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
THOMAS A PLEIN FOUNDATION LTD
 
Number and street (or P.O. box number if mail is not delivered to street address)3415 COMMERCE CT
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
APPLETON, WI54911
A Employer identification number

39-1558684
B Telephone number (see instructions)

(702) 492-1177
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$7,241,564J 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... 214,463 214,463  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 627,473
b Gross sales price for all assets on line 6a 1,326,006
7 Capital gain net income (from Part IV, line 2)... 627,473
8 Net short-term capital gain.........  
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)....... Click to see attachment 7,833 7,833  
12 Total. Add lines 1 through 11........ 849,769 849,769  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 18,000 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 2,650 0   0
c Other professional fees (attach schedule).... Click to see attachment 31,451 31,451   0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 4,811 0   0
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 26,736 0   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 83,648 31,451   0
25 Contributions, gifts, grants paid....... 416,072 416,072
26 Total expenses and disbursements. Add lines 24 and 25 499,720 31,451   416,072
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 350,049
b Net investment income (if negative, enter -0-) 818,318
c Adjusted net income (if negative, enter -0-)...  
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............. 1    
2 Savings and temporary cash investments......... 359,897 189,562 189,562
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)....... 2,818,644 Click to see attachment2,797,335 3,753,302
c Investments—corporate bonds (attach schedule)....... 2,064,907 Click to see attachment2,073,098 2,020,160
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 839,843 Click to see attachment1,373,346 1,278,540
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment1,312 Click to see attachment1,312 Click to see attachment0
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 6,084,604 6,434,653 7,241,564
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 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........ 0 0
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 6,084,604 6,434,653
30 Total net assets or fund balances (see instructions)..... 6,084,604 6,434,653
31 Total liabilities and net assets/fund balances (see instructions). 6,084,604 6,434,653
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
6,084,604
2
Enter amount from Part I, line 27a .....................
2
350,049
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
6,434,653
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
6,434,653
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 FIRST CLEARING LLC     2015-12-31
b
c
d
e
(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 1,326,006   698,533 627,473
b
c
d
e
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       627,473
b
c
d
e
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 2 627,473
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))
2014 451,550 7,998,110 0.056457
2013 355,650 7,294,120 0.048758
2012 357,195 6,802,811 0.052507
2011 360,375 6,470,023 0.055699
2010 347,267 5,960,031 0.058266
2
Total of line 1, column (d) .....................
20.271687
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
0.054337
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
7,844,755
5
Multiply line 4 by line 3......................
5
426,260
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
8,183
7
Add lines 5 and 6........................
7
434,443
8
Enter qualifying distributions from Part XII, line 4.............
8
416,072
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 16,366
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 16,366
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 16,366
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 16,280
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.............. 7 16,280
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 86
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet   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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
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 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 ofbulletH MATTEW FRAZIER Telephone no.bullet (702) 492-1177

    Located atbullet1920 SPYGLASS DRIVEHENDERSONNV ZIP+4bullet89074
    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
    H MATTHEW FRAZIER PRESIDENT
    3.00     		3,000 0 0
    1920 SPYGLASS DRIVE
    HENDERSON,NV89074
    JASON W KETTER EXECUTIVE VICE PRESIDENT
    0.50     		3,000 0 0
    40 OVERLOOK DRIVE
    READING,PA19606
    DAVID NAUMCHEFF DIRECTOR
    0.25     		3,000 0 0
    16134 RAMBLING RD
    ODESSA,FL33556
    STEVE PLEIN DIRECTOR
    0.25     		6,000 0 0
    5215 WELLFIELD RD
    NEW PORT RICHEY,FL34655
    THERESA SKURZEWSKI DIRECTOR
    0.25     		3,000 0 0
    S85 W32420 JOSHUA DRIVE
    MUKWONAGO,WI53149
    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  
    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.........................bullet0
    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
    7,433,631
    b
    Average of monthly cash balances.......................
    1b
    529,187
    c
    Fair market value of all other assets (see instructions)................
    1c
    1,400
    d
    Total (add lines 1a, b, and c).........................
    1d
    7,964,218
    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
    7,964,218
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    119,463
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    7,844,755
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    392,238
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    392,238
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    16,366
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    16,366
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    375,872
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    375,872
    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
    375,872
    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
    416,072
    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
     
    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
    416,072
    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
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    416,072
    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 7 375,872
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2015:
    a From 2010...... 56,541
    b From 2011...... 42,087
    c From 2012...... 22,495
    d From 2013......  
    e From 2014...... 67,917
    fTotal of lines 3a through e........ 189,040
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 416,072
    a Applied to 2014, 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 2015 distributable amount..... 375,872
    e Remaining amount distributed out of corpus 40,200
    5 Excess distributions carryover applied to 2015. 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 5 229,240
    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 2014. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    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) .......     		0
    8Excess distributions carryover from 2010 not
    applied on line 5 or line 7 (see instructions) ...     		56,541
    9Excess distributions carryover to 2016.
    Subtract lines 7 and 8 from line 6a ......     		172,699
    10 Analysis of line 9:
    a Excess from 2011.... 42,087
    b Excess from 2012.... 22,495
    c Excess from 2013....  
    d Excess from 2014.... 67,917
    e Excess from 2015.... 40,200
    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).)
    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.
    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:
    H MATTHEW FRAZIER
    1920 SPYGLASS DRIVE
    HENDERSON,NV89074
    (702) 492-1177
    bThe form in which applications should be submitted and information and materials they should include:
    BRIEF DESCRIPTION OF CHARITABLE PURPOSE
    cAny submission deadlines:
    APPLICATIONS ARE ACCEPTED AT ANY TIME. NOTICE OF APPROVAL, REJECTION, OR REQUESTS FOR ADDITIONAL INF
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    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
    AMERICAN RED CROSS
    PO BOX 37243
    WASHINGTON,DC20013     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 1,000
    DUCKS UNLIMITED INC
    ONE WATERFOWL WAY
    MEMPHIS,TN38120     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 1,640
    GALESBURG AUGUSTA ED
    1076 NORTH 37TH STREET
    GALESBURG,MI49053     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 25,000
    GUSTAVUS ADOLPHUS COLLEGE
    800 W COLLEGE AVE
    SAINT PETER,MN56082     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 25,000
    HOLY TRINITY ABBEY
    1250 S 9500 E
    HUNTSVILLE,UT84317     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 5,000
    HOSPICE SOUTHWESTPALLIATIVE CARE
    5400 MACARTHUR BLVD
    VANCOUVER,WA98661     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 25,000
    HUMANE SOCIETY FOR SOUTHWEST WASH
    1100 NE 192ND AVE
    VANCOUVER,WA98660     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 15,000
    LSU FOUNDATION FOR THE COLLEGE OF AGRICULTURE
    3838 WEST LAKESHORE DRIVE
    BATON ROUGE,LA70808     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 20,000
    NAVAJO LUTHERAN MISSION
    ONE MISSION LANE
    ROCK POINT,AZ865450354     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 5,000
    NORTH PARK UNIVERSITY
    3225 FOSTER AVENUE
    CHICAGO,IL606254895     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 25,000
    ROBERT MORRIS UNIVERSITY
    1507 S WAUKEGAN ROAD
    WAUKEGAN,IL60085     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 9,000
    RONALD MCDONALD HOUSE CHARITIES OF NORTH CENTERAL FLORIDA
    1600 SW 14TH STREET
    GAINSVILLE,FL32608     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 11,750
    SAINT LEO UNIVERSITY
    33701 STATE ROAD 52
    SAINT LEO,FL335746665     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 3,000
    SALVATION ARMY
    2900 PALOMINO LANE
    LAS VEGAS,NV89126     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 1,000
    SANTA FE COLLEGE
    3000 NW 83RD STREET
    GAINSVILLE,FL32606     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 26,500
    ST ROSE HEALTH FOUNDATION
    3001 ST ROSE PARKWAY
    HENDERSON,NV89052     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 21,216
    ST THERESE CENTER
    100 EAST LAKE MEAD PARKWAY
    HENDERSON,NV89009     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 15,000
    UNIVERSITY OF IOWA FOUNDATION
    1 WEST PARK ROAD
    IOWA CITY,IA52244     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 27,500
    UNIVERSITY OF QUEENSLAND USA FOUNDATION
    805 15TH STREET NW SUITE 610
    WASHINGTON,DC20005     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 25,000
    PUBLIC EDUCATION FOUNDATION
    4350 SOUTH MARYLAND PARKWAY
    LAS VEGAS,NV89119     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 5,000
    BALL STATE UNIVERSITY
    2800 W BETHEL AVE
    MUNCIE,IN47304     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 26,500
    TEXAS A&M
    700 UNIVERSITY BLVD
    KINGSVILLE,TX78363     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 2,000
    DAVE DUERSON ATHLETIC SAFETY FUND
    1807 E HINES ST
    MUNCIE,IN47303     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 24,966
    MISSISSIPPI STATE UNIVERSITY
    PO BOX 6100
    MISSISSIPPI STATE,MS39762     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 28,000
    UNIVERSITY NEVADA LAS VEGAS
    4505 S MARYLAND PARKWAY
    LAS VEGAS,NV89154     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 27,000
    IMAGO DEI
    4765 BRUSSELS ST
    LAS VEGAS,NV89119     		  PUBLIC PUBLIC GENERAL CONTRIBUTION 15,000
    Total .................................bullet 3a 416,072
    bApproved for future payment
    Total .................................bullet 3b 0
    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....     14 214,463  
    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.....     14 7,833  
    8
    Gain or (loss) from sales of assets other than inventory ............     		    18 627,473  
    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).. 0 849,769 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13849,769
    (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:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2015 AccountingFeesSchedule
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING 2,650 0   0

    TY 2015 InvestmentsCorpBondsSchedule
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Name of Bond End of Year Book Value End of Year Fair Market Value
    CHESAPEAKE ENERGY CORP 56,127 39,500
    MARSHALL & ILSLEY BANK 92,539 102,903
    SYMANTEC CORP SR UNSECURED 105,986 102,529
    GENERAL ELECTRIC CAP CORP 76,762 76,727
    AT&T INC NOTES 116,257 110,302
    WHITING PETROLEUM CORP 47,132 37,750
    JPMORGAN CHASE & CO 116,324 111,873
    VERIZON COMMUNICATIONS 107,348 107,416
    JOHNSON CONTROLS INC 92,144 60,408
    WALGREEN CO SR UNSECURED 93,406 96,692
    FISERV INC 93,852 100,289
    GENERAL ELECTRIC CO INTERNOTES 46,968 49,938
    WEINGARTEN REALTY INVEST 98,807 97,356
    MURPHY OIL CORP SR UNSECURED 77,866 63,519
    WELLS FARGO & CO SR 92,885 100,752
    ST JUDE MEDICAL INC 96,709 98,590
    NUCOR CORP SR UNSECURED 100,322 95,943
    ASSOC BANC-CORP 99,073 100,578
    COOK CNTY IL 102,820 104,053
    CIT BK CD 100,000 100,019
    BANK OF BARODA CD 100,000 101,230
    GE CAPITAL RETAIL BK CD 100,000 101,385
    TEVA PHARM FIN IV BV COMPANY 59,771 60,408

    TY 2015 InvestmentsCorpStockSchedule
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBOTT LABORATORIES 39,676 44,910
    ACI WORLDWIDE INC 59,658 64,200
    ADOBE SYSTEMS INC 28,081 93,940
    AFFILIATED MANAGERS GROUP 63,731 47,928
    AFLAC INC 62,451 59,900
    AKAMAI TECH INC 46,530 78,945
    ALLSCRIPTS HEALTHCARE 52,192 53,830
    ALPHABET INC - VOTING 21,910 77,801
    ALPHABET INC - NONVOTING 21,840 75,888
    AMETEK INC 54,118 53,590
    APPLE INC 13,774 105,260
    BORG WARNER INC 49,922 43,230
    BOTTOMLINE TECHNOLOGIES 122,580 148,650
    BRYN MAWR BANK CORP 59,348 57,440
    CA INC 89,108 99,960
    CELGENE CORP 36,335 35,928
    COGNIZANT TECH SOL 8,795 60,020
    DISCOVER FINANCIAL 62,229 53,620
    DISCOVERY COMMUNICATIONS INC SERIS C 83,737 60,528
    ECHO GLOBAL LOGISTICS 49,900 61,170
    ECOLAB INC 39,601 45,752
    ENERGY SELECT SECTOR 25,409 30,160
    EQUIFAX INC 24,203 77,959
    EVERTEC INC 64,714 50,220
    FEDEX CORPORATION 38,591 70,770
    FIDELITY NATIONAL INFO SVCS 27,090 60,600
    FRANKLIN RESOURCES 22,488 47,866
    GLOBAL PAYMENTS INC 21,278 64,510
    HOLOGIC INC 45,002 77,380
    ILLINOIS TOOL WORKS 23,903 46,340
    INTUIT INC 21,020 67,550
    LOWES COMPANIES INC 20,928 60,832
    MERCANTILE BK CORP 50,345 61,350
    NATIONAL INSTRUMENTS CORP 28,937 28,690
    NETSCOUT SYSTEMS 35,634 30,700
    NEWFIELD EXPLORATION COMPANY 25,002 32,560
    PANHANDLE OIL & GAS 36,837 32,320
    PAYPAL HOLDINGS 73,904 72,400
    PERRIGO CO PLC 46,602 43,410
    PRINCIPAL FINANCIAL GROUP 42,965 76,466
    SCHLUMBERGER LTD 37,385 48,825
    SEI INVESTMENTS CO 46,993 52,400
    SPDR S&P BANK 82,476 91,314
    T ROWE PRICE GROUP 29,350 50,043
    THERMO FISHER SCIENTIFIC 45,366 70,925
    TOWERS WATSON & CO 79,786 77,076
    TREEHOUSE FOODS INC 72,382 70,614
    UNION PACIFIC CORP 48,124 46,920
    UNITED PARCEL SERVICE 35,801 57,738
    VERIFONE SYSTEMS INC 30,858 47,634
    VISA INC CLASS A 18,839 77,550
    WHITING PETROLEUM CORP 100,133 37,760
    WYNDHAM WORLDWIDE CORP 47,396 50,855
    XILINX INC 34,168 70,455
    ZIMMER BIOMET HOLDINGS 27,301 41,036
    NIKE INC CLASS B 10,884 68,750
    STRYKER CORP 15,783 46,470
    VANGUARD INTL EQUITY 215,125 176,634
    YUM BRANDS 40,151 65,745
    QUALCOMM INC 38,666 49,985

    TY 2015 InvestmentsOtherSchedule2
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    HARBOR INTL AT COST 276,653 320,927
    LIMITED PARTNERSHIP INTERESTS AT COST 65,643 45,000
    AES TR III 6.75% PFD AT COST 73,463 75,120
    AFFILIATED MANAGERS GROUP AT COST 79,387 79,980
    CUSTOMERS BANCORP AT COST 53,727 54,380
    TELEPHONE DATA SYS PFD AT COST 25,961 25,140
    US CELLULAR 6.95% PFD AT COST 25,555 25,240
    TWEEDY BROWNE FD INC GLOBAL VALUE AT COST 360,574 340,941
    TEMPLETON DRAGON FUND AT COST 98,606 0
    OLD SECOND CAPITAL TR I AT COST 75,370 74,625
    SLM CORP CPI AT COST 49,315 47,200
    STIFEL FINL CO AT COST 51,732 50,207
    WSFS FINANCIAL AT COST 52,932 53,500
    ZIONS BANCORP AT COST 84,428 86,280

    TY 2015 OtherAssetsSchedule
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    PROOF SET OF COINS 1,312 1,312  


    TY 2015 OtherExpensesSchedule
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE EXPENSES 1,743 0   0
    FEDERAL EXCISE TAX 24,993 0   0


    TY 2015 OtherIncomeSchedule2
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    MIDWEST RESOURCES 7,833 7,833 7,833


    TY 2015 OtherProfessionalFeesSchedule
    Name:
    THOMAS A PLEIN FOUNDATION LTD
    EIN:
    39-1558684
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    MANAGEMENT INVESTMENT FEES 31,451 31,451   0