6
d       -6
e       -9
      -57
      -4
      -28
      25
      470
      15
       
      -1
      9
      28
      144
      299
      -1,313
      173
      66
      -221
      70
      101
      -1,106
      -198
      -43
      757
      1,993
      -481
      193
       
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 11,762
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 . . . . . . . . . . . . . . . .
Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2013 30,392 476,298 0.063809
2012 19,272 463,268 0.0416
2011 16,669 445,025 0.037456
2010 21,202 467,790 0.045324
2009 21,804 424,443 0.051371
2 Total of line 1, column (d) ...................... 2 0.23956
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
. . .
3 0.047912
4 Enter the net value of noncharitable-use assets for 2014 from Part X, line 5..... 4 465,369
5 Multiply line 4 by line 3....................... 5 22,297
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 190
7 Add lines 5 and 6......................... 7 22,487
8 Enter qualifying distributions from Part XII, line 4.............. 8 24,993
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form 990-PF (2014)
Form 990-PF (2014)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A" on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 190
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 190
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 190
6 Credits/Payments:
a 2014 estimated tax payments and 2013 overpayment credited to 2014 6a 426
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 426
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 236
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet192 RefundedBullet 11 44
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletWI
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2014 or the taxable year beginning in 2014 (see instructions for Part XIV)?
    If "Yes," complete Part XIV.............................
    9
     
    No
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
     
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletn/a
    14
    The books are in care ofbulletUS BANK NA Telephone no.bullet (920) 457-8505
    Located atbullet605 N 8TH STSHEBOYGANWI ZIP+4bullet53081
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16 At any time during calendar year 2014, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country?
    16   No
    See instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? ........
    1b
     
    No
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2014?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2014, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2014?...............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
    No
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?........................
    b
    If "Yes," did it have excess business holdings in 2014 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2014.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2014?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? (see instructions)..................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
    No
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.......................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to
    employee benefit plans
    and deferred compensation
    (e) Expense account,
    other allowances
    US BANK N A TRUSTEE
    40
    4,774    
    PO BOX 0663
    SHEBOYGAN,WI53082
    JERRY DOYLE CHAIRPERSON
    0
    0    
    2221 ERIE AVENUE
    SHEBOYGAN,WI53081
    JOHN WINTER COMMITTEE MEMBER
    0
    0    
    2213 BROADWAY AVENUE
    SHEBOYGAN,WI53081
    MARIANNE HERMAN COMMITTEE MEMBER
    0
    0    
    3744 ENTERPRIZE DRIVE
    SHEBOYGAN,WI53081
    JOAN KING COMMITTEE MEMBER
    0
    0    
    2730 N 28TH STREET
    SHEBOYGAN,WI53083
    MIKE HARRIER COMMITTEE MEMBER
    0
    0    
    2107A N 18TH STREET
    SHEBOYGAN,WI53081
    JOHN FRIEDL COMMITTEE MEMBER
    0
    0    
    1332 SCHOOL AVENUE
    SHEBOYGAN,WI53083
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 8
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    464,846
    b
    Average of monthly cash balances.......................
    1b
    7,610
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    472,456
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    472,456
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    7,087
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    465,369
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    23,268
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    23,268
    2a
    Tax on investment income for 2014 from Part VI, line 5......
    2a
    190
    b
    Income tax for 2014. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    190
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    23,078
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    23,078
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    23,078
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    24,993
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    24,993
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see instructions).................
    5
    190
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    24,803
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus
    (b)
    Years prior to 2013
    (c)
    2013
    (d)
    2014
    1 Distributable amount for 2014 from Part XI, line 7 23,078
    2 Undistributed income, if any, as of the end of 2014:
    a Enter amount for 2013 only....... 0
    b Total for prior years:2012, 20, 20 0
    3 Excess distributions carryover, if any, to 2014:
    a From 2009....... 746
    b From 2010....... 0
    c From 2011....... 0
    d From 2012....... 0
    e From 2013....... 7,429
    fTotal of lines 3a through e......... 8,175
    4Qualifying distributions for 2014 from Part
    XII, line 4: bullet$ 24,993
    a Applied to 2013, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
    0
    c Treated as distributions out of corpus (Election
    required—see instructions).........
    0
    d Applied to 2014 distributable amount..... 23,078
    e Remaining amount distributed out of corpus 1,915
    5 Excess distributions carryover applied to 2014. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 10,090
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........
    0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
    0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
    0
    e Undistributed income for 2013. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
    0
    f Undistributed income for 2014. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2015 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
    0
    8Excess distributions carryover from 2009 not
    applied on line 5 or line 7 (see instructions) ...
    746
    9Excess distributions carryover to 2015.
    Subtract lines 7 and 8 from line 6a ......
    9,344
    10 Analysis of line 9:
    a Excess from 2010.... 0
    b Excess from 2011.... 0
    c Excess from 2012.... 0
    d Excess from 2013.... 7,429
    e Excess from 2014.... 1,915
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2014, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2014 (b) 2013 (c) 2012 (d) 2011
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used
    directly for active conduct of exempt activities ...........
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...
             
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    US BANK NA
    PO BOX 0663
    SHEBOYGAN,WI53081
    (920) 459-6957
    bThe form in which applications should be submitted and information and materials they should include:
    SCHOLARSHIP APPLICATION
    cAny submission deadlines:
    JULY 1
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    MEMBERS OF FOUNTAIN PARK METHODIST CHURCH OR INVOLVED IN BIG BROTHERS BIG BROTHERS/ BIG SISTERS
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    SHANNON MCCABE
    1927 N 11TH ST
    SHEBOYGAN,WI53081
    NONE N/A LAKESHORE TECHNICAL COLLEGE 100
    PEARL OUTLAND
    2706 EDINBURGH STREET C36
    FORT COLLINS,CO80525
    NONE N/A SCHOLARSHIP 1,500
    KRISTY PHILLIPS
    578 N DANZ AVE APT 6
    GREEN BAY,WI54302
    NONE N/A UW-GREEN BAY SCHOLARSHIP 1,750
    TONYA HARBAUGH
    409 ISADORE ST
    STEVENS POINT,WI54481
    NONE N/A UW-STEVENS POINT 375
    TAYLOR RADDER
    N6803 WEST KARPATHY LANE
    PLYMOUTH,WI53073
    NONE N/A UNIVERSITY OF MINN 3,450
    AARON OLIVAS
    618 HURON AVE
    SHEBOYGAN,WI53089
    NONE N/A SCHOLARSHIP 2,000
    TINA CASTILLO
    3603 LARKSPUR WAY
    SHBOYGAN,WI53083
    NONE N/A SCHOLARSHIP 1,500
    HOLLYNN GAHAGAN
    1117 HIGH AVENUE
    SHEBOYGAN,WI53081
    NONE N/A SCHOLARSHIP 50
    CELESTE BENZSCHAWEL
    125 MEADOW RIDGE DRIVE
    SHEBOYGAN FALLS,WI53085
    NONE N/A UW - MADISON SCHOLARSHIP 1,850
    TAYLOR BRUINOOGE
    3404 N 8TH STREET
    SHEBOYGAN,WI53083
    NONE N/A SCHOLARSHIP 1,250
    ARIANA DEVRIEND
    18250 N CAVE CREEK RD UNIT 200
    PHOENIX,AZ85032
    NONE N/A SCHOLARSHIP 1,500
    AMALIA RINCON
    1512 S 14TH STREET
    SHEBOYGAN,WI53081
    NONE N/A SCHOLARSHIP 750
    TONYA BURBY
    822 OAKLAND AVE
    SHEBOYGAN,WI53081
    NONE N/A SCHOLARSHIP 600
    ASHTON HOFFMAN
    638 N EVANS STREET
    SHEBOYGAN,WI53081
    NONE N/A SCHOLARSHIP 566
    JOYCE HOLSTEIN
    104 SIXTH STREET
    SHEBOYGAN FALLS,WI53085
    NONE N/A LAKESHORE TECHNICAL COLLEGE 100
    TANNER MOENNING
    3629 NORTH 12TH ST
    SHEBOYGAN,WI53083
    NONE N/A VITERBO UNIVERSITY 4,800
    ROBBY MUELLER
    1420 MARVERY ROAD
    SHEBOYGAN,WI53081
    NONE N/A UW GREEN BAY SCHOLARSHIP 1,625
    Total .................................bullet 3a 23,766
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3
    Interest on savings and temporary cash investments ............
        14 1  
    4 Dividends and interest from securities....     14 11,423  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6
    Net rental income or (loss) from personal property .............
             
    7 Other investment income.....          
    8
    Gain or (loss) from sales of assets other than inventory .............
        18 11,683  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..       0  
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   23,107  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1323,107
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
    Yes
    No
    organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If "Yes," complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







    Firm's EINbullet
    Phone no.
    Form 990-PF (2014)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2014 AccountingFeesSchedule
    Name:
    CLARENCE KELLER SCHOLARSHIP TR 000010367500
    EIN: 39-6500681
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 750     750

    TY 2014 InvestmentsOtherSchedule2
    Name:
    CLARENCE KELLER SCHOLARSHIP TR 000010367500
    EIN: 39-6500681
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    NUVEEN INTERMEDIATE GOVT BD FD      
    T ROWE PRICE MID CAP VALUE FD AT COST 10,898 13,221
    NUVEEN REAL ESTATE SECURIT CL AT COST 23,985 27,228
    CAUSEWAY EMRGING MRKETS AT COST 24,197 23,695
    COLUMBIA INCOME FD CL Z AT COST 7,159 6,975
    NUVEEN INFLAT PRO SEC CL Y AT COST 14,141 13,965
    GLENMEDE SC EQUITY PORT ADV AT COST 14,159 14,634
    NUVEEN HIGH INCOME BD FD AT COST 13,246 11,685
    PIMCO TOTAL RETURN FUND      
    AMER CENT DIVERSIFI BOND INS AT COST 26,096 26,048
    JOHN HANCOCK FDS III DISCIPLN AT COST 33,929 35,239
    SCOUT INTERNATIONAL FUND      
    LS OPPORTUNITY AT COST 10,297 9,359
    T ROWE INTL BOND FUND      
    ABERDEEN FDS EMRGN MKT AT COST 25,711 23,428
    BAIRD AGGREGATE BOND FUND      
    CAMBIAR INTL EQUITY FUND INS # AT COST 9,633 10,186
    TCW EMERGING MARKETS INCOME FD AT COST 28,128 26,008
    FIDELITY INVT TRAD INTL DISCI AT COST 25,977 27,996
    FEDERATED INST HI YLD BD FD AT COST 39,436 37,494
    GOLDMAN SACHS COMM STRAT AT COST 11,817 7,049
    LOOMIS SAYLES STRATEGIC ALPHA AT COST 18,342 17,894
    MORGAN DEMPSEY SMALL MICRO CAP      
    NEUBERGER BERMAN LONG SH INS AT COST 8,876 9,150
    ROBECO BOSTON PARTNERS L S AT COST 9,677 9,991
    T ROWE PRICE GROWTH STOCK #40 AT COST 34,981 37,378
    T ROWE PRICE INTL GR& INC FD # AT COST 26,963 25,391
    VANGUARD 500 IDX FD AT COST 27,414 31,785
    T ROWE MID CAP GROWTH FD #64 AT COST 13,164 14,544

    TY 2014 OtherIncreasesSchedule
    Name:
    CLARENCE KELLER SCHOLARSHIP TR 000010367500
    EIN: 39-6500681
    Description Amount
       


    TY 2014 TaxesSchedule
    Name:
    CLARENCE KELLER SCHOLARSHIP TR 000010367500
    EIN: 39-6500681
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES PAID   178   0
    QUARTERLY EXCISE TAX ESTIMATES 28 0   0