DAVID S AND BRENDA K CARLSON FOUNDATION: Form 990PF, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: DAVID S AND BRENDA K CARLSON FOUNDATION (EIN 68-0467243)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-10-12
IRS object ID: 202302859349100715
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990-PF
Accounting Fees Schedule
Investments Corp Bonds Schedule
Investments Corp Stock Schedule
Investments Govt Obligations Sch
Investments Other Schedule2
Legal Fees Schedule
Other Expenses Schedule
Other Increases Schedule
Other Professional Fees Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-10-12T12:45:23-04:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	208169085	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Mark Halversen CPA	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 23499	AddressLine1Txt
City	Pleasant Hill	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	945230499	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	680467243	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE DAVID S AND BRENDA K CARLSON FO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	DAVI	BusinessNameControlTxt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	889 MOHICAN COURT	AddressLine1Txt
City	WALNUT CREEK	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94598	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVID S CARLSON	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	9254484554	PhoneNum
Signature	2023-10-11	SignatureDt
Discuss With Paid Preparer	false	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	DAVID	PersonFirstNm
Person Last	CARLSON	PersonLastNm

Field	Value	IRS element (for citing)
SSN	XXX-XX-XXXX	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Mark Halversen	PreparerPersonNm
PTIN	P01243703	PTIN
Phone	9256871040	PhoneNum
Preparation	2023-10-12	PreparationDt
Self Employed	Yes (X)	SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	0	TrustedCustomerCd
OOB Security Verification	00	OOBSecurityVerificationCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Organization501c3 Exempt PF	Yes (X)	Organization501c3ExemptPFInd
FMV Assets EOY	$2,030,773	FMVAssetsEOYAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Schedule B Not Required	Yes (X)	ScheduleBNotRequiredInd
Dividends Rev And Expnss	$118,955	DividendsRevAndExpnssAmt
Dividends Net Invst Incm	$118,955	DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss	-$76,560	NetGainSaleAstRevAndExpnssAmt
Gross Sales Price	$136,079	GrossSalesPriceAmt
Total Rev And Expnss	$42,395	TotalRevAndExpnssAmt
Total Net Invst Incm	$118,955	TotalNetInvstIncmAmt
Legal Fees Rev And Expnss	$50	LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm	$50	LegalFeesNetInvstIncmAmt
Accounting Fees Rev And Expnss	$250	AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm	$250	AccountingFeesNetInvstIncmAmt
Other Prof Fees Rev And Expnss	$150	OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm	$150	OtherProfFeesNetInvstIncmAmt
Taxes Rev And Expnss	$182	TaxesRevAndExpnssAmt
Taxes Net Invst Incm	$182	TaxesNetInvstIncmAmt
Other Expenses Rev And Expnss	$57	OtherExpensesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss	$689	TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm	$632	TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl	$0	TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss	$133,990	ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl	$0	ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss	$134,679	TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm	$632	TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl	$0	TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses	-$92,284	ExcessRevenueOverExpensesAmt
Net Investment Income	$118,323	NetInvestmentIncomeAmt
Adjusted Net Income	$0	AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

Field	Value	IRS element (for citing)
Cash BOY	$7,241	CashBOYAmt
Cash EOY	$33,481	CashEOYAmt
Cash EOYFMV	$33,481	CashEOYFMVAmt
US Government Obligations BOY	$228,442	USGovernmentObligationsBOYAmt
US Government Obligations EOY	$0	USGovernmentObligationsEOYAmt
Corporate Stock BOY	$443,161	CorporateStockBOYAmt
Corporate Stock EOY	$452,391	CorporateStockEOYAmt
Corporate Stock EOYFMV	$544,032	CorporateStockEOYFMVAmt
Corporate Bonds BOY	$1,234,714	CorporateBondsBOYAmt
Corporate Bonds EOY	$87,559	CorporateBondsEOYAmt
Corporate Bonds EOYFMV	$63,975	CorporateBondsEOYFMVAmt
Other Investments EOY	$1,248,718	OtherInvestmentsEOYAmt
Other Investments EOYFMV	$1,389,285	OtherInvestmentsEOYFMVAmt
Total Assets BOY	$1,913,558	TotalAssetsBOYAmt
Total Assets EOY	$1,822,149	TotalAssetsEOYAmt
Total Assets EOYFMV	$2,030,773	TotalAssetsEOYFMVAmt
Total Liabilities BOY	$0	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117	Yes (X)	OrgDoesNotFollowFASB117Ind
Capital Stock BOY	$2,676,583	CapitalStockBOYAmt
Capital Stock EOY	$2,030,773	CapitalStockEOYAmt
Retained Earning BOY	-$763,025	RetainedEarningBOYAmt
Retained Earning EOY	-$208,624	RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY	$1,913,558	TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY	$1,822,149	TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY	$1,913,558	TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY	$1,822,149	TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

Field	Value	IRS element (for citing)
Tot Net Ast Or Fund Balances BOY	$1,913,558	TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses	-$92,284	ExcessRevenueOverExpensesAmt
Other Increases	$875	OtherIncreasesAmt
Subtotal	$1,822,149	SubtotalAmt
Tot Net Ast Or Fund Balances EOY	$1,822,149	TotNetAstOrFundBalancesEOYAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

Field	Value	IRS element (for citing)
Investment Income Excise Tax	$1,645	InvestmentIncomeExciseTaxAmt
Tax Under Section511	$0	TaxUnderSection511Amt
Subtotal	$1,645	SubtotalAmt
Subtitle A Tax	$0	SubtitleATaxAmt
Tax Based On Investment Income	$1,645	TaxBasedOnInvestmentIncomeAmt
Tax Due	$1,645	TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

Field	Value	IRS element (for citing)
Legislative Political Acty	false	LegislativePoliticalActyInd
More Than100 Spent	false	MoreThan100SpentInd
Form1120 POL Filed	false	Form1120POLFiledInd
Activities Not Previously Rpt	false	ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws	false	ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc	false	OrganizationDissolvedEtcInd
Section508e Rqr Satisfied	Yes (true)	Section508eRqrSatisfiedInd
At Least5000 In Assets	Yes (true)	AtLeast5000InAssetsInd
Org Report Or Register State	CA	OrgReportOrRegisterStateCd
Form990 PF Filed With Atty Gen	Yes (true)	Form990PFFiledWithAttyGenInd
Private Operating Foundation	false	PrivateOperatingFoundationInd
New Substantial Contributors	false	NewSubstantialContributorsInd
Own Controlled Entity	false	OwnControlledEntityInd
Donor Advised Fund	false	DonorAdvisedFundInd
Comply With Public Insp Rqr	false	ComplyWithPublicInspRqrInd
Individual With Books	DAVID S CARLSON	IndividualWithBooksNm
Phone	9254484554	PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

Field	Value	IRS element (for citing)
Address Line1	889 MOHICAN CT	AddressLine1Txt
City	WALNUT CREEK	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94598	ZIPCd

Field	Value	IRS element (for citing)
Foreign Accounts Question	false	ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

Field	Value	IRS element (for citing)
Sale Or Exch Disqualified Prsn	false	SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn	false	BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn	false	FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn	false	PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn	false	TransferAstDisqualifiedPrsnInd
Payment To Government Official	false	PaymentToGovernmentOfficialInd
Uncorrected Prior Acts	false	UncorrectedPriorActsInd
Undistributed Income PY	false	UndistributedIncomePYInd
Undistr Incm Sect4942a2 Not App	false	UndistrIncmSect4942a2NotAppInd
Business Holdings	false	BusinessHoldingsInd
Jeopardy Investments	false	JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst	false	UncorrectedPYJeopardyInvstInd
Influence Legislation	false	InfluenceLegislationInd
Influence Election	false	InfluenceElectionInd
Grants To Individuals	false	GrantsToIndividualsInd
Grants To Organizations	false	GrantsToOrganizationsInd
Noncharitable Purpose	false	NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	TitleTitleTxt	Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt	CompensationCompensationAmt	Employee Benefit ProgramEmployeeBenefitProgramAmt	Expense Account Other AllwncExpenseAccountOtherAllwncAmt
DAVID S CARLSON
889 MOHICAN CT	WALNUT CREEK	CA	94598	CEO	0.00	$0	$0	$0
BRENDA K CARLSON
889 MOHICAN CT	WALNUT CREEK	CA	94598	CFO AND SECR	0.00	$0	$0	$0

Field	Value	IRS element (for citing)
Comp Of Hghst Pd Empl Or NONE	NONE	CompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k	0	OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONE	NONE	CompOfHghstPdCntrctOrNONETxt

Minimum Investment Return MinimumInvestmentReturnGrp

Field	Value	IRS element (for citing)
Average Monthly FMV Of Sec	$1,997,292	AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances	$33,481	AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast	$0	FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets	$2,030,773	TotalFMVOfUnusedAssetsAmt
Acquisition Indebtedness	$0	AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast	$2,030,773	AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable	$30,462	CashDeemedCharitableAmt
Net Vl Noncharitable Assets	$2,000,311	NetVlNoncharitableAssetsAmt
Minimum Investment Return	$100,016	MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
Sect4942j3j5 Fndtn And Frgn Org	Yes (X)	Sect4942j3j5FndtnAndFrgnOrgInd

PF Qualifying Distributions PFQualifyingDistributionsGrp

Field	Value	IRS element (for citing)
Expenses And Contributions	$0	ExpensesAndContributionsAmt

Supplementary Information SupplementaryInformationGrp

Field	Value	IRS element (for citing)
Contributing Manager	DAVID CARLSON	ContributingManagerNm
Contributing Manager	BRENDA CARLSON	ContributingManagerNm
Shareholder Manager	NONE	ShareholderManagerNm
Only Contri To Preselected	Yes (X)	OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (10 entries)

Address Line1RecipientUSAddress/AddressLine1Txt	CityRecipientUSAddress/CityNm	State AbbreviationRecipientUSAddress/StateAbbreviationCd	ZIPRecipientUSAddress/ZIPCd	Recipient RelationshipRecipientRelationshipTxt	Recipient Foundation StatusRecipientFoundationStatusTxt	Grant Or Contribution PurposeGrantOrContributionPurposeTxt	AmtAmt
NORTH PARK UNIVERSITY
3225 W FOSTER AVE	CHICAGO	IL	60625	NONE	NC	PRIVATE UNIVERSITY EVANGELICAL COVENANT	$64,800
LOAVES AND FISHES OF CONTRA COSTA
835 FERRY ST	MARTINEZ	CA	94553	NONE	PC	FEEDING THE POOR	$5,000
SALVATION ARMY
615 SLATERS LANE	ALEXANDRIA	VA	22314	NONE	PC	PROVIDING ASSISTANCE TO THE POOR	$15,000
ST JOHNS LUTHERAN CHURCH
1360 E TREGALLAS RD	ANTIOCH	CA	94509	NONE	PC	RELIGIOUS MINISTERING	$12,000
JOHN MUIR HEALTH FOUNDATION
1400 TREAT BLVD	WALNUT CREEK	CA	94597	NONE	POF	SUPPORT FOR HOSPITAL PATIENT CARE	$5,000
SHRINERS FOR CHILDREN HOSPITAL
2900 N ROCKY POINT DR	TAMPA	FL	33607	NONE	POF	PATIENT CARE RESEARCH AND EDUCATION	$16,000
UCSF FOUNDATION RHEUMATOLOGY
10 KORET WAY	SAN FRANCISCO	CA	94143	NONE	POF	MEDICAL RESEARCH AND TRAINING	$16,000
CARINGBRIDGE
PO BOX 6032	ALBERT LEA	MN	56007	NONE	PC	RESOURCE FOR HEALTH STATUS UPDATES TO OTHERS	$30
HENRY KNUEPPIE FOUNDATION
4939 W MONTROSE AVE	CHICAGO	IL	60641	NONE	PF	ST JOHNS LUTHERAN SCHOOL	$100
ELDER LOVE USA
41550 ECLECTIC ST	PALM DESERT	CA	92260	N	PC	IN HOME HEALTH SERVICES	$60

Field	Value	IRS element (for citing)
Total Grant Or Contri Pd Dur Yr	$133,990	TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut	$0	TotalGrantOrContriApprvFutAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

Field	Value	IRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO	false	TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO	false	TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets	false	SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO	false	PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets	false	RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements	false	ReimbursementArrangementsInd
Loans Or Loan Guarantees	false	LoansOrLoanGuaranteesInd
Performance Of Services Etc	false	PerformanceOfServicesEtcInd
Sharing Of Facilities Etc	false	SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO	false	RelationshipsNonchrtblEOInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

Field	Value	IRS element (for citing)
Category	ACCOUNING	CategoryTxt
Amt	$250	Amt
Net Investment Income	$250	NetInvestmentIncomeAmt
Adjusted Net Income	$0	AdjustedNetIncomeAmt
Disbursements Charitable Prps	$0	DisbursementsCharitablePrpsAmt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (2 entries)

BondBondNm	EOY Book ValueEOYBookValueAmt	EOYFMVEOYFMVAmt
BONDS	$87,559	$63,975
PCM	$0	$0

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

Field	Value	IRS element (for citing)
Stock	SECURITIES	StockNm
EOY Book Value	$452,391	EOYBookValueAmt
EOYFMV	$544,032	EOYFMVAmt

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

Field	Value	IRS element (for citing)
US Govt Obligations Book Vl EOY	$0	USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV	$0	USGovtObligationsEOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (2 entries)

Category Or ItemCategoryOrItemTxt	Book ValueBookValueAmt	EOYFMVEOYFMVAmt
MUTUAL FUNDS	$1,248,718	$1,389,285
CL END FUND	$0	$0

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

Field	Value	IRS element (for citing)
Category	LEGAL	CategoryTxt
Legal Fees	$50	LegalFeesAmt
Net Investment Income	$50	NetInvestmentIncomeAmt
Adjusted Net Income	$0	AdjustedNetIncomeAmt
Disbursements Charitable Prps	$0	DisbursementsCharitablePrpsAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

Field	Value	IRS element (for citing)
Desc	FEDERAL TAX PAYMENTS	Desc
Revenue And Expenses Per Books	$57	RevenueAndExpensesPerBooksAmt
Net Investment Income	$0	NetInvestmentIncomeAmt
Adjusted Net Income	$0	AdjustedNetIncomeAmt
Disbursements Charitable Prps	$0	DisbursementsCharitablePrpsAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

Field	Value	IRS element (for citing)
Desc	DIFFERENCE IN COST BASIS AND MKT VA	Desc
Amt	$875	Amt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

Field	Value	IRS element (for citing)
Category	OTHER PROFESSIONAL	CategoryTxt
Amt	$150	Amt
Net Investment Income	$150	NetInvestmentIncomeAmt
Adjusted Net Income	$0	AdjustedNetIncomeAmt
Disbursements Charitable Prps	$0	DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxt	AmtAmt	Net Investment IncomeNetInvestmentIncomeAmt	Adjusted Net IncomeAdjustedNetIncomeAmt	Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt
STATE OF CALIFORNIA	$182	$182	$0	$0
FRANCHISE TAX BOARD	$0	$0	$0	$0