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 01-01-2021 , and ending 12-31-2021
Name of foundation
AbbVie Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)1 North Waukegan Road
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
North Chicago, IL60064
A Employer identification number

46-0827839
B Telephone number (see instructions)

(847) 938-8188
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$222,134,337J 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) 211
2 Check bullet.............
3 Interest on savings and temporary cash investments 198,099 198,099  
4 Dividends and interest from securities... 3,811,143 3,811,143  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 0
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances 0
b Less: Cost of goods sold.... 0
c Gross profit or (loss) (attach schedule)..... 0  
11 Other income (attach schedule)....... 605 0 0
12 Total. Add lines 1 through 11........ 4,010,058 4,009,242 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... 101,091 0 0 100,827
b Accounting fees (attach schedule)....... 79,236 39,618 0 0
c Other professional fees (attach schedule).... 0 0 0 0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 53,762 0 0 0
19 Depreciation (attach schedule) and depletion... 0 0 0
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 2,804,890 2,000 0 2,351,240
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 3,038,979 41,618 0 2,452,067
25 Contributions, gifts, grants paid....... 41,728,245 41,728,245
26 Total expenses and disbursements. Add lines 24 and 25 44,767,224 41,618 0 44,180,312
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -40,757,166
b Net investment income (if negative, enter -0-) 3,967,624
c Adjusted net income (if negative, enter -0-)... 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.............      
2 Savings and temporary cash investments......... 112,059,441 71,774,415 71,774,415
3 Accounts receivable bullet15,774
Less: allowance for doubtful accounts bullet   35,077 15,774 15,774
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet   0 0 0
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)..... 0 0 0
7 Other notes and loans receivable (attach schedule) bullet0
Less: allowance for doubtful accounts bullet0 0 0 0
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 0 0 0
b Investments—corporate stock (attach schedule)....... 420,920 420,920 150,344,148
c Investments—corporate bonds (attach schedule)....... 0   0
11 Investments—land, buildings, and equipment: basis bullet0
Less: accumulated depreciation (attach schedule) bullet0 0   0
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 0 0 0
14 Land, buildings, and equipment: basis bullet0
Less: accumulated depreciation (attach schedule) bullet0 0   0
15 Other assets (describe bullet) 0 0 0
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 112,515,438 72,211,109 222,134,337
Liabilities 17 Accounts payable and accrued expenses.......... 0 2,550
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons 0 0
21 Mortgages and other notes payable (attach schedule)...... 0 0
22 Other liabilities (describe bullet) 1,633,646 2,083,933
23 Total liabilities (add lines 17 through 22)......... 1,633,646 2,086,483
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........... 110,881,792 70,124,626
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    
29 Total net assets or fund balances (see instructions)..... 110,881,792 70,124,626
30 Total liabilities and net assets/fund balances (see instructions). 112,515,438 72,211,109
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
110,881,792
2
Enter amount from Part I, line 27a .....................
2
-40,757,166
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
70,124,626
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
70,124,626
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.)
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) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 0
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 0
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 55,150
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 55,150
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 50,872
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 50,872
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 4,278
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11 0
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:
round bullet By language in the governing instrument, or
round bullet 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 XIV..................................
7
Yes
 
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
bulletIL
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
Yes
 
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
 
Website addressbullethttps://www.abbviefoundation.org/
14
The books are in care ofbulletTracie Haas Telephone no.bullet (847) 935-1112

Located atbullet1 North Waukegan RdNorth ChicagoIL ZIP+4bullet60064
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)
Yes
 
(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
 
No
c
Organizations relying on a current notice regarding disaster assistance check here ........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
 
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 2021, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) 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)
Yes
 
(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
Organizations relying on a current notice regarding disaster assistance check .........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
Yes
 
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
Timothy Kolenda ASSISTANT TREASURER
1.000 		0 0 0
1 North Waukegan Road
NORTH CHICAGO,IL60064
EMILY ALEXANDER SECRETARY
1.000 		0 0 0
1 North Waukegan Road
NORTH CHICAGO,IL60064
RICHARD A GONZALEZ DIRECTOR
1.000 		0 0 0
1 NORTH WAUKEGAN ROAD
NORTH CHICAGO,IL60064
LAURA SCHUMACHER DIRECTOR
1.000 		0 0 0
1 NORTH WAUKEGAN ROAD
NORTH CHICAGO,IL60064
TRACIE HAAS DIRECTOR & PRESIDENT
4.000 		0 0 0
1 North Waukegan Road
NORTH CHICAGO,IL60064
WAYNE KLINTWORTH TREASURER
0.500 		0 0 0
1 North Waukegan Road
NORTH CHICAGO,IL60064
Claudia Carravetta VICE PRESIDENT
16.000 		0 0 0
1 North Waukegan Road
North Chicago,IL60064
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
 
Total number of other employees paid over $50,000...................bullet 0
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
Executive Medical Services PC Covid-19 vaccine clinic for seniors 1,879,800
15 Canal Road Pelham Manor
New York,NY10803
Simpson Thacher & Bartlett LLP Legal Services 98,092
425 Lexington Avenue
New York,NY10017
Total number of others receiving over $50,000 for professional services.............bullet2
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 NONE  
2  
All other program-related investments. See instructions.
3  
Total. Add lines 1 through 3.........................bullet0
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
127,631,549
b
Average of monthly cash balances.......................
1b
100,163,862
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
227,795,411
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
227,795,411
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
3,416,931
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
224,378,480
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
11,218,924
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
11,218,924
2a
Tax on investment income for 2021 from Part V, line 5.......
2a
55,150
b
Income tax for 2021. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
55,150
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
11,163,774
4
Recoveries of amounts treated as qualifying distributions................
4
 
5
Add lines 3 and 4............................
5
11,163,774
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
11,163,774
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
44,180,312
b
Program-related investments—total from Part VIII-B..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes...............................
2
 
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)....................
3a
 
b
Cash distribution test (attach the required schedule) .................
3b
0
4
Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
4
44,180,312
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 11,163,774
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only....... 0
b Total for prior years:2019, 2018, 2017 0
3 Excess distributions carryover, if any, to 2021:
a From 2016...... 18,590,750
b From 2017...... 22,220,650
c From 2018...... 25,481,074
d From 2019...... 28,262,974
e From 2020...... 55,142,979
f Total of lines 3a through e ........ 149,698,427
4Qualifying distributions for 2021 from Part
XI, line 4: bullet$ 44,180,312
a Applied to 2020, but not more than line 2a 0
b Applied to undistributed income of prior years
(Election required—see instructions)..... 		0
c Treated as distributions out of corpus (Election
required—see instructions)........ 		0
d Applied to 2021 distributable amount..... 11,163,774
e Remaining amount distributed out of corpus 33,016,538
5 Excess distributions carryover applied to 2021.   0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6Enter the net total of each column as
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 182,714,965
b Prior years’ undistributed income. Subtract
line 4b from line 2b .......... 		0
c Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed...... 		 
d Subtract line 6c from line 6b. Taxable amount
—see instructions ........... 		0
e Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions ............. 		0
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) ....... 		0
8 Excess distributions carryover from 2016 not
applied on line 5 or line 7 (see instructions) ... 		18,590,750
9 Excess distributions carryover to 2022.
Subtract lines 7 and 8 from line 6a ...... 		164,124,215
10 Analysis of line 9:
a Excess from 2017.... 22,220,650
b Excess from 2018.... 25,481,074
c Excess from 2019.... 28,262,974
d Excess from 2020.... 55,142,979
e Excess from 2021.... 33,016,538
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 IX 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 email address of the person to whom applications should be addressed:
bThe form in which applications should be submitted and information and materials they should include:
cAny submission deadlines:
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
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

Alzheimer's Greater Los Angeles

4221 WILSHIRE BLVD STE 400
Los Angeles,CA900103504 		N/A PC General Mission 10,000

American Association of Pharmaceutical Scientists (USC Chapter)

1985 Zonal Avenue PSC 608
Los Angeles,CA90089 		N/A PC General Mission 10,000

American Glaucoma Society Foundation

655 BEACH STREET
SAN FRANCISCO,CA941091342 		N/A PC General Mission Support 175,000

Angel Faces

770 Rancho Santa Fe Road Suite 10
ENCINITAS,CA920244356 		N/A PC General Mission 10,000

Armenian EyeCare Project

100 W Foothill Blvd Ste 203
San Dimas,CA91773 		N/A PC General Mission 10,000

Association of University Professors of Ophthalmology

655 Beach Street
San Francisco,CA94109 		N/A PC General Mission 25,000

Breast Cancer Solutions

25422 TRABUCO RD STE 105 167
LAKE FOREST,CA926302796 		N/A PC General Mission 12,000

CSULB 49er Foundation

6300 E STATE UNIVERSITY DR
LONG BEACH,CA908154669 		N/A PC General Mission 10,000

Cal State Fullerton Philanthropic Foundation

2600 NUTWOOD AVE STE 850
Fullerton,CA928314669 		N/A PC General Mission 15,000

Chapman University

1 UNIVERSITY DR
ORANGE,CA928661005 		N/A PC General Mission Support 40,000

Direct Relief

6100 Wallace Becknell Road
Santa Barbara,CA931173214 		N/A PC COVID-19 Response in India 150,000

Direct Relief

6100 Wallace Becknell Road
Santa Barbara,CA931173214 		N/A PC Fund for Health Equity 1,900,000

Direct Relief

6100 Wallace Becknell Road
Santa Barbara,CA931173214 		N/A PC Improving Health Access for Pediatric Cancer Patients in Underserved Communities in Mexico 400,000

Discovery Science Center of Orange County

2500 N MAIN ST
SANTA ANA,CA927056600 		N/A PC General Mission 10,000

Fresh Start Surgical Gifts

2011 PALOMAR AIRPORT ROAD SUITE 206
CARLSBAD,CA920111430 		N/A PC Surgery Weekend Program 25,000

Glaucoma Research Foundation

251 POST ST STE 600
SAN FRANCISCO,CA941085017 		N/A PC General Mission 50,000

Hispanic Scholarship Fund

HSFnet
Gardena,CA90248 		N/A PC HSF General Operating Support 10,000

Iola Foundation

7288 Sunset Blvd Ste 207
Los Angeles,CA90046 		N/A PC General Mission 50,000

Marshall B Ketchum University

2575 YORBA LINDA BLVD
FULLERTON,CA928311615 		N/A PC General Mission 10,000

Mission Plasticos

8502 E CHAPMAN AVE 447
Orange,CA928692461 		N/A PC General Mission 50,000

National Spasmodic Torticollis Association

14772 MORAN ST
WESTMINSTER,CA926835553 		N/A PC General Mission 10,000

Ophthalmology Foundation

2261 MARKET STREET 445
SAN FRANCISCO,CA941141612 		N/A PC General Mission 50,000

Resurge International

145 Wolfe Rd
Sunnyvale,CA94086 		N/A PC General Mission Support 25,000

The Aesthetic Surgery Education and Research Foundation

11262 MONARCH STREET
GARDEN GROVE,CA928411437 		N/A PC General Mission 50,000

The Trevor Project Inc

PO Box 69232
WEST HOLLYWOOD,CA900694555 		N/A PC General Mission _The Trevor Project: Saving Young LGBTQ Lives 50,000

UCSF Benioff Children's Hospitals Foundation

2201 BROADWAY STE 600
Sunnyvale,CA94086 		N/A PC General Mission Support 10,000

United Cerebral Palsy Association of Orange County Inc

1251 E Dyer Rd Suite 150
Santa Ana,CA92705 		N/A PC General Mission 25,000

University of California Irvine Foundation

100 Theory Suite 250
Irvine,CA92619 		N/A PC General Mission 105,000

University of California Irvine Foundation

100 Theory Suite 250
Irvine,CA92619 		N/A PC UCI SAGE Scholars 100,000

Women in Ophthalmology

655 Beach Street
San Francisco,CA94109 		N/A PC WIO 2021 Summer Symposium 25,000

National Asian American Pacific Islander Mental Health Association

777 W WASHINGTON STREET 707
DENVER,CO802030000 		N/A PC General Mission 25,000

OPTOMETRY GIVING SIGHT

1019 8TH STREET 304
GOLDEN,CO80401 		N/A PC General Mission Support 15,000

Americares

88 Hamilton Ave
Stamford,CT06902 		N/A PC Americares India Covid-19 2021 Response 500,000

KaBOOM

4301 CONNECTICUT AVE NW Suite ML-1
WASHINGTON,DC200082304 		N/A PC 2022 KABOOM! WOP Build Projects 56,250

NATIONAL ASSOCIATION OF NURSE PRACTITIONERS IN WOMENS HEALTH INC

Post Office Box 15837
WASHINGTON,DC20003 		N/A PC General Mission 25,000

National Alliance for Caregiving

1730 RHODE ISLAND AVE NW STE
WASHINGTON,DC200363114 		N/A PC In Support of Mission Work 15,000

National Breast Cancer Coalition Fund

2001 L Street NW Suite 500 PMB 5011
11
WASHINGTON,DC20036 		N/A PC General Mission 25,000

National Council for Mental Wellbeing

1400 K ST NW STE 400
WASHINGTON,DC200052434 		N/A PC General Mission 50,000

Paralyzed Veterans of America

801 EIGHTEENTH ST NW
WASHINGTON,DC200063517 		N/A PC General Mission 30,000

Project HOPE - The People-to-People Health Foundation Inc

1220 19th Street NW Suite 800
Washington,DC20036 		N/A PC Project HOPE's COVID-19 Response in Brazil 200,000

Project HOPE - The People-to-People Health Foundation Inc

1220 19th Street NW Suite 800
Washington,DC20036 		N/A PC Project HOPE's COVID-19 Response in India 350,000

The Heart of America Foundation

655 15th Street NW Suite 800
Washington,DC20785 		N/A PC 2022 Week of Possibilities Transformation Projects 450,000

United Negro College Fund

1805 7TH STREET NW
WASHINGTON,DC200013186 		N/A PC UNCF Healthcare Workforce Diversity Program 2,400,000

American Academy of Optometry Foundation

622 E WASHINGTON ST STE 300
ORLANDO,FL328012972 		N/A PC General Mission Support 75,000

FORCE-Facing Our Risk of Cancer Empowered

16057 TAMPA PALMS BLVD WEST NO 37
TAMPA,FL336472001 		N/A PC General Mission Support 25,000

MAP International

4700 Glynco Parkway
Brunswick,GA31525 		N/A PC General Mission 200,000

AMERICAN SOCIETY FOR DERMATOLOGIC SURGERY

5550 MEADOWBROOK INDUSTRIAL CT 120
ROLLING MDWS,IL600083805 		N/A PC General Support 250,000

Arden Shore Child and Family Services

329 N GENESEE ST
WAUKEGAN,IL600854205 		N/A PC Chagas Disease Prevention and Control in Rural Bolivia Municipalities of Morochata & Tiquipaya 40,000

Asian Americans Advancing Justice Chicago

4716 N BROADWAY ST
CHICAGO,IL606404997 		N/A PC General Mission 500,000

Beacon Place NFP

603 South McAlister Avenue
Waukegan,IL60085 		N/A PC Beacon Place Community Center Support 175,000

Bernie's Book Bank

917 North Shore Drive
Lake Bluff,IL60044 		N/A PC Bernie's Book Bank General Operating Support 345,000

Boys & Girls Club of Lake County

1801 Sheridan Road
North Chicago,IL60064 		N/A PC General Mission 25,000

CASA Lake County Inc

700 Forest Edge Dr
Vernon Hills,IL600613172 		N/A PC General Mission Support 25,000

Chocolate Chips Association

5010 RED PINE AVE
GURNEE,IL600313389 		N/A PC General Mission_ Girls STEAM Program 50,000

Cradles to Crayons Inc

4141 West George Street
Chicago,IL60641 		N/A PC Everyday Essentials for Children 400,000

Cristo Rey St Martin College Prep

3106 Belvidere Road
WAUKEGAN,IL60085 		N/A PC General Mission 50,000

Depression and Bipolar Support Alliance

55 E JACKSON BLVD STE 490
Chicago,IL606044396 		N/A PC General Mission 75,000

Dystonia Medical Research Foundation

1 E WACKER DR STE 1730
Chicago,IL606011980 		N/A PC General Mission 75,000

Erie Family Health Centers

1701 W Superior Street
Chicago,IL60622 		N/A PC General Operations, Erie HealthReach Waukegan Health Center 50,000

Foundation for PM&R

9700 BRYN MAWR AVE STE 200
ROSEMONT,IL600185706 		N/A PC General Mission 10,000

Girls 4 Science

PO BOX 288958
CHICAGO,IL606288958 		N/A PC General mission 25,000

Habitat for Humanity Lake County IL Inc

315 N MARTIN LUTHER KING JR AVE
WAUKEGAN,IL600854207 		N/A PC 2 home builds North Chicago 300,000

Have Dreams

515 BUSSE HWY STE 150
PARK RIDGE,IL600683155 		N/A PC Mission Support : Have Dreams Academy Workforce Development Program for Individuals with Autism Spectrum Disorder 50,000

Illinois Science & Technology Institute

20 N Wacker Dr Suite 1200
Chicago,IL60606 		N/A PC 2020-2021 STEM Challenge 42,500

Illinois Science & Technology Institute

20 N Wacker Dr Suite 1200
Chicago,IL60606 		N/A PC STEM Challenge 56,000

Innovations for Learning

1570 Elmwood Ave Apt 503
EVANSTON,IL60201 		N/A PC North Chicago Literacy 25,000

Lake County Crisis Center

2710 17TH STREET
ZION,IL600991543 		N/A PC General Mission 100,000

Lake County Veterans and Family Services Foundation

100 South Atkinson Road Ste 110
Grayslake,IL60030 		N/A PC General Operating 50,000

Little City Foundation

1760 W Algonquin Road
Palatine,IL600674791 		N/A PC General Mission 50,000

Mothers Trust Foundation

400 E ILLINOIS RD
LAKE FOREST,IL600452355 		N/A PC General Mission 25,000

National Headache Foundation

820 North Orleans St
Chicago,IL60610 		N/A PC General Mission 40,000

National Spasmodic Dysphonia Association

300 PARK BLVD STE 175
ITASCA,IL601432661 		N/A PC general mission support 10,000

North Chicago Community Partners

855 Skokie Highway Suite D
Lake Bluff,IL60044 		N/A POF K-12 Community School Initiative 575,000

Northern Illinois Food Bank

273 DEARBORN CT
GENEVA,IL601343587 		N/A PC General Mission 50,000

PADS Lake County Inc

1800 Grand Avenue
Waukegan,IL60085 		N/A PC General Mission Support 25,000

Prairie State Legal Services Inc

303 N MAIN ST STE 600
ROCKFORD,IL611011050 		N/A PC General Mission Support 25,000

Providence St Mel School

119 S CENTRAL PARK BLVD
CHICAGO,IL606242941 		N/A PC AbbVie Scholarships and the Academic Intervention Model 300,000

Reading Power Inc

736 N Western Ave Suite 226
Lake Forest,IL60045 		N/A PC General Mission Support 50,000

SUFU Foundation

1100 EAST WOODFIELD RD
SCHAUMBURG,IL601735116 		N/A PC SUFU Foundation Operational Funding 75,000

Simon Foundation

3621 THAYER ST
EVANSTON,IL602014951 		N/A PC General Mission 10,000

Teach For America

300 West Adams Suite 1000
Chicago,IL60606 		N/A PC Expanding Impact for North Chicago Students through Teacher Recruitment and Support 122,000

The American Academy of Physical Medicine and Rehabilitation

9700 BRYN MAWR AVE STE 200
ROSEMONT,IL600185706 		N/A PC General Mission Support 75,000

Transform for Kids

855 Skokie Highway Suite D
Lake Bluff,IL60044 		N/A NC Week of Possibilities 2022 60,000

Transitional Living Services

805 S McHenry Ave Suite D
Crystal Lake,IL60014 		N/A PC General Mission 50,000

United Way of Lake County

330 S GREENLEAF ST
GURNEE,IL600313389 		N/A PC General Mission 25,000

University of Chicago

5801 S ELLIS AVENUE
CHICAGO,IL606375418 		N/A PC Liaison in Care Program (LinC): Empowering our Community to Reduce Health Disparities 1,500,000

University of Chicago

5801 S ELLIS AVENUE
CHICAGO,IL606375418 		N/A PC Shaping the Future of Cancer Research and Care 2,000,000

YBLC Inc

2303 Kemble Ave
North Chicago,IL600643216 		N/A PC General Mission 50,000

American Academy of Family Physicians Foundation

11400 TOMAHAWK CREEK PARKWAY SUITE
LEAWOOD,KS662112680 		N/A PC General Support 50,000

American Chronic Pain Association

11936 W 119th Street
Overland Park,KS66213 		N/A PC General Mission 10,000

Association of Schools and Colleges of Optometry Inc

6110 EXECUTIVE BLVD STE 420
ROCKVILLE,MD208523942 		N/A PC General Mission Support 20,000

Pelvic Floor Disorders Research Foundation

1100 WAYNE AVE STE 825
SILVER SPRING,MD209105670 		N/A PC 2021 PFD Research Foundation Grants Program 25,000

Urology Care Foundation

1000 Corporate Blvd
Linthicum,MD21090 		N/A PC General Mission 30,000

A Little Easier Recovery Inc

1 PARKER STREET Ste 2F
LAWRENCE,MA018431540 		N/A PC General Mission 25,000

City Year Inc

287 COLUMBUS AVE
BOSTON,MA021165334 		N/A PC Team Sponsorship - City Year Los Angeles 100,000

Families for Depression Awareness

391 TOTTEN POND RD STE 101
WALTHAM,MA024512014 		N/A PC General Mission 30,000

Family Reach Foundation

142 Berkeley Street 3rd Floor
Boston,MA02116 		N/A PC Family Reach Financial Treatment Program and LiFT Network 800,000

Oneinforty

PO Box 705
Westborough,MA01581 		N/A PC Programmatic Activities 25,000

Partners In Health

800 Boylston St Suite 300
Boston,MA02199 		N/A PC Strengthening Community Health in Mexico 400,000

Reconstructing Women International

239 Commonwealth Avenue
Boston,MA02116 		N/A PC Reconstructive Surgery for Women in East Africa 50,000

United Way of Central Massachusetts

484 Main Street Suite 300
Worcester,MA016081817 		N/A PC Reading Together 165,000

Year Up Inc

45 MILK STREET 9TH FLOOR
BOSTON,MA021095165 		N/A PC Year Up: Closing the Opportunity Divide 2,000,000

Indiana University

PO Box 78000
Detroit,MI482780867 		N/A PC Scaling AMPATH's Population Health with Universal Health Coverage 1,100,000

Abbott Northwestern Hospital Foundation

2925 Chicago Ave MR 10721
MINNEAPOLIS,MN554151126 		N/A PC General Mission 10,000

American Academy of Neurology Institute

201 CHICAGO AVE
MINNEAPOLIS,MN554151126 		N/A PC General Mission 33,000

Scholarship America

7900 International Drive Suite 500
Minneapolis,MN554252561 		N/A PC Scholarship Grants 1,342,059

OPTOMETRY CARES- THE AOA FOUNDATION

743 NORTH LINDBERGH BLVD
ST LOUIS,MO631417851 		N/A PC General Mission 25,000

Warriors & Quiet Waters Foundation Inc

351 EVERGREEN DR STE A
BOZEMAN,MT597152438 		N/A PC Coaching Experience and Reunion 50,000

New Jersey Organ and Tissue Sharing Network Inc

691 CENTRAL AVE
NEW PROVIDNCE,NJ079741560 		N/A PC General Mission 25,000

CUREMONOS INC

1053 BELAIR CT
MOUNTAINSIDE,NJ070922132 		N/A PC General Mission 15,000

Fairleigh Dickinson University

1000 RIVER ROAD
TEANECK,NJ076661938 		N/A PC General Mission 75,000

National Women's Health Resource Center

PO Box 336 1715 State Route 35 Suit
e 204
Middletown,NJ07748 		N/A PC General Mission 50,000

Sharsheret

1086 TEANECK RD STE 2G
TEANECK,NJ076664855 		N/A PC General Mission of Sharsheret 10,000

Students 2 Science

66 DEFOREST AVE
EAST HANOVER,NJ079362811 		N/A PC General Mission 20,000

Alzheimer's Foundation of America

322 EIGHTH AVENUE 16th floor
NEW YORK,NY10001 		N/A PC General Mission Support 10,000

Alzheimers Disease and Related Disorders New York City Inc

360 LEXINGTON AVENUE 3RD FL
NEW YORK,NY100176568 		N/A PC Providing care and support, free of charge, families affected by dementia 10,000

American Foundation for Suicide Prevention

199 WATER ST FL 11
NEW YORK,NY100383541 		N/A PC General Mission 50,000

American India Foundation

216 E 45TH ST 7TH FL
NEW YORK,NY100173304 		N/A PC Mission Support : Covid Relief for India 75,000

Asian American Legal Defense and Education Fund

99 HUDSON ST 12TH FLOOR
NEW YORK,NY100132815 		N/A PC General MIssion 500,000

Brain & Behavior Research Foundation

747 3RD AVENUE 33RD FL
NEW YORK,NY100172831 		N/A PC General Mission 25,000

Cerebral Palsy Foundation

3 COLUMBUS CIRCLE 15TH FLOOR
NEW YORK,NY10019 		N/A PC General Mission Support 50,000

Global Health Corps

318 W 39th Street Room 9L
New York City,NY10018 		N/A PC General Mission Support 200,000

Helen Keller International

1 DAG HAMMARSKJOLD PLZ FL 2
NEW YORK,NY100172208 		N/A PC General Mission 27,000

Mission Restore Inc

120 E 87TH ST Suite P4B
NEW YORK,NY101281117 		N/A PC General Mission 25,000

NEXTGENFACE INC

812 Park Avenue
New York,NY10021 		N/A PC General Mission Support 25,000

National Alliance on Mental Illness of New York City (NAMI-NYC)

505 8TH AVE RM 1103
NEW YORK,NY100184541 		N/A PC General Mission 15,000

National Foundation for Facial Reconstruction (dba myFace)

333 EAST 30TH STREET LOBBY UNIT
NEW YORK,NY100166416 		N/A PC General Mission 25,000

National Urban League Inc

80 PINE STREET 9TH FLOOR wwwnulorg
NEW YORK,NY10005 		N/A PC Project Ready Mentor 1,400,000

New York University

222 East 41st Street 11th floor
New York,NY10017 		N/A PC General Mission 50,000

Research to Prevent Blindness Inc

360 Lexington Ave 22nd Floor
New York,NY10017 		N/A PC General Mission 30,000

The Glaucoma Foundation

80 Maiden Lane
New York,NY10038 		N/A PC General Support 50,000

United Spinal Association

12034 QUEENS BLVD STE 320
KEW GARDENS,NY114151232 		N/A PC General Mission 25,000

Foundation For The Carolinas

220 North Tryon St
Charlotte,NC28202 		N/A PC AbbVie Employee Relief Fund 1,780,000

OWL Advancing Diversity in Leadership

PMB 125 3434-135 KILDAIRE FARM ROAD
CARY,NC275182278 		N/A PC General Mission 25,000

American Heart Association

5211 Madison Road
Cincinnati,OH45227 		N/A PC General Mission 20,000

National Inventors Hall of Fame Inc

3701 HIGHLAND PARK NW
NORTH CANTON,OH447204535 		N/A PC Camp Invention - 2021 50,000

Society of St Vincent de Paul District Council

1125 BANK ST
CINCINNATI,OH452142130 		N/A PC General Mission 40,000

The Cincinnati Eye Institute Foundation

1945 CEI DR
BLUE ASH,OH452425664 		N/A PC General Mission Support 25,000

Breastcancerorg

120 E Lancaster Ave
Ardmore,PA19003 		N/A PC General Mission 25,000

Living Beyond Breast Cancer

40 MONUMENT RD STE 104
BALA CYNWYD,PA190041713 		N/A PC General Mission Living Beyond Breast Cancer 50,000

Travis Manion Foundation

164 E State St
Doylestown,PA18901 		N/A PC General Mission Support 100,000

National Association For Continence

215 East Bay Street Suite 500-I
Charleston,SC29402 		N/A PC Supporting the Pelvic Floor to maintain health - Support at every age 40,000

Vanderbilt University

2301 Vanderbilt Place
Nashville,TN37235 		N/A PC General Mission Support 24,000

Alliance in Reconstructive Surgery Foundation

3401 LEE PKWY SUITE 1504
DALLAS,TX752195226 		N/A PC General Mission 25,000

Baylor College of Medicine International Pediatric AIDS Initiative

1102 Bates Street Suite 630 attenti
on Michael Mizwa
HOUSTON,TX770302399 		N/A SO I BIPAI HIV and General Mission Support 1,580,000

Baylor Medical Foundation

ONE BAYLOR PLZ BCM 160
HOUSTON,TX770303411 		N/A PC General Mission Support 50,000

Benign Essential Blepharospasm Research Foundation

PO BOX 12468
BEAUMONT,TX777262468 		N/A PC General Mission 15,000

Helmets of Love LLC

107 N 3RD ST
VALLEY MILLS,TX766894443 		N/A PC General Mission Support 10,000

La Vega Pirates Education Foundation

PO Box 154897
WACO,TX76715 		N/A PC General Mission 10,000

Midway ISD Education Foundation

13885 Woodway Drive
Waco,TX76712 		N/A PC General Mission Support 10,000

Pan-American Ophthalmological Foundation

2504 W Park Row Dr Suite B5 129
Pantego,TX76013 		N/A PC General Mission 25,000

Robinson Education Foundation

500 W LYNDALE AVE
ROBINSON,TX767065505 		N/A PC General Mission Support 10,000

Special Olympics Texas Inc

13400 IMMANUEL RD STE 1C
PFLUGERVILLE,TX78660 		N/A PC General Mission 10,000

Susan G Komen Breast Cancer Foundation

Attn Orange County CA301 13770 Noel
Road Suite 801889
Dallas,TX75380 		N/A PC Patient Navigation Initiative Pilot for Breast Health in Orange County, CA. 100,000

The Rose

12700 N FEATHERWOOD DR STE
HOUSTON,TX770344494 		N/A PC General Mission 20,000

The Sturge-Weber Foundation

12345 JONES RD STE 125
HOUSTON,TX770704958 		N/A PC General Mission 10,000

The TSTC Foundation

3801 CAMPUS DR
WACO,TX767051607 		N/A PC General Mission 10,000

American Society of Cataract and Refractive Surgery Foundation

12587 Fair Lakes Circle Suite 348
FAIRFAX,VA22033 		N/A PC General Mission 100,000

Blinded Veterans Association

1101 KING ST STE 300
ALEXANDRIA,VA223142963 		N/A PC General Mission 10,000

Communities In Schools Inc

2345 Crystal Drive
Suite,VA22202 		N/A PC CIS New Jersey Statewide Expansion 100,000

Mental Health America

500 Montgomery Street Ste 820
Alexandria,VA22314 		N/A PC General Mission 100,000

NAMI

4301 WILSON BLVD STE 300
ARLINGTON,VA222031867 		N/A PC General Mission 100,000

The Educational & Research Foundation

310 S HENRY ST
ALEXANDRIA,VA223143524 		N/A PC General Mission 25,000

Miles for Migraine

16 Cilley Hill Rd
Jericho,VT05465 		N/A PC General Mission 20,000

American Society for Laser Medicine and Surgery Inc

2100 STEWART AVE STE 240
WAUSAU,WI544011709 		N/A PC General Mission 25,000

Combat Blindness International INC

PO BOX 5332
MADISON,WI537050332 		N/A PC General Mission 40,000

The Blackbaud Giving Fund

2000 Daniel Island Dr
Charleston,SC29492 		N/A PC Matching Grants 12,368,436
Total ................................. bullet3a 41,728,245
bApproved for future payment
Total .................................bullet 3b 0
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     14 3,811,143  
2 Membership dues and assessments ....          
3 Interest on savings and temporary cash
investments ........... 		    14 198,099  
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 ............ 		         
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue:
aOTHER INCOME 		    1 605  
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) .. 0 4,009,847 0
13Total. Add line 12, columns (b), (d), and (e)..................
13
4,009,847
(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: 21014044
Software Version: 2021v4.2


Form 990PF - Special Condition Description:
Special Condition Description