-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
IOWA FOUNDATION FOR AGRICULTURAL
ADVANCEMENT
Number and street (or P.O. box number if mail is not delivered to street address)
10550 NEW YORK AVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
DES MOINES
,
IA
50322
A Employer identification number
42-1183067
B
Telephone number (see instructions)
(515) 987-2116
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
0
J
Accounting method:
Cash
Accrual
Other (specify)
(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)
1
Contributions, gifts, grants, etc., received (attach schedule)
235,393
2
Check
.............
3
Interest on savings and temporary cash investments
552
552
552
4
Dividends and interest from securities
...
2,281
2,281
2,281
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-25
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
364,040
b
Less: Cost of goods sold
....
341,135
c
Gross profit or (loss) (attach schedule)
.....
22,905
22,905
11
Other income (attach schedule)
.......
64,017
37,654
12
Total.
Add lines 1 through 11
........
325,123
2,833
63,392
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
9,920
1,000
8,920
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
34
34
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
2,872
2,872
22
Printing and publications
..........
290
290
23
Other expenses (attach schedule)
.......
89,030
89,030
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
102,146
1,000
101,146
0
25
Contributions, gifts, grants paid
.......
231,050
231,050
26
Total expenses and disbursements.
Add lines 24 and 25
333,196
1,000
101,146
231,050
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-8,073
b
Net investment income
(if negative, enter -0-)
1,833
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
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
1
Cash—non-interest-bearing
.............
28,672
21,037
2
Savings and temporary cash investments
.........
263,127
275,500
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
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)
.......
116,556
115,182
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
408,355
411,719
0
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
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
408,355
411,719
29
Total net assets or fund balances
(see instructions)
.....
408,355
411,719
30
Total liabilities and net assets/fund balances
(see instructions)
.
408,355
411,719
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 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
408,355
2
Enter amount from Part I, line 27a
.....................
2
-8,073
3
Other increases not included in line 2 (itemize)
3
11,437
4
Add lines 1, 2, and 3
..........................
4
411,719
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
411,719
Form
990-PF
(2019)
Form 990-PF (2019)
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.)
1a
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
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
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
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
...................
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?
Yes
No
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))
2018
213,016
393,862
0.54084
2017
196,800
386,994
0.50854
2016
216,000
414,903
0.52060
2015
213,150
369,878
0.57627
2014
210,950
365,851
0.57660
2
Total
of line 1, column (d)
.....................
2
2.722850
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years
......
3
0.544570
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
426,417
5
Multiply line 4 by line 3
......................
5
232,214
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
18
7
Add lines 5 and 6
........................
7
232,232
8
Enter qualifying distributions from Part XII, line 4
,.............
8
231,050
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
(2019)
Form 990-PF (2019)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
37
here
and 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
3
Add lines 1 and 2
...........................
3
37
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
37
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
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
8
Enter any
penalty
for underpayment of estimated tax.
Check here
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
.......
9
37
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
Refunded
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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)
IA
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 2019 or the taxable year beginning in 2019? See the 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
(2019)
Form 990-PF (2019)
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 address
N/A
14
The books are in care of
TIMMINS JACOBSEN STRAWHACKER
Telephone no.
(515) 270-8080
Located at
10550 NEW YORK AVE STE 200
DES MOINES
IA
ZIP+4
50322
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
...............
Yes
No
(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.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
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 2019?
.............
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 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
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.
20
,
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?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 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 2019.)
..................
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 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
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:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
..........
Yes
No
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?
.....................
Yes
No
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?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
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
JACK BAIR
Director
2.00
0
4462 NE 150TH AVE
ELKHART
,
IA
50073
ROB BOHNSACK
Director
2.00
0
2063 VERMONT AVE
WILTON
,
IA
52778
BROOKE BEELNER
Director
2.00
0
914 MURRAY DRIVE
AMES
,
IA
50010
PAUL FLINT
Director
2.00
0
632 230TH ST
ALEXANDER
,
IA
50420
GARY VANAERNAM
Director
2.00
0
2810 280TH STREET
EXIRA
,
IA
50076
MARK KAHLER
Director
2.00
0
502 4TH ST
CAMBRIDGE
,
IA
50046
TIM MESSENGER
President
4.00
0
1869 255TH STREET
FAIRFIELD
,
IA
52556
ANDREW LAUVER
Vice President
2.00
0
225 PRAIRIE VIEW DRIVE
WEST DES MOINES
,
IA
50266
MIKE DORAN
Director
2.00
0
3116 EVERGREEN ROAD
AMES
,
IA
50014
BREANNA WAGNER
Secretary
2.00
0
1427 250TH ST
EAGLE GROVE
,
IA
50533
JOSH WILLIAMS
Treasurer
2.00
0
175 TERRACE DR
WAUKEE
,
IA
50263
MIKE PETZENHAUSER
Director
2.00
0
62750 150TH STREET
ROLAND
,
IA
50236
DOUG PULLIN
Director
2.00
0
24751 270TH STREET
ADEL
,
IA
50003
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
...................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
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
.............
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
SCHOLARSHIPS AND GRANTS (WHICH DO NOT HAVE SIGNIFICANT ONGOING INVOLVEMENT).
0
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
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
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
115,843
b
Average of monthly cash balances
.......................
1b
317,068
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
432,911
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
3
Subtract line 2 from line 1d
.........................
3
432,911
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
6,494
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
426,417
6
Minimum investment return.
Enter 5% of line 5
..................
6
21,321
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
21,321
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
37
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
37
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
21,284
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
21,284
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
21,284
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
231,050
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
231,050
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
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
231,050
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
(2019)
Form 990-PF (2019)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2018
(c)
2018
(d)
2019
1
Distributable amount for 2019 from Part XI, line 7
21,284
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
192,671
b
From 2015
......
194,710
c
From 2016
......
195,255
d
From 2017
......
177,450
e
From 2018
......
193,391
f
Total
of lines 3a through e
........
953,477
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
231,050
a
Applied to 2018, 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)
........
0
d
Applied to 2019 distributable amount
.....
21,284
e
Remaining amount distributed out of corpus
209,766
5
Excess distributions carryover applied to 2019.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
1,163,243
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 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
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)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
192,671
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
970,572
10
Analysis of line 9:
a
Excess from 2015
....
194,710
b
Excess from 2016
....
195,255
c
Excess from 2017
....
177,450
d
Excess from 2018
....
193,391
e
Excess from 2019
....
209,766
Form
990-PF
(2019)
Form 990-PF (2019)
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 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
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)
2019
(b)
2018
(c)
2017
(d)
2016
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 foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List 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).)
b
List 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.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
WINNER'S CIRCLE SCHOLARSHIP
30805 595TH AVE
CAMBRIDGE
,
IA
50046
(515) 383-4386
b
The form in which applications should be submitted and information and materials they should include:
APPLICATION FORM AVAILABLE FROM DR. HODSON OR ONLINE.
c
Any submission deadlines:
JUNE 1
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
AWARDED TO RECIPIENTS WHO ARE PURSUING A COURSE OF STUDY RELATED TO THE ANIMAL INDUSTRY AT ANY TWO YEAR OR FOUR YEAR POST SECONDARY EDUCATIONAL INSTITUTION IN IOWA.
Form
990-PF
(2019)
Form 990-PF (2019)
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)
a
Paid during the year
ERICA BAIER
226067 OLD HWY 6
ADEL
,
IA
50003
NONE
N/A
SCHOLARSHIP
5,000
EMILY HAROLD
1213 PLATO RD
WEST BRANCH
,
IA
52358
NONE
N/A
SCHOLARSHIP
5,000
LEAH MOSHER
109 NORTH ST
LISCOMB
,
IA
50148
NONE
N/A
SCHOLARSHIP
5,000
EMILY CAMPBELL
2442 LARK AVE
HAMLIN
,
IA
50117
NONE
N/A
SCHOLARSHIP
6,500
GABRIELLA FERGUSON
2525 133RD ST
NEW SHARON
,
IA
50207
NONE
N/A
SCHOLARSHIP
6,500
LARAME BOYSEN
20409 105TH ST
COLUMBUS JUNCTION
,
IA
52738
NONE
N/A
SCHOLARSHIP
5,000
PEYTON SCHMITT
201820 HWY 16
BIRMINGHAM
,
IA
52535
NONE
N/A
SCHOLARSHIP
5,000
RYAN CHALUPA
1109 HWY 92
KEOTA
,
IA
52248
NONE
N/A
SCHOLARSHIP
5,000
EMMA OLSON
1984 250TH ST
GRAND MOUND
,
IA
52751
NONE
N/A
SCHOLARSHIP
5,000
GRACIE GREINER
2453 KIWI AVE
WASHINGTON
,
IA
52353
NONE
N/A
SCHOLARSHIP
3,000
GRACE LONG
906 2ND ST
SHELDAHL
,
IA
50243
NONE
N/A
SCHOLARSHIP
3,000
GENEVIEVE VAN WYE
19000 ROCKING CHAIR DR
LANCASTER
,
MO
63548
NONE
N/A
SCHOLARSHIP
3,000
LILY SKARTVEDT
3059 YOUNG AVENUE
RADCLIFFE
,
IA
50230
NONE
N/A
SCHOLARSHIP
3,000
ABBY GREIMAN
20350 F AVE
PERRY
,
IA
50220
NONE
N/A
SCHOLARSHIP
2,500
GAVIN MEYER
1855 WILSON AVE
WILTON
,
IA
52778
NONE
N/A
SCHOLARSHIP
2,500
KIERSTEN JASS
2035 PINE AVE
GARNER
,
IA
50438
NONE
N/A
SCHOLARSHIP
2,500
HOLLY COOK
2866 TROY MILLS BLVD
WINTHROP
,
IA
50682
NONE
N/A
SCHOLARSHIP
2,000
ALISON BUELTEL
1607 320TH AVE
ESTHERVILLE
,
IA
51334
NONE
N/A
SCHOLARSHIP
2,000
CULLY FORSYTH
2283 7 MILE ROAD
CHARLES CITY
,
IA
50616
NONE
N/A
SCHOLARSHIP
2,000
JAYDEN JORGENSEN
2011 130TH ST
RUDD
,
IA
50471
NONE
N/A
SCHOLARSHIP
2,000
PAIGE ZHORNE
3064 120TH ST
MALCOMB
,
IA
50157
NONE
N/A
SCHOLARSHIP
2,000
BRIELLE SMEBY
1445 VAIL AVE
KLEMME
,
IA
50449
NONE
N/A
SCHOLARSHIP
2,000
KABE BOYSEN
19394 COUNTRY ROAD G62
MORNING SUN
,
IA
52640
NONE
N/A
SCHOLARSHIP
2,000
TATE BOYSEN
20409 105TH ST
COLUMBUS JUNCTION
,
IA
52738
NONE
N/A
SCHOLARSHIP
2,000
CAYLA NOLTING
1255 OLD STAGE ROAD
WAUKON
,
IA
52172
NONE
N/A
SCHOLARSHIP
2,000
SARAH PHELPHS
1264 440TH ST
SAINT ANSGAR
,
IA
50472
NONE
N/A
SCHOLARSHIP
2,000
JUSTIN SWANTON
1791 360TH AVE
GOOSE LAKE
,
IA
52750
NONE
N/A
SCHOLARSHIP
1,500
BENJAMIN HEEREN
3164 XAVIER AVE
LEHIGH
,
IA
50557
NONE
N/A
SCHOLARSHIP
1,500
NOLAN LYNESS
837 EAST UNION ST
MANCHASTER
,
IA
52057
NONE
N/A
SCHOLARSHIP
1,500
WALKER MCDERMOTT
68475 INDEPENDENCE ROAD
WIOTA
,
IA
50274
NONE
N/A
SCHOLARSHIP
1,500
TAYLOR CONLEY
327 CHESTNUT ST
NEW ENTERPRISE
,
PA
16664
NONE
N/A
SCHOLARSHIP
1,500
LARISSA BECKER
2041 170TH ST
FAIRMONT
,
MN
56031
NONE
N/A
SCHOLARSHIP
1,500
PAIGE BURGETT
19925 540TH LANE
CHARITON
,
IA
50049
NONE
N/A
SCHOLARSHIP
1,250
ERIN CHALUPA
1109 HIGHWAY 92
KEOTA
,
IA
52248
NONE
N/A
SCHOLARSHIP
1,250
CALVIN CARLSON
901 12TH STREET SW
HUMBOLDT
,
IA
50548
NONE
N/A
SCHOLARSHIP
1,000
KADE FAGA
13818 570TH AVE
STORY CITY
,
IA
50248
NONE
N/A
SCHOLARSHIP
1,000
ZOE DUNCAN
1266 275TH ST
GARWIN
,
IA
50632
NONE
N/A
SCHOLARSHIP
1,000
SYDNEY GARRETT
1991 CLOVER ST
OSCEOLA
,
IA
50213
NONE
N/A
SCHOLARSHIP
1,000
JACOB STERLE
59096 130TH ST
ROLAND
,
IA
50236
NONE
N/A
SCHOLARSHIP
1,000
GRACE CHRISTENSEN
17750210TH ST
AUDUBON
,
IA
50025
NONE
N/A
SCHOLARSHIP
1,000
MCKENNA BRINNING
2264 GINKGO AVE
KEOTA
,
IA
52248
NONE
N/A
SCHOLARSHIP
1,000
TAYLOR LEKIN
110 COLUMBIAN COURT
TOLEDO
,
IA
52342
NONE
N/A
SCHOLARSHIP
1,500
BETHANY WIDMAN
1665 220TH ST
SERGEANT BLUFF
,
IA
51054
NONE
N/A
SCHOLARSHIP
1,500
AVERIE HASCALL
1150 D AVE
ESSEX
,
IA
51638
NONE
N/A
SCHOLARSHIP
1,000
KAITLYN BOYER
3188 MORMON TRAIL
WELDON
,
IA
50264
NONE
N/A
SCHOLARSHIP
1,000
TY HOUSTON
5131 210TH TRAIL
MONDAMIN
,
IA
51557
NONE
N/A
SCHOLARSHIP
1,000
KYLE BREDEMEYER
19404 WILLOW AVE
BONAPARTE
,
IA
52620
NONE
N/A
SCHOLARSHIP
1,000
KENDRA SPEIR
N4633 HWY A
CAMBRIDGE
,
WI
53523
NONE
N/A
SCHOLARSHIP
1,000
ERIKA JOHNSON
1674 WEST RIDGE ROAD
WAUKON
,
IA
52172
NONE
N/A
SCHOLARSHIP
1,000
ELIZABETH MOORE
3289 160TH ST
WHAT CHEER
,
IA
50268
NONE
N/A
SCHOLARSHIP
1,000
JACOB EWART
8608 142ND AVE
WAPELLO
,
IA
52653
NONE
N/A
SCHOLARSHIP
1,000
MYA PARGEON
104 SOUTH 10TH ST
MONTEZUMA
,
IA
50171
NONE
N/A
SCHOLARSHIP
1,000
CHLOE LEVAN
4371 MARCH AVE
OSAGE
,
IA
50461
NONE
N/A
SCHOLARSHIP
1,000
LEXIE BERRY
3121 280TH ST
SAC CITY
,
IA
50583
NONE
N/A
SCHOLARSHIP
1,000
KARA SMITH
712 63RD ST
WEST DES MOINES
,
IA
50266
NONE
N/A
SCHOLARSHIP
1,000
ELIZABETH SMITH
2417 348TH ST
DECORAH
,
IA
52101
NONE
N/A
SCHOLARSHIP
1,000
CHELSEA LARSEN
1676 HWY 25
GUTHRIE CENTER
,
IA
50115
NONE
N/A
SCHOLARSHIP
500
JACK CARTER
2305 180TH ST
WASHINGTON
,
IA
52353
NONE
N/A
SCHOLARSHIP
500
JESSICA FRASHER
22703 FISH HOUSE ROAD
ANAMOSA
,
IA
52205
NONE
N/A
SCHOLARSHIP
500
COLE SPAIN
29738 EASTERN ROAD
CASTALIA
,
IA
52133
NONE
N/A
SCHOLARSHIP
500
MATTIE WHEELER
3346 ELMWOOD AVE
LORIMOR
,
IA
50149
NONE
N/A
SCHOLARSHIP
1,000
GRACE GREIMAN
1770 140TH ST
GOODEL
,
IA
50439
NONE
N/A
SCHOLARSHIP
2,000
JARED BIRKS
2644 HARRIS AVE
ROCKWELL CITY
,
IA
50579
NONE
N/A
SCHOLARSHIP
2,000
ELLEN COOK
32132 K AVE
HUBBARD
,
IA
50122
NONE
N/A
SCHOLARSHIP
2,000
EMMA EHLERS
39457 GLACIER ROAD
EDGEWOOD
,
IA
52042
NONE
N/A
SCHOLARSHIP
2,000
ASHLEY KAHLER
58833 HWY 210
CAMBRIDGE
,
IA
50046
NONE
N/A
SCHOLARSHIP
2,000
BRYCE LAFRANZ
1815 VERMONT AVE
WILTON
,
IA
52778
NONE
N/A
SCHOLARSHIP
2,000
KYLE POEN
33184 FLETCHER AVE
LAKE CITY
,
IA
51449
NONE
N/A
SCHOLARSHIP
2,000
RACHEL ROSS
53582 CEDAR JONES ROAD
LISBON
,
IA
52253
NONE
N/A
SCHOLARSHIP
2,000
BRETT SCHIELE
217 BUCKEYE ROAD
WEST LIBERTY
,
IA
52776
NONE
N/A
SCHOLARSHIP
2,000
CLARA SCHMITZ
PO BOX 34
CRAWFORDSVILLE
,
IA
52621
NONE
N/A
SCHOLARSHIP
2,000
EMMA SINCLAIR
2197 F52 TRAIL
WILLIAMSBURG
,
IA
52361
NONE
N/A
SCHOLARSHIP
2,000
JULIANNA WISE
3275 PAINT CREEK ROAD
DECORAH
,
IA
52101
NONE
N/A
SCHOLARSHIP
2,000
DAWSON BRADER
14500 PLEASANT GROVE RD
MEDIAPOLIS
,
IA
52637
NONE
N/A
SCHOLARSHIP
1,000
MORGAN DEHAAI
9875 W 24TH ST S
MONROE
,
IA
50170
NONE
N/A
SCHOLARSHIP
1,000
CHARLI MOSIER
110 MEADOW LAND
TIPTON
,
IA
52772
NONE
N/A
SCHOLARSHIP
1,000
JENNA PAGEL
21362 185TH ST
HAWKEYE
,
IA
52147
NONE
N/A
SCHOLARSHIP
1,000
QUINN SCHMIDT
2825 BLACK DIAMOND ROAD SW
IOWA CITY
,
IA
52240
NONE
N/A
SCHOLARSHIP
1,000
ISAAC WILEY
50677 29TH AVE
WALKER
,
IA
52352
NONE
N/A
SCHOLARSHIP
1,000
ARTHUR RILEY
6772 SW 92ND AVE
ELLENDALE
,
MN
56026
NONE
N/A
SCHOLARSHIP
5,000
SHELBY WESTHOFF
1769 310TH AVE
DYERSVILLE
,
IA
52040
NONE
N/A
SCHOLARSHIP
3,500
JAKE HLAS
1734 K AVE
TRAER
,
IA
50675
NONE
N/A
SCHOLARSHIP
3,500
PHOEBE SANDERS
1020 2ND AVE NE
CLARION
,
IA
50525
NONE
N/A
SCHOLARSHIP
500
WHITNEY REEVER
24714 TIMBER AVE
GLIDDEN
,
IA
51443
NONE
N/A
SCHOLARSHIP
2,000
RILEY ARTHUR
6772 SW 92ND AVE
ELLENDALE
,
MN
56026
NONE
N/A
SCHOLARSHIP
5,000
JAKE HLAS
1734 K AVE
TRAER
,
IA
50675
NONE
N/A
SCHOLARSHIP
5,000
SHELBY WESTHOFF
1769 310TH AVE
DYERSVILLE
,
IA
52040
NONE
N/A
SCHOLARSHIP
5,000
DAWSON BRADER
14500 PLEASANT GROVE RD
MEDIAPOLIS
,
IA
52637
NONE
N/A
SCHOLARSHIP
1,000
MORGAN DEHAAI
9875 W 24TH ST S
MONROE
,
IA
50170
NONE
N/A
SCHOLARSHIP
1,000
CHARLI MOSIER
110 MEADOW LANE
TIPTON
,
IA
52772
NONE
N/A
SCHOLARSHIP
1,000
JENNA PAGEL
21362 185TH ST
HAWKEYE
,
IA
52147
NONE
N/A
SCHOLARSHIP
1,000
QUINN SCHMIDT
2825 BLACK DIAMOND RD SW
IOWA CITY
,
IA
52240
NONE
N/A
SCHOLARSHIP
1,000
ISAAC WILEY
5067 29TH AVE
WALKER
,
IA
52352
NONE
N/A
SCHOLARSHIP
1,000
IOWA STATE UNIVERSITY JUDGING TEAM
119 KILDEE
AMES
,
IA
50011
NONE
N/A
AWARD
8,000
CARSON FINCH
28776 520TH AVE
KELLEY
,
IA
50134
NONE
N/A
AWARD
1,000
ASHTON DANKER
27586 HWY 59
AVOCA
,
IA
51521
NONE
N/A
AWARD
750
SARA SULLIVAN
35 INDUSTRIAL DRIVE
DUNLAP
,
IA
51529
NONE
N/A
AWARD
1,000
KINNICK PAULSON
104 E FARLEY ST
PRESTON
,
IA
52069
NONE
N/A
AWARD
1,000
ABI HENDERSON
513 W DIVISION ST
OGDEN
,
IA
50212
NONE
N/A
AWARD
500
TREY LETTOW
2184 MAGNOLIA RD
WOODWARD
,
IA
50276
NONE
N/A
AWARD
1,000
BRANDI BOHIKE
301 KURTZ DRIVE
KINGSLEY
,
IA
51028
NONE
N/A
AWARD
500
KYLE HAROLD
1213 PLATO RD WEST
WEST BRANCH
,
IA
52358
NONE
N/A
AWARD
1,000
RYLEE LIBE
1214 N 4TH AVE
WASHINGTON
,
IA
52353
NONE
N/A
AWARD
500
ISABELLA BUESING
3812 120TH ST
STOCKTON
,
IA
52739
NONE
N/A
AWARD
600
DREW JACOBSON
1760 195TH AVE
OSCEOLA
,
IA
50213
NONE
N/A
AWARD
400
MADELYN MORNINGSTAR
181 ADAMS AV
LISBON
,
IA
52253
NONE
N/A
AWARD
600
ASHLEY KAHLER
58833 HWY 210
CAMBRIDGE
,
IA
50046
NONE
N/A
AWARD
400
BELLA OPHEIM
15 RIVER OAKS
HUMBOLDT
,
IA
50548
NONE
N/A
AWARD
1,000
EMILY HAROLD
1213 PLATO ROAD
WEST BRANCH
,
IA
52358
NONE
N/A
AWARD
750
SYDNEY CAIN
20267 475TH ST
CHARITON
,
IA
50049
NONE
N/A
AWARD
500
MAGGIE STAUDACHER
10782 GRIMES ST
INDIANOLA
,
IA
50125
NONE
N/A
AWARD
1,000
MEGAN MOORE
1300 QUEBEC ST
KNOXVILLE
,
IA
50138
NONE
N/A
AWARD
750
JESSICA FRASHER
22703 FISH HOUSE ROAD
ANAMOSA
,
IA
52205
NONE
N/A
AWARD
1,500
AARON CAIN
20492 495TH LANE
CHARITON
,
IA
50049
NONE
N/A
AWARD
500
SAGE VOEHELE
46588 281ST ST
LENNOX
,
SD
57037
NONE
N/A
AWARD
1,000
EMILY HAROLD
1213 PLATO RD
WEST BRANCH
,
IA
52358
NONE
N/A
AWARD
500
KABE BOYSEN
19394 COUNTRY ROAD G62
MORNING SUN
,
IA
52640
NONE
N/A
AWARD
250
BELLA OPHEIM
15 RIVER OAKS
HUMBOLD
,
IA
50548
NONE
N/A
AWARD
250
NICHOLAS EDWARDS
107 CENTENNIAL DRIVE
HUXLEY
,
IA
50124
NONE
N/A
AWARD
250
MAGGIE STAUDACHER
10782 GRIMES ST
INDIANOLA
,
IA
50125
NONE
N/A
AWARD
250
BRIELLE SMEBY
1445 VAIL AVE
KLEMME
,
IA
50449
NONE
N/A
AWARD
250
TATE LINTON
32778 K 22
SIOUX CITY
,
IA
51108
NONE
N/A
AWARD
250
TYLER WELLMAN
1937 150TH ST
WEST POINT
,
IA
52656
NONE
N/A
AWARD
250
LUKE MASSMAN
1106 202ND AVE
OSSIAN
,
IA
52161
NONE
N/A
AWARD
1,000
COOPER GREENSLADE
33316 K AVE
ADEK
,
IA
50003
NONE
N/A
AWARD
500
MADISION RULE
4764 HWY 12
HAWARDEN
,
IA
51023
NONE
N/A
AWARD
500
COLE NELSON
15873 141ST ST
PERRY
,
IA
50220
NONE
N/A
AWARD
250
SAVANNAH KEITZER
14901 240TH ST
MEDIAPOLIS
,
IA
52637
NONE
N/A
AWARD
500
JAXSON KRAMPEN
207 4TH STREET N
HUMBOLDT
,
IA
50548
NONE
N/A
AWARD
250
MAX GIBSON
23074 DRAKE RD
ELGIN
,
IA
52141
NONE
N/A
AWARD
500
BEN GIBSON
23074 DRAKE RD
ELGIN
,
IA
52141
NONE
N/A
AWARD
500
OLIVER DIES
17934 SILVERTHORNE LANE
AMES
,
IA
50014
NONE
N/A
AWARD
300
CADEN SPROUSE
305 NW BAKER DRIVE
KEOTA
,
IA
52248
NONE
N/A
AWARD
250
JOSHUA HILBY
1276 255TH ST
MANCHESTER
,
IA
52057
NONE
N/A
AWARD
1,000
LAUAREN MOSHER
109 NORTH STREET
LISCOMB
,
IA
50148
NONE
N/A
AWARD
500
JEB SHWAGGER
26917 216TH ST
BELLEVUE
,
IA
52031
NONE
N/A
AWARD
250
BEN MCCLAIN
2130 150TH
BAYARD
,
IA
50029
NONE
N/A
AWARD
1,000
TRISTAN HAAG
3425 STARLING AVE
PRIMGHAR
,
IA
51245
NONE
N/A
AWARD
500
COLLIN SWATON
1791 360TH AVE
GOOSE LAKE
,
IA
52750
NONE
N/A
AWARD
250
OLIVIA MASSMAN
7743 HAMLET ROAD
OSSIAN
,
IA
52161
NONE
N/A
AWARD
1,000
NOLAN LYNESS
837 EAST UNION ST
MANCHESTER
,
IA
52057
NONE
N/A
AWARD
500
GABE GREINER
2453 KIWI AVE
WASHINGTON
,
IA
52353
NONE
N/A
AWARD
500
COLTON WARRICK
10649 HWY S6G
PRAIRIE CITY
,
IA
50228
NONE
N/A
AWARD
300
ADAM KOCH
3826 PRIMROSE AVE
OSAGE
,
IA
50461
NONE
N/A
AWARD
200
CARTER MOMMSEN
2128 340TH AVE
GOOSE LAKE
,
IA
52780
NONE
N/A
AWARD
500
KINLEE BROWN
12837 COUNTRY RD X17
COLUMBUS JUNCTION
,
IA
52738
NONE
N/A
AWARD
500
NICHOLAS EDWARDS
107 CENTENNIAL DR
HUXLEY
,
IA
50124
NONE
N/A
AWARD
250
JILLIAN WOODRUFF
1787 250TH ST
MOORLAND
,
IA
50566
NONE
N/A
AWARD
250
BETH ANDERSON
2609 150TH AVE
ALGONA
,
IA
50511
NONE
N/A
AWARD
250
TOMMY JANSSEN
15899 F AVE
WELLSBURG
,
IA
50680
NONE
N/A
AWARD
250
CORY CLARK
15937 HIGHWAY 78
MORNING SUN
,
IA
52640
NONE
N/A
AWARD
1,000
COLBY TOOL
10179 RIFLEST
MONROE
,
IA
50170
NONE
N/A
AWARD
500
Total
.................................
3a
231,050
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
552
4
Dividends and interest from securities
....
14
2,281
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not 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
9
Net income or (loss) from special events:
1
31,244
10
Gross profit or (loss) from sales of inventory
22,905
11
Other revenue:
a
MEMBERSHIP DUES
6,410
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
34,052
29,315
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
63,367
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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.)
10
SEE ATTACHED STATEMENT
Form
990-PF
(2019)
Form 990-PF (2019)
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) (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) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
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.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
19009920
Software Version:
2019v5.0
Form 990PF - Special Condition Description:
Special Condition Description