Instrumentl eFile Render
Object ID: 202233199349105643 - Rendered 2024-07-27
TIN: 47-4967720
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
For calendar year 2021, or tax year beginning
01-01-2021
, and ending
12-31-2021
Name of foundation
MASSMUTUAL FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
1295 STATE STREET
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SPRINGFIELD
,
MA
01111
A Employer identification number
47-4967720
B
Telephone number (see instructions)
(413) 744-5031
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
16,295,000
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
8,380,000
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
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
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
........
8,380,000
0
0
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
68,000
0
0
68,000
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
1,000
0
0
1,000
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
10,852,000
0
0
9,463,000
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
10,921,000
0
0
9,532,000
25
Contributions, gifts, grants paid
.......
6,175,000
9,606,484
26
Total expenses and disbursements.
Add lines 24 and 25
17,096,000
0
0
19,138,484
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-8,716,000
b
Net investment income
(if negative, enter -0-)
0
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
1
Cash—non-interest-bearing
.............
1,413,000
1,279,000
1,279,000
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
24,516,000
15,016,000
15,016,000
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
25,929,000
16,295,000
16,295,000
17
Accounts payable and accrued expenses
..........
876,000
901,000
18
Grants payable
.................
10,165,000
9,222,000
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
11,041,000
10,123,000
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
14,888,000
6,172,000
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
14,888,000
6,172,000
30
Total liabilities and net assets/fund balances
(see instructions)
.
25,929,000
16,295,000
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
14,888,000
2
Enter amount from Part I, line 27a
.....................
2
-8,716,000
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
6,172,000
5
Decreases not included in line 2 (itemize)
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
6,172,000
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)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
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
and enter “N/A" on line 1.
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
0
3
Add lines 1 and 2
...........................
3
0
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
0
6
Credits/Payments:
a
2021 estimated tax payments and 2020 overpayment credited to 2021
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
0
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
0
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
0
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2022 estimated tax
Refunded
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.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
.........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XIV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
MA
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 address
WWW.MASSMUTUAL.COM/FOUNDATION
14
The books are in care of
DENNIS DUQUETTE
Telephone no.
(413) 744-4056
Located at
1295 STATE STREET
SPRINGFIELD
MA
ZIP+4
01111
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part 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
Organizations relying on a current notice regarding disaster assistance check here
........
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
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
..............................
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
Organizations relying on a current notice regarding disaster assistance check
.........
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
DENNIS DUQUETTE
PRESIDENT/CEO
3.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
JAMES PAUL PUHALA III
CLERK
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
ALISON MATHIAS
VICE PRESIDENT
3.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
BRIAN FUNICANE
ASSISTANT TREASURER
2.00
0
0
0
10 FAN PIER BLVD
BOSTON
,
MA
02210
NOELL TUESTA
ASSOCIATE CLERK
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
CHRISTINE GOUIN
ASSOCIATE CLERK
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
JUDY BREAULT
DIRECTOR THRU 7/1/21
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
AMY DIAZ
DIRECTOR FROM 7/1/21
2.00
0
0
0
1296 STATE STREET
SPRINGFIELD
,
MA
01111
KEIA COLE
DIRECTOR THRU 1/15/21
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
MICHAEL MORRISSEY
DIRECTOR FROM 1/15/21
2.00
0
0
0
1296 STATE STREET
SPRINGFIELD
,
MA
01111
DEREK DARLEY
TREASURER/DIRECTOR THRU 6/7/21
2.00
0
0
0
1297 STATE STREET
SPRINGFIELD
,
MA
01111
PABLO CABRERA
TREASURER/DIRECTOR FROM 6/7/21
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
DOROTHY VARON
DIRECTOR
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
ELEANOR WILLIAMS
DIRECTOR
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
SHERRIFF BALOGUN
DIRECTOR
2.00
0
0
0
1295 STATE STREET
SPRINGFIELD
,
MA
01111
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
...................
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
ROOT CAUSE
COACHING SERVICES
96,000
ONE BROADWAY 14TH FLOOR
CAMBRIDGE
,
MA
02142
JUDGE DINA E FEIN
CONSULTING SERVICES
62,000
69B DAY AVE
NORTHAMPTON
,
MA
01060
MISSION MEASUREMENT
PROGRAM SERVICES
60,000
200 NORTH LASALLE ST
CHICAGO
,
IL
60601
Total
number of others receiving over $50,000 for professional services
.............
0
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
0
2
All other program-related investments. See instructions.
3
0
Total.
Add lines 1 through 3
.........................
0
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
0
b
Average of monthly cash balances
.......................
1b
3,887,905
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
3,887,905
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
3,887,905
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions)
.............................
4
58,319
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3.
............
5
3,829,586
6
Minimum investment return.
Enter 5% (0.05) of line 5
................
6
191,479
Part X
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part IX, line 6
..................
1
191,479
2a
Tax on investment income for 2021 from Part V, line 5
.......
2a
b
Income tax for 2021. (This does not include the tax from Part V.)
...
2b
c
Add lines 2a and 2b
............................
2c
0
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
191,479
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
191,479
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1
...
7
191,479
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
19,138,484
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
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part XII, line 4.
4
19,138,484
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
191,479
2
Undistributed income, if any, as of the end of 2021:
a
Enter amount for 2020 only
.......
0
b
Total for prior years:
2017
,
2018
,
2019
0
3
Excess distributions carryover, if any, to 2021:
a
From 2016
......
9,689,565
b
From 2017
......
c
From 2018
......
17,733,057
d
From 2019
......
17,792,688
e
From 2020
......
18,722,350
f
Total
of lines 3a through e
........
63,937,660
4
Qualifying distributions for 2021 from Part
XI, line 4:
$
19,138,484
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
.....
191,479
e
Remaining amount distributed out of corpus
18,947,005
5
Excess distributions carryover applied to 2021.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
82,884,665
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 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)
...
9,689,565
9
Excess distributions carryover to 2022.
Subtract lines 7 and 8 from line 6a
......
73,195,100
10
Analysis of line 9:
a
Excess from 2017
....
b
Excess from 2018
....
17,733,057
c
Excess from 2019
....
17,792,688
d
Excess from 2020
....
18,722,350
e
Excess from 2021
....
18,947,005
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
......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part 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.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
N/A
c
Any submission deadlines:
N/A
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
N/A
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)
a
Paid during the year
AMERICAN ONLINE GIVING FOUNDATION
240 EAST MAIN STREET SUITE 887
NEWARK
,
DE
19711
NONE
PC
EXEMPT PURPOSE
2,428,138
UNIVERSITY OF MASSACHUSETTS AMHERST FOUNDATION INC
134 HICKS WAY MEMORIAL HALL
AMHERST
,
MA
11111
NONE
PC
EXEMPT PURPOSE
1,500,000
SPRINGFIELD PUBLIC SCHOOLS
1550 MAIN STREET
SPRINGFIELD
,
MA
01103
NONE
PC
EXEMPT PURPOSE
550,000
THE FOOD BANK OF WESTERN MASSACHUSETTS INC
97 N HATFIELD RD P0 BOX 160
HATFIELD
,
MA
010389773
NONE
PC
EXEMPT PURPOSE
595,000
WAY FINDERS INC
120 MAPLE ST 4TH FL
SPRINGFIELD
,
MA
01103
NONE
PC
EXEMPT PURPOSE
590,000
VIBRANT MEMPHIS INC
902 S COOPER ST
MEMPHIS
,
TN
381045603
NONE
PC
EXEMPT PURPOSE
443,152
BOSTON MEDICAL CENTER CORPORATION
801 MASSACHUSETTS AVENUE 1ST FLOOR
BOSTON
,
MA
021182335
NONE
PC
EXEMPT PURPOSE
350,000
WESTERN NEW ENGLAND UNIVERSITY
1215 WILBRAHAM ROAD
SPRINGFIELD
,
MA
011192684
NONE
PC
EXEMPT PURPOSE
293,910
FRAYSER COMMUNITY DEVELOPMENT CORPORATION
3684 N WATKINS ST
MEMPHIS
,
TN
381274361
NONE
PC
EXEMPT PURPOSE
254,650
BOSTON FOUNDATION INC
75 ARLINGTON STREET
BOSTON
,
MA
021163936
NONE
PC
EXEMPT PURPOSE
210,000
NAISMITH MEMORIAL BASKETBALL HALL OF FAME INC
1000 HALL OF FAME AVENUE
SPRINGFIELD
,
MA
011052538
NONE
PC
EXEMPT PURPOSE
200,000
NEW NORTH CITIZENS COUNCIL
2455 MAIN ST
SPRINGFIELD
,
MA
011071908
NONE
PC
EXEMPT PURPOSE
193,671
TEACH WESTERN MASS INC
1000 STATE ST
SPRINGFIELD
,
MA
011093151
NONE
PC
EXEMPT PURPOSE
150,000
RISE FOUNDATION INC
1355 LYNNFIELD ROAD
MEMPHIS
,
TN
38119
NONE
PC
EXEMPT PURPOSE
112,838
HEALING RACISM INSTITUTE OF THE PIONEER VALLEY INC
1 MONARCH PLACE SUITE 1300
SPRINGFIELD
,
MA
01144
NONE
PC
EXEMPT PURPOSE
100,000
SOCIAL INNOVATION FORUM INC
2 OLIVER STREET STE 802
BOSTON
,
MA
021094901
NONE
PC
EXEMPT PURPOSE
100,000
SPRINGFIELD CULTURAL PARTNERSHIP INCORPORATED
127 STATE ST
SPRINGFIELD
,
MA
011031929
NONE
PC
EXEMPT PURPOSE
100,000
WOMENS FUND OF WESTERN MASSACHUSETTS
1350 MAIN STREET SUITE 1006
SPRINGFIELD
,
MA
01103
NONE
PC
EXEMPT PURPOSE
100,000
ENTREPRENEURSHIP FOR ALL INC
175 CABOT STREET SUITE 100
LOWELL
,
MA
01854
NONE
PC
EXEMPT PURPOSE
80,000
JUNIOR ACHIEVEMENT OF ARIZONA
636 W SOUTHERN AVE
TEMPE
,
AZ
852824508
NONE
PC
EXEMPT PURPOSE
80,000
MAKE-IT SPRINGFIELD INC
168 WORTHINGTON ST
SPRINGFIELD
,
MA
011031220
NONE
PC
EXEMPT PURPOSE
80,000
UNION CAPITAL BOSTON INC
1542 COLUMBUS AVE
ROXBURY
,
MA
02119
NONE
PC
EXEMPT PURPOSE
80,000
AMERICAN NATIONAL RED CROSS
430 17TH ST
NW WASHINGTON
,
DC
20006
NONE
PC
EXEMPT PURPOSE
75,000
TEAM RUBICON
5230 PACIFIC CONCOURSE DRIVE SUITE
200
LOS ANGELES
,
CA
90045
NONE
PC
EXEMPT PURPOSE
75,000
ROCA INC
101 PARK ST
CHELSEA
,
MA
21500
NONE
PC
EXEMPT PURPOSE
75,000
TEACH FOR AMERICA INC
25 BROADWAY
NEW YORK
,
NY
10004
NONE
PC
EXEMPT PURPOSE
75,000
YMCA OF GREATER SPRINGFIELD
275 CHESTNUT STREET
SPRINGFIELD
,
MA
011043562
NONE
PC
EXEMPT PURPOSE
75,000
SPRINGFIELD COLLEGE
263 ALDEN ST
SPRINGFIELD
,
MA
011093707
NONE
PC
EXEMPT PURPOSE
50,000
COMMUNITY MUSIC SCHOOL OF SPRINGFIELD INC
127 STATE ST
SPRINGFIELD
,
MA
011032263
NONE
PC
EXEMPT PURPOSE
50,000
COMMUNITY UNITED WAY OF PIONEER VALLEY INC
1441 MAIN ST SUITE 147
SPRINGFIELD
,
MA
01103
NONE
PC
EXEMPT PURPOSE
50,000
BIG BROTHERS-BIG SISTERS
266 COLD SPRING AVENUE SUITE 201
WEST SPRINGFIELD
,
MA
01089
NONE
PC
EXEMPT PURPOSE
40,000
WELLSPRING COOPERATIVE CORPORATION
PO BOX 51116 121 PINEVALE ST
SPRINGFIELD
,
MA
01151
NONE
PC
EXEMPT PURPOSE
40,000
CENTER FOR EFFECTIVE PHILANTHROPY INC
675 MASSACHUSETTS AVENUE 7TH FLOOR
CAMBRIDGE
,
MA
02139
NONE
PC
EXEMPT PURPOSE
30,375
PIONEER VALLEY REGIONAL VENTURES CENTER INC
60 CONGRESS STREET FLOOR 1
W SPRINGFIELD
,
MA
011043491
NONE
PC
EXEMPT PURPOSE
25,750
COST OF FREEDOM INC
6619 RED HAWK CT
MAINEVILLE
,
OH
450397297
NONE
PC
EXEMPT PURPOSE
25,000
URBAN LEAGUE OF SPRINGFIELD INC
1 FEDERAL STREET BUILDING 111-3
SPRINGFIELD
,
MA
01151
NONE
PC
EXEMPT PURPOSE
25,000
YMCA OF THE NORTH SHORE INC
PO BOX 7073
BEVERLY
,
MA
019154511
NONE
PC
EXEMPT PURPOSE
25,000
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVE
DALLAS
,
TX
75231
NONE
PC
EXEMPT PURPOSE
11,000
BOYS & GIRLS CLUBS OF SOUTHEAST VIRGINIA
1300 DIAMOND SPRINGS ROAD SUITE 300
VIRGINIA BEACH
,
VA
23455
NONE
PC
EXEMPT PURPOSE
10,000
CENTRAL ARIZONA SHELTER SERVICES INC
230 S 12TH AVE
PHOENIX
,
AZ
850073101
NONE
PC
EXEMPT PURPOSE
10,000
CHINESE AMERICAN PLANNING COUNCIL INC
150 ELIZABETH ST
NEW YORK
,
NY
100124603
NONE
PC
EXEMPT PURPOSE
10,000
DYSLEXIA TUTORING PROGRAM INC
711 W 40TH STREET SUITE 310
BALTIMORE
,
MD
21211
NONE
PC
EXEMPT PURPOSE
10,000
FAMILY PROMISE OF SOUTHERN CHESTER COUNTY
1156 WEST BALTIMORE PIKE PO BOX 394
KENNETT SQUARE
,
PA
19348
NONE
PC
EXEMPT PURPOSE
10,000
FOUNDATION FOR INCLUSIVE RELIGIOUS EDUCATION INC
20 W 9TH ST
KANSAS CITY
,
MO
641051704
NONE
PC
EXEMPT PURPOSE
10,000
GUILD INCORPORATED
122 WABASHA STREET S 400
SAINT PAUL
,
MN
551071819
NONE
PC
EXEMPT PURPOSE
10,000
MAKE-A-WISH FOUNDATION OF MICHIGAN
7600 GRAND RIVER AVENUE SUITE 175
BRIGHTON
,
MI
48114
NONE
PC
EXEMPT PURPOSE
10,000
RACING FOR ORPHANS WITH DOWN SYNDROME INC
2901 W BLUE GRASS BLVD STE 320
LEHI UT
,
UT
84043
NONE
PC
EXEMPT PURPOSE
10,000
RANCHO LOS AMIGOS FOUNDATION INC
7601 IMPERIAL HWY TRAILER F3
DOWNEY
,
CA
90242
NONE
PC
EXEMPT PURPOSE
10,000
RISE 2 THRIVE FAMILY RESOURCE CENTER
6115 THE MEADOWS LN
HARRISBURG
,
NC
280756522
NONE
PC
EXEMPT PURPOSE
10,000
SOLOMONS TEMPLE FOUNDATION INC
2836 SPRINGDALE RD
SW ATLANTA
,
GA
303157802
NONE
PC
EXEMPT PURPOSE
10,000
SOUTH HUNTINGTON EDUCATIONAL FOUNDATION
60 WESTON ST
HUNTINGTN STA
,
NY
117464031
NONE
PC
EXEMPT PURPOSE
10,000
SPECIAL OLYMPICS NEW HAMPSHIRE
PO BOX 3598
CONCORD
,
NH
03302
NONE
PC
EXEMPT PURPOSE
10,000
STOLENYOUTH
PO BOX 296
SEATTLE
,
WA
981110296
NONE
PC
EXEMPT PURPOSE
10,000
UNITED WAY OF CENTRAL MASSACHUSETTS
484 MAIN ST STE 300
WORCESTER
,
MA
016081817
NONE
PC
EXEMPT PURPOSE
10,000
YOUNG MENS CHRISTIAN ASSOCIATION OF FLINT
411 E 3RD ST
FLINT
,
MI
485032006
NONE
PC
EXEMPT PURPOSE
10,000
ABINGTON MEMORIAL HOSPITAL FOUNDATION
1200 OLD YORK RD
ABINGTON
,
PA
190013720
NONE
PC
EXEMPT PURPOSE
5,000
AMERICAN CANCER SOCIETY INC
3380 CHASTAIN MEADOWS PARKWAY NW
SUITE 200
KENNESAW
,
GA
30144
NONE
PC
EXEMPT PURPOSE
5,000
BARNUM FOUNDATION FOR LIFE INC
6 CORPORATE DRIVE
SHELTON
,
CT
064846270
NONE
PC
EXEMPT PURPOSE
5,000
COMMONWEALTH ZOOLOGICAL CORPORATION
1 FRANKLIN PARK RD
BOSTON
,
MA
021213252
NONE
PC
EXEMPT PURPOSE
5,000
CURE SANFILIPPO FOUNDATION
PO BOX 6901
COLUMBIA
,
SC
292606901
NONE
PC
EXEMPT PURPOSE
5,000
FLOC FOR LOVE OF CHILDREN
1301 PENNSYLVANIA AVE
SE WASHINGTON
,
DC
20003
NONE
PC
EXEMPT PURPOSE
5,000
FOTC - LOS ANGELES
672 S LA FAYETTE PARK PL STE 33
LOS ANGELES
,
CA
900573234
NONE
PC
EXEMPT PURPOSE
5,000
GRACE FOUNDATION OF NEW YORK
460 BRIELLE AVENUE
STATEN ISLAND
,
NY
10314
NONE
PC
EXEMPT PURPOSE
5,000
HABITAT FOR HUMANITY OF MINNESOTA
2171 UNIVERSITY AVENUE W SUITE 200
SAINT PAUL
,
MN
55114
NONE
PC
EXEMPT PURPOSE
5,000
KOREAN AMERICAN COMMUNITY FOUNDATION OF SAN FRANCISCO
66 FRANKLIN STREET SUITE 300
OAKLAND
,
CA
94607
NONE
PC
EXEMPT PURPOSE
5,000
MAKE-A-WISH FOUNDATION OF UTAH INC
771 E WINCHESTER ST
MURRAY
,
UT
841077564
NONE
PC
EXEMPT PURPOSE
5,000
MAKING MEMORIES THAT LAST FOREVER INC
300 CORPORATE PARKWAY SUITE 216
N AMHERST
,
NY
14226
NONE
PC
EXEMPT PURPOSE
5,000
MID VALLEY YOUTH SOCCER
125 E ACORN HILL DR
OLYPHANT
,
PA
184472245
NONE
PC
EXEMPT PURPOSE
5,000
NEW JERSEY SYMPHONY ORCHESTRA
60 PARK PL STE 900
NEWARK
,
NJ
071025504
NONE
PC
EXEMPT PURPOSE
5,000
SISTERS OF ST FRANCIS OF PHILADELPHIA
226 NORRIS ST
CHESTER
,
PA
190133400
NONE
PC
EXEMPT PURPOSE
5,000
SKY HIGH FOR ST JUDES INC
9800 RICHMOND AVENUE SUITE 335
HOUSTON
,
TX
77042
NONE
PC
EXEMPT PURPOSE
5,000
SKYLIGHT FOUNDATION
2012 W 25TH ST
CLEVELAND
,
OH
441134124
NONE
PC
EXEMPT PURPOSE
5,000
WE FINISH TOGETHER INC
1415 NE 6TH ST
FT LAUDERDALE
,
FL
333042914
NONE
PC
EXEMPT PURPOSE
5,000
BREAKTHROUGH BIKE CHALLENGE
PO BOX 4359
PHILADELPHIA
,
PA
191183326
NONE
PC
EXEMPT PURPOSE
1,000
CAMP KUDZU INC
8601 DUNWOODY PL STE 508
SMYRNA
,
GA
303502551
NONE
PC
EXEMPT PURPOSE
1,000
CURRENT INITIATIVES
19046 BRUCE B DOWNS BLVD 160
TAMPA
,
FL
33647
NONE
PC
EXEMPT PURPOSE
1,000
FOLDS OF HONOR FOUNDATION - MINNESOTA INC
229 MINNETONKA AVE SOUTH PO BOX 723
WAYZATA
,
MN
55391
NONE
PC
EXEMPT PURPOSE
1,000
FRIENDS OF KIDS WITH CANCER INC
16 SUNNEN DRIVE SUITE 161
SAINT LOUIS
,
MO
10314
NONE
PC
EXEMPT PURPOSE
1,000
JUNIOR ACHIEVEMENT OF NEW JERSEY
360 PEAR BLOSSOM DRIVE
EDISON
,
NJ
08837
NONE
PC
EXEMPT PURPOSE
1,000
SPECIAL OLYMPICS VERMONT
16 GREGORY DR STE 2
S BURLINGTON
,
VT
054036015
NONE
PC
EXEMPT PURPOSE
1,000
THE ARMORY FOUNDATION
216 FORT WASHINGTON AVE
NEW YORK
,
NY
100323704
NONE
PC
EXEMPT PURPOSE
1,000
Total
.................................
3a
9,606,484
b
Approved for future payment
UNIVERSITY OF MASSACHUSETTS
134 HICKS WAY
AMHERST
,
MA
010039264
NONE
PC
EXEMPT PURPOSE
6,000,000
THE FOOD BANK OF WESTERN MASS INC
PO BOX 160
HATFIELD
,
MA
010380160
NONE
PC
EXEMPT PURPOSE
1,000,000
BOSTON FOUNDATION
75 ARLINGTON STREET
BOSTON
,
MA
021163936
NONE
PC
EXEMPT PURPOSE
800,000
SPRINGFIELD PUBLIC SCHOOLS
1550 MAIN STREET
SPRINGFIELD
,
MA
01103
NONE
PC
EXEMPT PURPOSE
500,000
BOSTON MEDICAL CENTER CORPORATION
1 BOSTON MEDICAL CTR PL STE 1
BOSTON
,
MA
02118
NONE
PC
EXEMPT PURPOSE
350,000
SPRINGFIELD CULTURAL PARTNERSHIP INCORPORATED
127 STATE ST
SPRINGFIELD
,
MA
011031929
NONE
PC
EXEMPT PURPOSE
200,000
COMMUNITY UNITED WAY OF PIONEER VALLEY INC
1441 MAIN ST SUITE 147
SPRINGFIELD
,
MA
01103
NONE
PC
EXEMPT PURPOSE
200,000
WOMENS FUND OF WESTERN MASS
1350 MAIN STREET SUITE 1006
SPRINGFIELD
,
MA
011036105
NONE
PC
EXEMPT PURPOSE
200,000
SPRINGFIELD COLLEGE
263 ALDEN ST
SPRINGFIELD
,
MA
01109
NONE
PC
EXEMPT PURPOSE
150,000
Total
.................................
3b
9,400,000
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part 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?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below?
See instructions.
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2021)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description