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.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 12-01-2021 , and ending 11-30-2022
Name of foundation
ALLISON EVERETT PEARSON FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)CLINTON NATIONAL BK 235 6TH AVE S
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CLINTON, IA52732
A Employer identification number

42-6122181
B Telephone number (see instructions)

(563) 243-1243
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... 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$1,051,775J 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.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 37,587 37,587  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 47,966
b Gross sales price for all assets on line 6a 93,146
7 Capital gain net income (from Part IV, line 2)... 47,966
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).......      
12 Total. Add lines 1 through 11........ 85,553 85,553  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 6,369      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment 1,049 1,049    
b Accounting fees (attach schedule)....... Click to see attachment 895 895    
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 1,330 30    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 9,643 1,974   0
25 Contributions, gifts, grants paid....... 57,000 57,000
26 Total expenses and disbursements. Add lines 24 and 25 66,643 1,974   57,000
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 18,910
b Net investment income (if negative, enter -0-) 83,579
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
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.........      
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).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 902,961 Click to see attachment921,870 1,051,775
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 902,960 921,870 1,051,775
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
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 bullet
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 902,960 921,870
29 Total net assets or fund balances (see instructions)..... 902,960 921,870
30 Total liabilities and net assets/fund balances (see instructions). 902,960 921,870
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
902,960
2
Enter amount from Part I, line 27a .....................
2
18,910
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
921,870
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
921,870
Form 990-PF (2021)
Form 990-PF (2021)
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 JP MORGAN INCOME BUILDER FD CL I P 2018-04-16 2022-11-29
b T ROWE PRICE CAP APPREC FD CL I P 1999-12-17 2022-11-29
c T ROWE PRICE CAP APPREC FD CL I P 2000-12-14 2022-11-29
d T ROWE PRICE SHORT TERM BD FD CL I P 2018-12-06 2022-11-29
e VANGUARD TOTAL STOCK MKT INDEX P 2001-05-10 2022-11-29
WESTERN ASSET CORE PLUS BD FD CL I P 2017-06-15 2022-11-29
(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 10,000   11,334 -1,334
b 5,654   2,128 3,526
c 4,346   1,753 2,593
d 8,000   8,304 -304
e 10,000   2,891 7,109
15,000   18,770 -3,770
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       -1,334
b       3,526
c       2,593
d       -304
e       7,109
      -3,770
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 47,966
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  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
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 Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) 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 1,162
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 1,162
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 1,300
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 1,300
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.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 138
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet138 RefundedBullet 11  
Part VI-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 the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
     
    No
    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 XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletIA
    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 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    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 (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-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 ofbulletCLINTON NATIONAL BANK Telephone no.bullet (563) 243-1243

    Located atbullet235 SIXTH AVENUE SOUTHCLINTONIA ZIP+4bullet52732
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, 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 the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-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? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    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)? ......................
    1a(5)
     
    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.) ...............
    1a(6)
     
    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
     
     
    c
    ........bullet
    d
    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 2021? .............
    1d
     
     
    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 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    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? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 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 2021.) .....................
    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 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-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))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    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? .............
    5a(5)
     
    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
     
     
    c
    .........bullet
    d
    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? .................
    5d
     
     
    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? .............................
    6a
     
    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?
    7a
     
    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? .........................
    8
     
    No
    Part VII
    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
    CLINTON NATIONAL BANK TRUSTEE
    2.00     		6,369 0 0
    235 SIXTH AVENUE SOUTH
    CLINTON,IA52732
    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  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    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.............bullet  
    Part VIII-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 VIII-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 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    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
    1,127,204
    b
    Average of monthly cash balances.......................
    1b
    5,523
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,132,727
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    1,132,727
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    16,991
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    1,115,736
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    55,787
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    55,787
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    1,162
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,162
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    54,625
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    54,625
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    54,625
    Part XI
    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
     
    b
    Program-related investments—total from Part VIII-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 XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 54,625
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 7,655
    b From 2017...... 8,779
    c From 2018...... 9,012
    d From 2019...... 8,206
    e From 2020...... 10,981
    f Total of lines 3a through e ........ 44,633
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 57,000
    a Applied to 2020, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount..... 54,625
    e Remaining amount distributed out of corpus 2,375
    5 Excess distributions carryover applied to 2021.    
    (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 47,008
    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 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		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 2016 not
    applied on line 5 or line 7 (see instructions) ...     		7,655
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		39,353
    10 Analysis of line 9:
    a Excess from 2017.... 8,779
    b Excess from 2018.... 9,012
    c Excess from 2019.... 8,206
    d Excess from 2020.... 10,981
    e Excess from 2021.... 2,375
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-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 2021, 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) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    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 IX, 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 XIV
    Supplementary Information (Complete this part only if the foundation 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:
    CLINTON NATIONAL BANK
    235 SIXTH AVENUE SOUTH
    CLINTON,IA52732
    (563) 243-1243
    bThe form in which applications should be submitted and information and materials they should include:
    APPLICATION REQUIREMENTS: EDUCATIONAL: FUNDS ARE AWARDED DIRECTLY TO IOWA UNIVERSITIES AND COLLEGES. FUNDS ARE PAID DIRECTLY TO THE INSTITUTIONS. NO FUNDS ARE AWARDED DIRECTLY TO INDIVIDUALS. CHARITABLE: THEIR IS NOT A STANDARD FORM OF APPLICATION. APPLICANTS MUST SUBMIT PROOF OF EXEMPTION UNDER IRC SECTION 501(C)(3) WITH A REQUEST FOR FUNDS.
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    LIMITED TO ORGANIZATIONS LOCATED IN THE IOWA COUNTIES OF CLINTON AND JACKSON
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    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 LEGION
    1317 S 17TH ST
    CLINTON,IA52732     		NONE   MILITARY MEMORIAL SITE 3,000
    AMERICAN LEGION
    1317 S 17TH ST
    CLINTON,IA52732     		NONE   STONE ENGRAVEMENT 1,500
    BRIDGEVIEW COMMUNITY MENTAL
    HEALTH CENTER
    638 SOUTH BLUFF BLVD
    CLINTON,IA52732     		NONE   BUS PASSES 3,000
    COMMUNITY FOUNDATION OF
    JACKSON COUNTY
    120 1/2 S MAIN STREET
    MAQUOKETA,IA52060     		NONE   GRADE LEVEL READING 4,000
    COMMUNITY FOUNDATION OF
    JACKSON COUNTY
    120 1/2 S MAIN STREET
    MAQUOKETA,IA52060     		NONE   IMAGINATION LIBRARY PROJECT 2,000
    COMMUNITY FOUNDATION OF
    JACKSON COUNTY
    120 1/2 S MAIN STREET
    MAQUOKETA,IA52060     		NONE   MILES WELCOME BANNERS 968
    COMMUNITY FOUNDATION OF
    JACKSON COUNTY
    120 1/2 S MAIN STREET
    MAQUOKETA,IA52060     		NONE   PRESTON PEPPERMINT PARK 1,500
    COMMUNITY FOUNDATION OF
    JACKSON COUNTY
    120 1/2 S MAIN STREET
    MAQUOKETA,IA52060     		NONE   SPRAGUEVILLE COMM CENTER REPAIRS 2,000
    EASTON VALLEY HIGH SCHOOL
    321 W SCHOOL ST
    PRESTON,IA52069     		NONE   ONE SCHOLARSHIP 1,000
    GIRL SCOUTS OF EASTERN IOWA
    940 GOLDEN VALLEY DR
    BETTENDORF,IA52722     		NONE   SUPPORT FOR CLINTON AND JACKSON CTY 2,000
    GREAT RIVER THRESHERS INC
    99 CENTENNIAL ST
    MILES,IA52064     		NONE   SCHOOL HOUSE ROOF REPLACEMENT 4,000
    INFORMATION REFERRAL & ASSISTANCE
    SERVICES
    415 S 3RD ST
    CLINTON,IA52732     		NONE   BACK PACK BUDDY PROGRAM 4,532
    LIFE CONNECTIONS PEER RECOVERY
    SERVICES
    240 N BLUFF BLVD
    CLINTON,IA52732     		NONE   RHONDA'S HOUSE FURNISHING FUND 2,500
    NORTHEAST HIGH SCHOOL
    3690 HWY 136
    GOOSE LAKE,IA52750     		NONE   ONE SCHOLARSHIP 1,000
    OHNWARD FINE ARTS CENTER
    1215 E PLATT ST
    MAQUOKETA,IA52060     		NONE   TOILETS FOR FACILITY 2,000
    YWCA OF CLINTON IA
    317 7TH AVE S
    CLINTON,IA52732     		NONE   CONTACTLESS DOOR SYSTEM 4,000
    THE FRIENDS OF THE PRESTON
    PUBLIC LIBRARY
    1 WEST GILLET PO BOX 605
    PRESTON,IA52069     		NONE   STORY WALK SIGNAGE 3,000
    HOSPICE OF JACKSON COUNTY
    611 W QUARRY ST
    MAQUOKETA,IA52060     		NONE   COMMUNITY OUTREACH TEAM 500
    LUTHERAN SERVICES IN IOWA
    244 23RD AVE N
    CLINTON,IA52732     		NONE   ASSISTANCE FOR NEEDS AND TRANSPORT 1,500
    MAQUOKETA AREA FAMILY YMCA
    500 E SUMMIT ST
    MAQUOKETA,IA52060     		NONE   INDOOR POOL MAINTENANCE 4,000
    MIDWEST LUMBER MUSEUM
    2231 GRANT ST
    CLINTON,IA52732     		NONE   SAWMILL MUSEUM CHILDREN ADMISSION 1,000
    MILES VOLUNTEER FIRE DEPARTMENT
    18 ORSON ST
    MILES,IA52064     		NONE   MILES PARK PROJECT 1,500
    RIVER BEND FOODBANK
    4010 KIMMEL DRIVE
    DAVENPORT,IA52802     		NONE   MEALS FOR CLINTON CTY RESIDENTS 3,000
    ST JOHNS EVANGELICAL LUTHERAN
    CHURCH
    2209 N 2ND ST
    CLINTON,IA52732     		NONE   FOOD AND TOILETRY DISTRIBUTION 1,500
    ST JOHNS EVANGELICAL LUTHERAN
    CHURCH
    2209 N 2ND ST
    CLINTON,IA52732     		NONE   FOOD BACKPACK PROGRAM 2,000
    Total .................................bullet 3a 57,000
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-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 ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 47,966  
    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) ..   85,553  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    85,553
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-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 XV-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 (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    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? ...........
    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 instructions.
    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 (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    ALLISON EVERETT PEARSON FOUNDATION
    EIN:
    42-6122181
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT ACCOUNTING FEES 895 895    

    TY 2021 InvestmentsOtherSchedule2
    Name:
    ALLISON EVERETT PEARSON FOUNDATION
    EIN:
    42-6122181
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    NORTHERN INST US GOVERNMENT SELECT AT COST 1,174 1,174
    NORTHERN INST US GOVERNMENT SELECT AT COST    
    DWS SHORT DURATION FUND CI S AT COST 19,816 18,355
    FEDERATED MORTGAGE FUND CL IS 835 AT COST    
    FEDERATED CORE BOND FD CL IS AT COST 21,534 17,932
    FEDERATED HIGH YIELD TRUST FD IS 77 AT COST 15,196 14,449
    FEDERATED SHORT-INTER TOTAL RTN      
    BOND FUND IS 63 AT COST 29,903 28,494
    FEDERATED TOTAL RTN BD FD CL IS 328 AT COST 41,938 37,083
    FIDELITY ADVISOR STRATEGIC INCOME FD AT COST 22,000 19,553
    FIDELITY TOTAL BOND FUND 820 AT COST 40,440 34,219
    GUGGENHEIM TOTAL RETURN BOND FD INST AT COST 41,500 36,453
    JP MORGAN CORE BOND FD CL I AT COST 21,000 18,038
    T ROWE PRICE HIGH YIELD FUND CL I AT COST 12,000 10,382
    T ROWE PRICE SHORT TERM BD FD CL I AT COST 12,696 12,313
    VANGUARD CORE BD FD ADM AT COST 40,000 32,912
    VANGUARD GNMA FD ADM 536 AT COST 23,489 20,608
    VANGUARD INTER-TERM BD INDEX      
    FUND ADM SHS 5314 AT COST 36,500 31,223
    VANGUARD SHORT-TERM INV GRADE ADM AT COST 4,000 3,921
    VANGUARD TOTAL BOND MKT INDEX      
    ADM SHS 584 AT COST 34,085 31,853
    WESTERN ASSETCORE PLUS BOND FD CI I AT COST 27,230 22,416
    JP MORGAN INCOME BUILDER FD CL I AT COST 28,644 25,460
    T ROWE PRICE BALANCED FD CI I AT COST 26,095 28,717
    VANGUARD BALANCED INDEX FD      
    ADM SHS 502 AT COST 33,000 40,158
    DWS CORE EQUITY FUND CI S AT COST 18,834 27,427
    FEDERATED MDT LG CAP VALUE FD IS 22 AT COST 14,000 15,779
    FEDERATED MID-CAP INDEX FD IS 153 AT COST 18,486 18,831
    FEDERATED STRATEGIC VALUE DIV      
    FD CL IS 662 AT COST 33,780 37,606
    FIDELITY ADV EQUITY INCOME FD 80 AT COST 24,130 28,773
    FIDELITY ADV GROWTH OPPORT      
    FD CI I 688 AT COST 9,821 24,331
    FIDELITY ADV STRATEGIC DIV & INCOME      
    FD CL I AT COST 24,000 26,661
    FIDELITY EQUITY DIV INC FUND 319 AT COST 28,005 32,997
    T ROWE PRICE CAP APPREC FUND CI I AT COST 26,045 50,845
    T ROWE PRICE MID CAP GROWTH FD CI I AT COST 12,516 31,254
    VANGUARD EQUITY INC FD 565 ADM SHS AT COST 26,000 33,089
    VANGUARD GROWTH INDX FD ADM SHS 509 AT COST 27,006 46,761
    VANGUARD REIT INDEX FD ADM SHS 5123 AT COST 5,000 4,853
    VANGUARD TOTAL STOCK MKT INDEX ADM      
    SHS FD 585 AT COST 15,278 54,491
    VANGUARD WELLESLEY INCOM FD ADM 527 AT COST 41,000 42,584
    VANGUARD WELLINGTON FD ADM 521 AT COST 37,365 48,167
    T ROWE PRICE GLOBAL STOCK FUND AT COST 14,889 25,110
    VANGUARD INTL GROWTH FUND ADM AT COST 13,475 16,503

    TY 2021 LegalFeesSchedule
    Name:
    ALLISON EVERETT PEARSON FOUNDATION
    EIN:
    42-6122181
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT LEGAL FEES 1,049 1,049    


    TY 2021 TaxesSchedule
    Name:
    ALLISON EVERETT PEARSON FOUNDATION
    EIN:
    42-6122181
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN W/H TAX 30 30    
    FEDERAL ESTIMATED TAX PAYMENTS 1,300