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
2015
Open to Public Inspection
For calendar year 2015, or tax year beginning 01-01-2015 , and ending 12-31-2015
Name of foundation
ARTHUR W & AUDREY F SMITH FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)100 EAST STATE STREET
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MASON CITY, IA50401
A Employer identification number

42-1411511
B Telephone number (see instructions)

(641) 423-2457
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$927,042J Accounting method:
 
(Part I, column (d) must be on cash basis.)
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      
4 Dividends and interest from securities... 20,673 20,673  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 15,253
8 Net short-term capital gain......... 10,364
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 20,673 35,926 10,364
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 7,701 3,850   3,851
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 705 352   353
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 1,445 1,445    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 9,851 5,647   4,204
25 Contributions, gifts, grants paid....... 75,340 75,340
26 Total expenses and disbursements. Add lines 24 and 25 85,191 5,647   79,544
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -64,518
b Net investment income (if negative, enter -0-) 30,279
c Adjusted net income (if negative, enter -0-)... 10,364
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2015)
Form 990-PF (2015)
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.............      
2 Savings and temporary cash investments......... 4,495 21,933 21,933
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
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 bullet        
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)....... 370,314 Click to see attachment334,454 349,459
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).......... 626,055 Click to see attachment605,078 555,650
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) 1,000,864 961,465 927,042
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........ 596,063 596,063
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 404,801 365,402
30 Total net assets or fund balances (see instructions)..... 1,000,864 961,465
31 Total liabilities and net assets/fund balances (see instructions). 1,000,864 961,465
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
1,000,864
2
Enter amount from Part I, line 27a .....................
2
-64,518
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
25,119
4
Add lines 1, 2, and 3 ..........................
4
961,465
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
961,465
Form 990-PF (2015)
Form 990-PF (2015)
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 BLACKSTONE GROUP LP P 2014-10-01 2015-01-16
b JP MORGAN CHASE & CO P 2014-10-01 2015-01-16
c O'REILLY AUTOMOTIVE P 2014-10-01 2015-01-16
d BLACKROCK INC P 2014-10-01 2015-01-16
e CAMERON INTL CORP P 2014-10-01 2015-01-16
CAMERON INTL CORP P 2014-10-01 2015-01-16
MFS INTL GROWTH FUND -1 P 2014-10-01 2015-01-23
ISHARES RUSSELL 1000 INDEX FD P 2014-10-01 2015-01-26
ISHARES RUSSELL 1000 INDEX FD P 2014-10-01 2015-01-26
FISERV INC P 2014-10-01 2015-01-30
SKYWORKS SOLUTIONS INC P 2014-10-01 2015-01-30
UNION PACIFIC CORP P 2014-10-01 2015-01-30
ISHARES RUSSELL 1000 INDEX FD P 2014-10-01 2015-01-30
DODGE & COX INTL STOCK FD P 2014-01-01 2015-02-06
MFS INTL GROWTH FUND-1 P 2014-10-01 2015-02-06
GOLDMEN SACHS HIGH YEILD FUND P 2014-10-01 2015-02-06
PIMCO TOTAL RETURN FUND P 2014-10-01 2015-02-06
BAIRD AGGREGATE BOND FUND P 2014-10-01 2015-02-06
T ROWE PRICE INTL GROWTH & INCOME P 2014-10-01 2015-02-06
RIDEWORTH ULTRA SHORT BOND FUND P 2014-10-01 2015-02-06
ISHARES RUSSELL 1000 INDEX FD P 2014-10-01 2015-02-06
PRUDENTIAL FINANCIAL P 2014-01-01 2015-02-10
APPLE COMPUTER INC P 2014-01-01 2015-02-10
THERMO FISHER SCIENTIFIC INC P 2014-10-01 2015-02-10
DANAHER CORP P 2014-10-01 2015-02-10
CELGENE CORP P 2014-10-01 2015-02-10
SKYWORKS SOLUTIONS INC P 2014-10-01 2015-02-10
CR BARD, INC P 2014-10-01 2015-02-10
ALCOA, INC P 2014-10-01 2015-02-10
UNION PACIFIC CORP P 2014-10-01 2015-02-10
PNC FINANCIAL SERVICES GROUP P 2014-10-01 2015-02-10
A E S CORP P 2014-10-01 2015-02-10
O'REILLY AUTOMOTIVE P 2014-10-01 2015-02-10
ALLIANCE DATA SYSTEMS CORP P 2014-10-01 2015-02-10
ALLERGAN INC P 2014-10-01 2015-02-10
MENTOR GRAPHICS CORP P 2014-10-01 2015-02-10
POLARIS INDS INC P 2014-10-01 2015-02-10
COGNIZANT TECH SOLUTIONS P 2014-10-01 2015-02-10
VALERO ENERGY CORP P 2014-10-01 2015-02-10
US BANCORP DEL P 2014-10-01 2015-02-10
FISERV INC P 2014-10-01 2015-02-10
EXPRESS SCRIPTS INC CL A P 2014-10-01 2015-02-10
BROADCOM CORPORATION- CL A P 2014-10-01 2015-02-10
BLACKROCK INC P 2014-10-01 2015-02-10
ROSS STORES INC P 2014-10-01 2015-02-10
BAKER HUGHES INC P 2014-10-01 2015-02-10
MEDTRONIC PLC P 2014-10-01 2015-02-10
MASTERCARD INC P 2014-10-01 2015-02-10
BUNGE LIMTIED P 2014-10-01 2015-02-10
WAL-MART STORES INC P 2014-10-01 2015-02-10
STERICYCLE INC P 2014-10-01 2015-02-10
CVS CAREMARK CORP P 2014-10-01 2015-02-10
GOOGLE INC P 2014-10-01 2015-02-10
APPLE COMPUTER INC P 2014-10-01 2015-02-10
APPLE COMPUTER INC P 2014-10-01 2015-02-10
BLACKSTONE GROUP LP P 2014-10-01 2015-02-10
BLACKSTONE GROUP LP P 2014-10-01 2015-02-10
RIDEWORTH ULTRA SHORT BOND FUND P 2014-10-01 2015-02-11
CIGNA CORPORATION P 2014-10-01 2015-02-13
ALLERGAN CIN P 2014-10-01 2015-02-13
BRUKER BIOSCIENCES CORP P 2014-10-01 2015-02-13
BRUKER BIOSCIENCES CORP P 2014-10-01 2015-02-13
EMERSON ELECTRIC CO P 2014-10-01 2015-02-13
EMERSON ELECTRIC CO P 2014-10-01 2015-02-13
LYONDELLBASELL IND NV P 2014-10-01 2015-03-02
LYONDELLBASELL IND NV P 2014-10-01 2015-03-02
DIRECT TV P 2014-10-01 2015-03-13
DIRECT TV P 2014-10-01 2015-03-13
METLIFE INC P 2014-01-01 2015-03-20
PRUDENTIAL FINANCIAL P 2014-01-01 2015-03-20
CELGENE CORP P 2014-10-01 2015-03-20
WALGREENS BOOTS ALLIANCE, INC P 2014-10-01 2015-03-20
WYNDHAM WORLDWIDE CORP P 2014-10-01 2015-03-20
METRONIC PLC P 2014-10-01 2015-03-20
EXPRESS SCRIPTS INC P 2014-10-01 2015-03-20
EMC CORP P 2014-10-01 2015-03-20
DANAHER CORP P 2014-10-01 2015-03-20
GOOGLE INC P 2014-10-01 2015-03-20
FISERV INC P 2014-10-01 2015-03-20
FORD MOTOR COMPANY P 2014-10-01 2015-03-20
JP MORGAN CHASE & CO P 2014-10-01 2015-03-20
HAIN CELETIAL GROUP INC P 2014-10-01 2015-03-20
MASTERCARD INC P 2014-10-01 2015-03-20
O'REILLY AUTOMOTIVE P 2014-10-01 2015-03-20
MENTOR GRAPHICS CORP P 2014-10-01 2015-03-20
ROSS STORES INC P 2014-10-01 2015-03-20
PNC FINANCIAL SERVICES GROUP P 2014-10-01 2015-03-20
ALEXION PHARMACEUTICALS INC P 2014-10-01 2015-03-20
ALLIANCE DATA SYSTEMS CORP P 2014-10-01 2015-03-20
BLACKSTONE GROUP LP P 2014-10-01 2015-03-20
C R BARD, INC P 2014-10-01 2015-03-20
BLACKROCK INC P 2014-10-01 2015-03-20
CIGNA CORPORATION P 2014-10-01 2015-03-20
CVS CAREMARK CORP P 2014-10-01 2015-03-20
CAPITAL ONE FINANCIAL CORP P 2014-10-01 2015-03-20
COMCAST CORPORATION P 2014-10-01 2015-03-20
COGNIZANT TECH SOLUTIONS P 2014-10-01 2015-03-20
SKYWORKS SOLUTIONS INC P 2014-10-01 2015-03-20
STERICYLCLE INC P 2014-10-01 2015-03-20
THERMO FISHER SCIENTIFIC INC P 2014-10-01 2015-03-20
US BANCORP P 2014-10-01 2015-03-20
UNION PACIFIC CORP P 2014-10-01 2015-03-20
VALERO ENERGY CORP P 2014-10-01 2015-03-20
VALERO ENERGY CORP P 2014-10-01 2015-03-20
BROADCOM CORP P 2014-10-01 2015-03-20
BROADCOM CORP P 2014-10-01 2015-03-20
VERIZON COMMUNICATIONS P 2014-10-01 2015-03-20
MERCK & CO INC P 2014-01-01 2015-03-27
AES CORP P 2014-10-01 2015-03-27
BUNGE LIMITED P 2014-10-01 2015-03-27
US BANKCORP P 2014-10-01 2015-03-27
VERIZON COMMUNICATIONS P 2014-10-01 2015-03-27
VERIZON COMMUNICATIONS P 2014-10-01 2015-03-27
AES CORP P 2014-10-01 2015-04-01
AES CORP P 2014-10-01 2015-04-01
AES CORP P 2014-10-01 2015-04-01
AES CORP P 2014-10-01 2015-04-01
PROCTOR & GAMBLE CO P 2014-10-01 2015-04-13
PROCTOR & GAMBLE CO P 2014-10-01 2015-04-13
PROCTOR & GAMBLE CO P 2014-10-01 2015-04-13
METLIFE INC P 2014-10-01 2015-05-05
WAL-MART STORES INC P 2014-10-01 2015-05-05
PRUDENTIAL FINANCIAL P 2014-01-01 2015-05-06
MICROSOFT CORP P 2014-10-01 2015-05-06
EMC CORP P 2014-10-01 2015-05-06
COGNIZANT TECH SOLUTIONS P 2014-10-01 2015-05-06
BUNGE LIMITED P 2014-10-01 2015-05-12
WILLIAMS COS INC P 2014-10-01 2015-05-12
O'REILLY AUTOMOTIVE P 2014-10-01 2015-05-12
LAZARD LTD LP P 2014-10-01 2015-05-12
C R BARD, INC P 2014-10-01 2015-05-12
ALCOA, INC P 2014-10-01 2015-05-12
ALCOA, INC P 2014-10-01 2015-05-12
AECOM TECHNOLOGY CORP P 2014-10-01 2015-05-22
COGNIZANT TECH SOLUTIONS P 2014-10-01 2015-05-22
QUANTA SERVICES, INC P 2014-10-01 2015-05-22
AVAGO TECHNOLOGIES, LTD P 2014-10-01 2015-06-01
BROADCOM CORP P 2014-10-01 2015-06-01
METLIFE INC P 2014-01-01 2015-06-03
AKORN INC P 2014-10-01 2015-06-03
HCA HOLDINGS INC P 2014-10-01 2015-06-03
GOOGLE INC P 2014-10-01 2015-06-03
METLIFE INC P 2014-10-01 2015-06-03
WILLIAMS COS INC P 2014-01-01 2015-06-25
CIGNA CORPORATION P 2014-10-01 2015-06-25
CABOT OIL & GAS P 2014-01-01 2015-07-07
PNC FINANCIAL SERVICES GROUP P 2014-01-01 2015-07-07
MERCK & CO INC P 2014-01-01 2015-07-07
C R BARD, INC P 2014-01-01 2015-07-07
MENTOR GRAPHICS CORP P 2014-01-01 2015-07-07
MENTOR GRAPHICS CORP P 2014-01-01 2015-07-07
ALEXION PHARMACEUTICALS INC P 2014-10-01 2015-07-07
GAMESTOP CORP P 2014-10-01 2015-07-07
HCA HOLDINGS INC P 2014-10-01 2015-07-07
HAIN CELESTIAL GROUP INC P 2014-10-01 2015-07-07
MERCK & CO INC P 2014-10-01 2015-07-07
C R BARD, INC P 2014-10-01 2015-07-07
C R BARD, INC P 2014-10-01 2015-07-07
CVS CAREMARK CORP P 2014-01-01 2015-07-14
GOOGLE INC P 2014-01-01 2015-07-14
O'REILLY AUTOMOTIVE P 2014-01-01 2015-07-14
US BANCORP P 2014-01-01 2015-07-14
UNION PACIFIC CORP P 2014-01-01 2015-07-14
UNION PACIFIC CORP P 2014-01-01 2015-07-14
UNION PACIFIC CORP P 2014-01-01 2015-07-14
UNION PACIFIC CORP P 2014-10-01 2015-07-17
UNION PACIFIC CORP P 2014-10-01 2015-07-17
AMERICAN CENTURY SMALL CAP VALUE FD P 2014-01-01 2015-08-18
LOOMIS SAYLES SMALL CAP GROWTH FD P 2014-01-01 2015-08-18
RIDGEWORTH ULTRA SHORT BOND FD P 2014-01-01 2015-08-18
RIDGEWORTH ULTRA SHORT BOND FD P 2014-01-01 2015-08-18
RIDGEWORTH ULTRA SHORT BOND FD P 2014-10-01 2015-08-18
CABOT OIL & GAS P 2014-01-01 2015-08-31
CABOT OIL & GAS P 2014-01-01 2015-08-31
CABOT OIL & GAS P 2014-01-01 2015-08-31
LKQ CORP P 2014-01-01 2015-09-21
MASTERCARD INC P 2014-01-01 2015-09-21
O'REILLY AUTOMOTIVE P 2014-01-01 2015-09-21
STERICYCLE INC P 2014-01-01 2015-09-21
ROSS STORES INC P 2014-01-01 2015-09-21
CELGENE CORP P 2014-01-01 2015-09-21
FISERV INC P 2014-01-01 2015-09-21
GOOGLE INC P 2014-01-01 2015-09-21
COGNIZANT TECH SOLUTIONS P 2014-01-01 2015-09-21
VULCAN MATERIALS P 2014-10-01 2015-09-21
ROYAL CARRIBEAN CRUISES LTD P 2014-10-01 2015-09-21
BROADCOM CORP P 2014-10-01 2015-09-21
BROADCOM CORP P 2014-10-01 2015-09-21
BROADCOM CORP P 2014-10-01 2015-09-21
WHIRLPOOL CORP P 2014-10-01 2015-09-21
WHIRLPOOL CORP P 2014-10-01 2015-09-21
WHIRLPOOL CORP P 2014-10-01 2015-09-21
ALLERGAN PLC P 2014-10-01 2015-10-16
PJT PARTNERS INC P 2014-01-01 2015-10-26
LAZARD LTD P 2014-01-01 2015-10-30
LAZARD LTD P 2014-01-01 2015-10-30
LAZARD LTD P 2014-10-01 2015-10-30
MICROSOFT CORP P 2014-01-01 2015-11-10
JP MORGAN CHASE & CO P 2014-01-01 2015-11-10
EXPRESS SCRIPTS INC P 2014-01-01 2015-11-10
ALPHABET INC P 2014-01-01 2015-11-10
DANAHER CORP P 2014-01-01 2015-11-10
ALLIANCE DATA SYSTEMS CORP P 2014-01-01 2015-11-10
MASTERCARD INC P 2014-01-01 2015-11-10
O'REILLY AUTOMOTIVE P 2014-01-01 2015-11-10
T ROWE PRICE INTL GROWTH & INCOME P 2014-01-01 2015-11-10
APPLE COMPUTER INC P 2014-01-01 2015-11-10
BLACKROCK INC P 2014-01-01 2015-11-10
LKQ CORP P 2014-01-01 2015-11-10
LKQ CORP P 2014-01-01 2015-11-10
GAMESTOP CORP P 2014-01-01 2015-11-10
GAMESTOP CORP P 2014-01-01 2015-11-10
BUNGE LTD P 2014-01-01 2015-11-10
BUNGE LTD P 2014-01-01 2015-11-10
VALERO ENERGY CORP P 2014-10-01 2015-11-10
VALERO ENERGY CORP P 2014-01-01 2015-11-10
MARATHON PETROLEUM CORP P 2014-10-01 2015-11-10
PJT PARTNERS INC P 2014-01-01 2015-11-10
QUANTA SERVICES, INC P 2014-10-01 2015-11-10
QUANTA SERVICES, INC P 2014-10-01 2015-11-10
BUNGE LTD P 2014-10-01 2015-11-10
BUNGE LTD P 2014-10-01 2015-11-10
(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 4,811 0 4,316 495
b 2,916 0 2,726 190
c 1,479 0 1,174 305
d 1,410 0 1,213 197
e 4,475 0 6,579 -2,104
825 0 1,218 -393
19,000 0 20,668 -1,668
2,602 0 2,619 -17
7,013 0 7,087 -74
589 0 482 107
1,150 0 601 549
1,213 0 906 307
2,502 0 2,515 -13
4,460 0 2,868 1,592
2,900 0 3,081 -181
5,800 0 6,184 -384
5,100 0 5,156 -56
5,100 0 5,002 98
3,180 0 3,110 70
1,780 0 1,785 -5
5,139 0 5,144 -5
901 0 712 189
1,317 0 568 749
1,132 0 1,047 85
681 0 628 53
942 0 1,501 -559
565 0 300 265
1,213 0 996 217
1,146 0 1,086 60
732 0 544 188
531 0 507 24
701 0 782 -81
1,045 0 733 312
1,380 0 1,267 113
1,127 0 793 334
1,172 0 1,060 112
585 0 596 -11
1,825 0 1,556 269
1,473 0 1,442 31
964 0 924 40
1,608 0 1,265 343
1,726 0 1,491 235
881 0 810 71
714 0 607 107
1,704 0 1,216 488
1,116 0 1,270 -154
1,279 0 1,026 253
1,439 0 1,309 130
1,268 0 1,088 180
1,041 0 913 128
1,615 0 1,348 267
1,198 0 927 271
526 0 571 -45
240 0 1,283 -1,043
718 0 550 168
545 0 466 79
763 0 663 100
25,000 0 25,075 -75
896 0 723 173
3,847 0 2,695 1,152
3,865 0 3,890 -25
1,831 0 1,850 -19
2,708 0 3,131 -423
807 0 936 -129
5,696 0 6,253 -557
1,356 0 1,499 -143
2,501 0 2,392 109
1,293 0 1,238 55
879 0 661 218
1,649 0 1,187 462
846 0 535 311
862 0 600 262
992 0 848 144
919 0 724 195
997 0 852 145
1,297 0 1,339 -42
690 0 628 62
559 0 571 -12
1,101 0 844 257
1,048 0 904 144
738 0 668 70
1,329 0 1,147 182
1,498 0 1,310 188
858 0 587 271
572 0 519 53
1,809 0 1,148 661
1,340 0 1,183 157
919 0 808 111
1,158 0 1,014 144
1,216 0 1,010 206
670 0 569 101
750 0 606 144
1,623 0 1,174 449
1,238 0 927 311
1,220 0 1,148 72
592 0 519 73
2,121 0 1,653 468
1,652 0 729 923
1,249 0 1,011 238
1,721 0 1,513 208
1,034 0 966 68
700 0 544 156
478 0 427 51
1,076 0 1,027 49
223 0 203 20
579 0 522 57
979 0 993 -14
1,930 0 1,567 363
3,770 0 4,162 -392
1,682 0 1,632 50
619 0 588 31
5,485 0 5,512 -27
148 0 147 1
522 0 587 -65
944 0 1,084 -140
944 0 1,086 -142
1,255 0 1,292 -37
2,067 0 2,107 -40
1,736 0 1,784 -48
1,902 0 1,921 -19
1,808 0 1,361 447
1,796 0 1,750 46
1,734 0 1,246 488
3,258 0 2,689 569
2,020 0 2,010 10
3,101 0 2,577 524
538 0 466 72
543 0 515 28
656 0 440 216
653 0 602 51
1,845 0 1,564 281
6,102 0 7,218 -1,116
1,013 0 1,187 -174
571 0 530 41
586 0 438 148
646 0 629 17
719 0 610 109
1,073 0 764 309
3,237 0 2,410 827
649 0 583 66
576 0 495 81
548 0 571 -23
574 0 547 27
779 0 609 170
1,804 0 994 810
1,017 0 1,197 -180
1,549 0 1,352 197
1,439 0 1,187 252
343 0 284 59
318 0 259 59
2,014 0 1,629 385
913 0 808 105
1,500 0 1,451 49
1,089 0 848 241
601 0 492 109
2,302 0 2,350 -48
2,577 0 2,265 312
859 0 864 -5
530 0 386 144
547 0 571 -24
694 0 440 254
1,723 0 1,680 43
1,929 0 1,813 116
579 0 1,187 -608
2,893 0 3,040 -147
2,327 0 2,874 -547
1,454 0 1,517 -63
1,600 0 1,698 -98
3,890 0 3,684 206
9,591 0 9,639 -48
2,191 0 2,200 -9
25,563 0 25,640 -77
1,558 0 2,684 -1,126
863 0 1,485 -622
779 0 1,218 -439
581 0 535 46
553 0 462 91
754 0 440 314
684 0 562 122
544 0 372 172
1,110 0 688 422
960 0 663 297
1,998 0 1,713 285
764 0 584 180
1,927 0 1,717 210
964 0 785 179
2,230 0 1,688 542
2,549 0 1,860 689
850 0 705 145
2,171 0 2,620 -449
1,002 0 1,177 -175
501 0 514 -13
4,757 0 5,302 -545
20 0 0 20
2,459 0 2,607 -148
2,365 0 2,607 -242
804 0 806 -2
542 0 401 141
530 0 445 85
529 0 426 103
762 0 571 191
672 0 550 122
1,197 0 1,014 183
702 0 539 163
543 0 293 250
809 0 698 111
608 0 458 150
714 0 607 107
2,851 0 2,704 147
683 0 647 36
46 0 43 3
462 0 428 34
1,666 0 1,788 -122
869 0 904 -35
852 0 685 167
639 0 482 157
772 0 620 152
109 0 0 109
3,906 0 5,518 -1,612
587 0 722 -135
435 0 545 -110
724 0 716 8
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 0 0 0 495
b 0 0 0 190
c 0 0 0 305
d 0 0 0 197
e 0 0 0 -2,104
0 0 0 -393
0 0 0 -1,668
0 0 0 -17
0 0 0 -74
0 0 0 107
0 0 0 549
0 0 0 307
0 0 0 -13
0 0 0 1,592
0 0 0 -181
0 0 0 -384
0 0 0 -56
0 0 0 98
0 0 0 70
0 0 0 -5
0 0 0 -5
0 0 0 189
0 0 0 749
0 0 0 85
0 0 0 53
0 0 0 -559
0 0 0 265
0 0 0 217
0 0 0 60
0 0 0 188
0 0 0 24
0 0 0 -81
0 0 0 312
0 0 0 113
0 0 0 334
0 0 0 112
0 0 0 -11
0 0 0 269
0 0 0 31
0 0 0 40
0 0 0 343
0 0 0 235
0 0 0 71
0 0 0 107
0 0 0 488
0 0 0 -154
0 0 0 253
0 0 0 130
0 0 0 180
0 0 0 128
0 0 0 267
0 0 0 271
0 0 0 -45
0 0 0 -1,043
0 0 0 168
0 0 0 79
0 0 0 100
0 0 0 -75
0 0 0 173
0 0 0 1,152
0 0 0 -25
0 0 0 -19
0 0 0 -423
0 0 0 -129
0 0 0 -557
0 0 0 -143
0 0 0 109
0 0 0 55
0 0 0 218
0 0 0 462
0 0 0 311
0 0 0 262
0 0 0 144
0 0 0 195
0 0 0 145
0 0 0 -42
0 0 0 62
0 0 0 -12
0 0 0 257
0 0 0 144
0 0 0 70
0 0 0 182
0 0 0 188
0 0 0 271
0 0 0 53
0 0 0 661
0 0 0 157
0 0 0 111
0 0 0 144
0 0 0 206
0 0 0 101
0 0 0 144
0 0 0 449
0 0 0 311
0 0 0 72
0 0 0 73
0 0 0 468
0 0 0 923
0 0 0 238
0 0 0 208
0 0 0 68
0 0 0 156
0 0 0 51
0 0 0 49
0 0 0 20
0 0 0 57
0 0 0 -14
0 0 0 363
0 0 0 -392
0 0 0 50
0 0 0 31
0 0 0 -27
0 0 0 1
0 0 0 -65
0 0 0 -140
0 0 0 -142
0 0 0 -37
0 0 0 -40
0 0 0 -48
0 0 0 -19
0 0 0 447
0 0 0 46
0 0 0 488
0 0 0 569
0 0 0 10
0 0 0 524
0 0 0 72
0 0 0 28
0 0 0 216
0 0 0 51
0 0 0 281
0 0 0 -1,116
0 0 0 -174
0 0 0 41
0 0 0 148
0 0 0 17
0 0 0 109
0 0 0 309
0 0 0 827
0 0 0 66
0 0 0 81
0 0 0 -23
0 0 0 27
0 0 0 170
0 0 0 810
0 0 0 -180
0 0 0 197
0 0 0 252
0 0 0 59
0 0 0 59
0 0 0 385
0 0 0 105
0 0 0 49
0 0 0 241
0 0 0 109
0 0 0 -48
0 0 0 312
0 0 0 -5
0 0 0 144
0 0 0 -24
0 0 0 254
0 0 0 43
0 0 0 116
0 0 0 -608
0 0 0 -147
0 0 0 -547
0 0 0 -63
0 0 0 -98
0 0 0 206
0 0 0 -48
0 0 0 -9
0 0 0 -77
0 0 0 -1,126
0 0 0 -622
0 0 0 -439
0 0 0 46
0 0 0 91
0 0 0 314
0 0 0 122
0 0 0 172
0 0 0 422
0 0 0 297
0 0 0 285
0 0 0 180
0 0 0 210
0 0 0 179
0 0 0 542
0 0 0 689
0 0 0 145
0 0 0 -449
0 0 0 -175
0 0 0 -13
0 0 0 -545
0 0 0 20
0 0 0 -148
0 0 0 -242
0 0 0 -2
0 0 0 141
0 0 0 85
0 0 0 103
0 0 0 191
0 0 0 122
0 0 0 183
0 0 0 163
0 0 0 250
0 0 0 111
0 0 0 150
0 0 0 107
0 0 0 147
0 0 0 36
0 0 0 3
0 0 0 34
0 0 0 -122
0 0 0 -35
0 0 0 167
0 0 0 157
0 0 0 152
0 0 0 109
0 0 0 -1,612
0 0 0 -135
0 0 0 -110
0 0 0 8
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 15,253
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 10,364
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))
2014 63,670 982,241 0.064821
2013 54,058 963,918 0.056082
2012 52,534 938,268 0.055990
2011 55,904 965,711 0.057889
2010 54,052 927,895 0.058252
2
Total of line 1, column (d) .....................
20.293034
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
0.058607
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
930,816
5
Multiply line 4 by line 3......................
5
54,552
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
303
7
Add lines 5 and 6........................
7
54,855
8
Enter qualifying distributions from Part XII, line 4.............
8
79,544
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 (2015)
Form 990-PF (2015)
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 Bullet and enter “N/A" on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 303
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........................... 3 303
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 303
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 860
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. Part VI Line 7 - Original Return Overpayment: -860 7 860
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
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 10 557
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet557 RefundedBullet 11  
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)
    bullet
    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 2015 or the taxable year beginning in 2015 (see instructions for Part XIV)?
    If "Yes," complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    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
     
    No
    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 ofbulletCLEAR LAKE BANK & TRUST Telephone no.bullet (641) 423-2457

    Located atbullet100 EAST STATE STMASON CITYIA ZIP+4bullet50401
    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 2015, 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  
    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
     
     
    ........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 2015?.............
    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 2015, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2015?.............
    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
     
     
    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 2015 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 2015.)..................
    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 2015?
    4b
     
    No
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (Continued)
    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
     
     
    .........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 (2015)
    Form 990-PF (2015)
    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
    CLEAR LAKE BANK & TRUST TRUSTEE
    1.00     		7,701 0 0
    100 EAST STATE ST
    MASON CITY,IA50401
    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 THE FOUNDATION DISTRIBUTED FUNDS TO TWELVE (12) AREAORGANIZATIONS THAT SERVE THE GENERAL PUBLIC IN ANDAROUND THE EMMETSBURG, IOWA COMMUNITY 75,340
    2  
    3  
    4  
    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  
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 8
    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
    930,589
    b
    Average of monthly cash balances.......................
    1b
    14,402
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    944,991
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    944,991
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    14,175
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    930,816
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    46,541
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    46,541
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    303
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    303
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    46,238
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    46,238
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    46,238
    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
    79,544
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    79,544
    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
    303
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    79,241
    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 (2015)
    Form 990-PF (2015)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2014     		(c)
    2014     		(d)
    2015
    1 Distributable amount for 2015 from Part XI, line 7 46,238
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2015:
    a From 2010...... 8,205
    b From 2011...... 8,208
    c From 2012...... 7,077
    d From 2013...... 6,978
    e From 2014...... 17,954
    fTotal of lines 3a through e........ 48,422
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 79,544
    a Applied to 2014, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2015 distributable amount..... 46,238
    e Remaining amount distributed out of corpus 33,306
    5 Excess distributions carryover applied to 2015.    
    (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 81,728
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    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......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2014. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2016. 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) .......     		 
    8Excess distributions carryover from 2010 not
    applied on line 5 or line 7 (see instructions) ...     		8,205
    9Excess distributions carryover to 2016.
    Subtract lines 7 and 8 from line 6a ......     		73,523
    10 Analysis of line 9:
    a Excess from 2011.... 8,208
    b Excess from 2012.... 7,077
    c Excess from 2013.... 6,978
    d Excess from 2014.... 17,954
    e Excess from 2015.... 33,306
    Form 990-PF (2015)
    Form 990-PF (2015)
    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 2015, 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) 2015 (b) 2014 (c) 2013 (d) 2012
             
    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:
    ARTHUR W SMITH AUDREY F SMITH FOUND
    100 EAST STATE STREET
    MASON CITY,IA50401
    (641) 423-2457
    bThe form in which applications should be submitted and information and materials they should include:
    NO PRESCRIBED FORM IS USED; ONLY A LETTER OF REQUEST IS REQUIRED.
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    PROJECTS SHOULD BE DESIGNED TO BENEFIT THE EMMETSBURG COMMUNITY AND PALO ALTO COUNTY
    Form 990-PF (2015)
    Form 990-PF (2015)
    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
    FIVE ISLAND COMMUNITY CENTER
    2021 MAIN STREET
    EMMETSBURG,IA50536     		  EXEMPT BUILDING PROJECTS 25,000
    FIVE ISLAND BIKE TRAIL
    2216 MAIN STREET
    EMMETSBURG,IA50536     		  EXEMPT BIKE PATHCONSTRUCTION 15,000
    LOST ISLAND TRAIL CNTR- PALO ALTO CONS FDN
    PO BOX 417
    RUTHVEN,IA51358     		  FOUNDATION TREE PLANTING 4,040
    EMMETSBURG SCHOOLS SCHOLARSHIP FDN
    205 KING STREET
    EMMETSBURG,IA50536     		  FOUNDATION SCHOLARSHIPSEDUCATION - 10,000
    EMMETSBURG LITTLE LEAGUE
    2216 MAIN ST
    EMMETSBURG,IA50536     		  EXEMPT UNIFORMS 3,750
    ISU EXTENSION & OUTREACH- PALO ALTO CO
    2008 10TH ST
    EMMETSBURG,IA50536     		  EXEMPT GENERALOPERATING 1,000
    PALO ALTO COUNTY CATTLEMEN'S ASSN
    2008 10TH ST PO BOX 323
    EMMETSBURG,IA50536     		  EXEMPT GENERALOPERATING 5,000
    EMMESTBURG DANCE TEAM
    205 KING ST
    EMMETSBURG,IA50536     		  EXEMPT UNIFORMS 1,000
    EMMESTBURG ST PATRICKS ASSN
    1001 BROADWAY ST
    EMMETSBURG,IA50536     		  EXEMPT GENERALOPERATING 2,050
    EMMETSBURG BAND BOOSTERS
    205 KING ST
    EMMETSBURG,IA50536     		  EXEMPT GENERALOPERATING 3,500
    ROTARY INTERNATIONAL
    308 LAKESHORE DRIVE
    EMMETSBURG,IA50536     		  EXEMPT GENERALOPERATING 1,000
    EMMETSBURG DINNER DATE SITE COUNCIL
    2008 11TH ST
    EMMETSBURG,IA50536     		  EXEMPT GENERALOPERATING 4,000
    Total .................................bullet 3a 75,340
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2015)
    Form 990-PF (2015)
    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 ...........     		         
    4 Dividends and interest from securities....     18 20,673  
    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 25,119  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   45,792  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1345,792
    (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 (2015)
    Form 990-PF (2015)
    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 organizations?
    Yes
    No
    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 name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2015)
    Additional Data


    Software ID:  
    Software Version:  
    Part VI Line 7 -Original Return Overpayment: -860


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2015 InvestmentsCorpStockSchedule
    Name:
    ARTHUR W & AUDREY F SMITH FOUNDATION
    EIN:
    42-1411511
    Name of Stock End of Year Book Value End of Year Fair Market Value
    AECOM TECHNOLOGY CORP 5,156 4,985
    AKORN INC 7,886 7,164
    ALEXION PHARMACEUTICALS INC 6,179 7,058
    ALLIANCE DATA SYSTEMS CORP 6,228 6,638
    ALPHABET INC 5,506 7,780
    AMERIPRISE FINANCIAL INC 5,770 4,895
    APPLE COMPUTER INC 10,247 11,052
    APPLIED MATERIALS INC 3,697 4,275
    AUTONATION INC 3,938 3,580
    BAKER HUGHES INC 8,792 6,276
    BLACKROCK INC 3,267 3,405
    BLACKSTONE GROUP LP 7,808 6,901
    CIGNA CORP 6,523 8,341
    CVS CAREMARK CORP 9,644 10,852
    CAPITAL ONE FIL CORP 4,639 4,259
    CELGENE CORP 4,345 6,108
    COGNIZANT TECH SOLUTIONS 6,119 6,962
    COMCAST CORP 3,278 3,555
    DANAHER CORP 4,598 5,387
    DISNEY (WALT) HOLDING CO 3,628 3,678
    EMC CORP 3,712 3,569
    EXPRESS SCRIPTS INC 5,993 7,255
    FISERV INC 7,896 10,518
    FORD MOTOR CO 7,320 6,975
    GAMESTOP CORP 3,331 2,187
    HCA HOLDINGS INC 9,490 9,062
    HAIN CELESTIAL GROUP INC 10,864 7,714
    JP MORGAN CHASE & CO 4,615 5,480
    JOHNSON & JOHNSON 5,486 5,547
    LAM RESEARCH CORP 3,765 3,892
    LOWE'S COMPANIES INC 3,684 3,802
    MARATHON PETROLEUM CORP 3,720 4,355
    MASTERCARD IN 7,156 8,957
    MC KESSON CORP 4,383 3,945
    MENTOR GRAPHICS CORP 3,192 2,671
    MICROSOFT CORP 2,686 3,717
    MORGAN STANLEY 5,379 5,312
    O'REILLY AUTOMOTIVE 4,236 6,842
    PNC FINL SVCS GRP 7,004 7,625
    POLARIS INDS INC 6,761 4,126
    PRUDENTIAL FINL 6,135 7,490
    ROSS STORES INC 5,510 7,910
    SKYWORKS SOLUTIONS INC 3,114 4,379
    STERICYCLE INC 6,952 7,115
    THERMO FISHER SCIENTIFIC INC 8,076 9,646
    US BANCORP 5,660 5,675
    UNITED RENTALS INC 4,269 3,482
    UNITED TECHNOLOGIES CORP 5,631 5,668
    VALEANT PHARMACEUTICALS INTL 5,623 4,066
    VALERO ENERGY CORP 5,469 7,354
    VERIZON COMMUNICATIONS 3,765 3,513
    VULCAN MATERIALS 6,561 6,933
    WAL-MART STORES INC 4,342 3,494
    WALGREEN CO 9,533 10,730
    WILLIAMS COS INC 5,574 3,033
    WYNDHAM WORLDWIDE CORP 5,344 4,940
    ZIMMER BIOMET HOLDINGS INC 3,762 3,590
    MEDTRONIC PLC- FOREIGN 4,558 5,538
    ROYAL CARIBBEAN CRUISES LTD- FOREIGN 2,981 3,846
    AVAGO TECHNOLOGIES LTD 3,674 4,355

    TY 2015 InvestmentsOtherSchedule2
    Name:
    ARTHUR W & AUDREY F SMITH FOUNDATION
    EIN:
    42-1411511
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    AMERICAN CENTURY SMALL CAP VALUE FD   22,702 18,131
    LOOMIS SAYLES SMALL CAP GROWTH FD   19,916 17,754
    DODGE & COX INTL STOCK FD   58,362 47,090
    MFS INTL GROWTH FD   39,480 35,908
    T ROWE PRICE INTL GROWTH & INCOME   38,090 35,789
    BAIRD AGGREGATE BOND FD   176,342 173,994
    GOLDMAN SACHS HIGH YEILD FD   41,581 35,320
    PIMCO TOTAL RETURN FD   181,133 167,221
    AMERICAN TOWER CORP   4,847 4,944
    DIVIDEND CAPITAL TOTAL REALTY TRUST INC   22,625 19,499

    TY 2015 OtherIncreasesSchedule
    Name:
    ARTHUR W & AUDREY F SMITH FOUNDATION
    EIN:
    42-1411511
    Description Amount
    CAPITAL GAIN 25,119


    TY 2015 TaxesSchedule
    Name:
    ARTHUR W & AUDREY F SMITH FOUNDATION
    EIN:
    42-1411511
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX 1,445 1,445