TY 2020 Form 990PF

- TIN:

Form990-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.
bullet

Go to www.irs.gov/Form990PF for instructions and the latest information.

OMB No. 1545-0052

2020

Open to Public Inspection

For calendar year 2020, or tax year beginning 07-01-2020 , and ending 06-30-2021

Name of foundation
THOMAS JACK N TUA

Number and street (or P.O. box number if mail is not delivered to street address)6325 S RAINBOW BLVD STE 300
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS, NV89118

A Employer identification number

95-6836176

B Telephone number (see instructions)

(888) 730-4933

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

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 ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$2,285,087J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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)
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...	51,007		51,007
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		117,543
b	Gross sales price for all assets on line 6a 758,068
7	Capital gain net income (from Part IV, line 2)...			117,543
8	Net short-term capital gain.........				0
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........	168,550		168,550
13	Compensation of officers, directors, trustees, etc.	30,903		27,813		3,090
14	Other employee salaries and wages......			0	0	0
15	Pension plans, employee benefits.......			0	0
16a	Legal fees (attach schedule).........					0
b	Accounting fees (attach schedule).......		1,007	0	0	1,007
c	Other professional fees (attach schedule)....					0
17	Interest...............					0
18	Taxes (attach schedule) (see instructions)...		3,118	838		0
19	Depreciation (attach schedule) and depletion...		0	0
20	Occupancy..............
21	Travel, conferences, and meetings.......			0	0
22	Printing and publications..........			0	0
23	Other expenses (attach schedule).......		25	15		10
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	35,053		28,666	0	4,107
25	Contributions, gifts, grants paid.......	139,443				139,443
26	Total expenses and disbursements. Add lines 24 and 25	174,496		28,666	0	143,550
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-5,946
b	Net investment income (if negative, enter -0-)			139,884
c	Adjusted net income (if negative, enter -0-)...				0

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2020)

Form 990-PF (2020)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	48	50	50
	2	Savings and temporary cash investments.........	51,756	22,861	22,861
	3	Accounts receivable
		Less: allowance for doubtful accounts		0	0
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts 0
	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).......		315,873	669,790
	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)..........	1,609,901	1,316,729	1,592,386
	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)	1,661,705	1,655,513	2,285,087
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........		0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	1,661,705	1,655,513
	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).....	1,661,705	1,655,513
	30	Total liabilities and net assets/fund balances (see instructions).	1,661,705	1,655,513

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

1,661,705

Enter amount from Part I, line 27a .....................

-5,946

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

1,655,759

Decreases not included in line 2 (itemize) bullet

246

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

1,655,513

Form 990-PF (2020)

Page 3

Part IV

Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kind(s) of property sold (e.g., real estate, 2-story brick warehouse; or common stock, 200 shs. MLC Co.)		(b) How acquired P—Purchase D—Donation	(c) Date acquired (mo., day, yr.)	(d) Date sold (mo., day, yr.)
1 a	27. CVS HEALTH CORPORATION			2020-07-20
b	17. COGNIZANT TECH SOLUTIONS CRP COM		2019-08-16	2020-07-20
c	8. COGNIZANT TECH SOLUTIONS CRP COM		2016-03-17	2020-07-20
d	3. APPLE INC		2020-04-03	2020-08-25
e	56. HAIN CELESTIAL GROUP INC			2020-08-25
	4. HAIN CELESTIAL GROUP INC		2020-04-03	2020-08-25
	36. TORONTO DOMINION BK ONT COM NEW		2019-07-31	2020-08-25
	10. UNITED PARCEL SERVICE-CL B		2018-11-26	2020-08-25
	39. APPLE INC		2020-04-03	2020-09-14
	4. NIKE INC CL B		2019-08-16	2020-09-14
	8. NIKE INC CL B		2020-04-03	2020-09-14
	10. UNITED PARCEL SERVICE-CL B			2020-09-14
	19. TE CONNECTIVITY LTD		2016-11-09	2020-09-14
	1. ALPHABET INC CL C		2020-05-12	2020-09-25
	5. APPLE INC		2020-04-03	2020-09-25
	15. APPLE INC		2019-08-16	2020-09-25
	312. INVESCO OPTIMUM YIELD DIVERS		2020-04-03	2020-09-25
	239. ISHARES CORE U.S. AGGREGATE ETF		2020-05-12	2020-09-25
	19. ISHARES CORE U.S. AGGREGATE ETF		2019-08-16	2020-09-25
	179. ISHARES CORE MSCI EMERGING ETF		2018-09-25	2020-09-25
	7. MICROSOFT CORP		2020-04-03	2020-09-25
	3. MICROSOFT CORP		2019-08-16	2020-09-25
	536.538 TCW EMRG MKTS INCM-I 4721		2018-07-13	2020-09-25
	91. VANGUARD INTERMEDIATE TERM B		2020-05-12	2020-09-25
	1002. VANGUARD INTERMEDIATE TERM B			2020-09-25
	93. VANGUARD FTSE DEVELOPED ETF		2013-02-13	2020-09-25
	23. APPLE INC		2019-08-16	2020-10-21
	64. AT & T INC			2020-11-02
	4. CME GROUP INC		2020-04-03	2020-11-02
	32. CME GROUP INC		2012-06-21	2020-11-02
	6. NIKE INC CL B		2020-04-03	2020-11-02
	10. NIKE INC CL B		2017-11-02	2020-11-02
	339. FLEXTRONICS INTL LTD			2020-11-02
	103. FLEXTRONICS INTL LTD		2020-07-20	2020-11-02
	42. AT & T INC		2018-02-13	2020-11-03
	108. SPIRIT AEROSYTSEMS HOLD-CL A			2020-11-03
	3. THERMO FISHER SCIENTIFIC INC		2012-05-21	2020-11-03
	4. UNITED PARCEL SERVICE-CL B		2020-03-04	2020-11-03
	7. UNITED PARCEL SERVICE-CL B		2015-07-24	2020-11-03
	6. BROADCOM INC			2020-11-19
	2. TARGET CORP		2019-08-16	2020-11-30
	8. TARGET CORP		2020-04-03	2020-11-30
	43. AT & T INC		2018-02-13	2020-12-09
	1. ALPHABET INC CL C		2020-04-27	2020-12-09
	1. ALPHABET INC CL C		2019-08-16	2020-12-09
	31. APPLE INC			2020-12-09
	3. BLACKROCK INC		2019-08-16	2020-12-09
	7. BOEING CO			2020-12-09
	5. BROADCOM INC		2019-07-03	2020-12-09
	17. CVS HEALTH CORPORATION		2019-08-14	2020-12-09
	6. CELANESE CORP		2019-08-16	2020-12-09
	6. CELANESE CORP		2020-04-03	2020-12-09
	38. CISCO SYSTEMS INC		2019-08-16	2020-12-09
	36. CITIGROUP INC.			2020-12-09
	18. COGNIZANT TECH SOLUTIONS CRP COM			2020-12-09
	8. DIAGEO PLC - ADR		2018-12-24	2020-12-09
	8. WALT DISNEY CO		2019-08-16	2020-12-09
	1446.82 EV GL MACR ABS RTRN ADV-R6 #1072		2017-10-24	2020-12-09
	9. ELECTRONIC ARTS INC		2019-10-17	2020-12-09
	1343. INVESCO OPTIMUM YIELD DIVERS		2020-04-03	2020-12-09
	19. JPMORGAN CHASE & CO			2020-12-09
	4. LAM RESEARCH CORP COM		2020-04-27	2020-12-09
	17. LAS VEGAS SANDS CORP		2018-10-01	2020-12-09
	9. LAS VEGAS SANDS CORP		2020-02-03	2020-12-09
	8. ELI LILLY & CO COM		2020-07-20	2020-12-09
	105. MANULIFE FINANCIAL CORP			2020-12-09
	14. MERCK & CO INC NEW		2019-08-16	2020-12-09
	16. MICROSOFT CORP		2019-08-16	2020-12-09
	7. MONDELEZ INTERNATIONAL INC		2020-04-03	2020-12-09
	18. MONDELEZ INTERNATIONAL INC			2020-12-09
	13. NIKE INC CL B			2020-12-09
	21. RAYTHEON TECHNOLOGIES CORP			2020-12-09
	2. RAYTHEON TECHNOLOGIES CORP		2019-11-03	2020-12-09
	15. SYSCO CORP		2020-08-25	2020-12-09
	8. TARGET CORP			2020-12-09
	23. TORONTO DOMINION BK ONT COM NEW			2020-12-09
	28. TOTAL S.A. - ADR			2020-12-09
	1. UNION PACIFIC CORP		2020-04-03	2020-12-09
	7. UNION PACIFIC CORP			2020-12-09
	9. UNITED PARCEL SERVICE-CL B		2020-03-04	2020-12-09
	4. UNITEDHEALTH GROUP INC		2020-07-20	2020-12-09
	4. UNITEDHEALTH GROUP INC		2019-08-16	2020-12-09
	69. VANGUARD FTSE DEVELOPED ETF		2013-02-13	2020-12-09
	138. VANGUARD MIDCAP VIPER		2020-02-13	2020-12-09
	11. WASTE MANAGEMENT INC		2020-03-04	2020-12-09
	10. EATON CORP PLC		2020-11-30	2020-12-09
	10. MEDTRONIC PLC		2019-08-16	2020-12-09
	79. GILEAD SCIENCES INC			2020-12-10
	4. LAM RESEARCH CORP COM			2020-12-10
	3. LAM RESEARCH CORP COM		2019-08-16	2020-12-10
	11. NIKE INC CL B		2017-10-23	2020-12-10
	41. SUNCOR ENERGY INC NEW F		2019-08-16	2020-12-10
	20. TOTAL S.A. - ADR			2020-12-10
	9. UNION PACIFIC CORP		2012-05-21	2020-12-10
	110. FLEXTRONICS INTL LTD		2019-02-15	2020-12-21
	13. APPLE INC		2011-09-08	2021-02-11
	4. BROADCOM INC		2019-07-03	2021-02-11
	3. LAM RESEARCH CORP COM		2019-08-16	2021-02-11
	191. MANULIFE FINANCIAL CORP			2021-02-11
	41. AT & T INC		2018-02-13	2021-02-23
	2. ALPHABET INC CL C		2019-08-16	2021-02-23
	5. AMGEN INC		2020-09-14	2021-02-23
	42. APPLE INC		2011-09-08	2021-02-23
	2. BLACKROCK INC		2021-02-11	2021-02-23
	37. BLACKSTONE GROUP INC/THE			2021-02-23
	1. BOOKING HOLDINGS INC		2020-03-04	2021-02-23
	4. BROADCOM INC		2019-07-03	2021-02-23
	16. CVS HEALTH CORPORATION		2019-08-14	2021-02-23
	7. CELANESE CORP			2021-02-23
	4. CELANESE CORP		2020-04-03	2021-02-23
	35. CISCO SYSTEMS INC			2021-02-23
	35. CITIGROUP INC.			2021-02-23
	16. COGNIZANT TECH SOLUTIONS CRP COM		2016-08-25	2021-02-23
	9. DIAGEO PLC - ADR		2020-08-25	2021-02-23
	9. WALT DISNEY CO		2020-12-10	2021-02-23
	9. ELECTRONIC ARTS INC			2021-02-23
	8. FIDELITY NATL INFORMATION SVCS INC		2019-08-16	2021-02-23
	5.00008 FIDELITY NATL INFORMATION SVCS INC		2020-03-04	2021-02-23
	3.99992 FIDELITY NATL INFORMATION SVCS INC		2020-03-04	2021-02-23
	41. HAIN CELESTIAL GROUP INC		2020-04-03	2021-02-23
	79. INTERPUBLIC GROUP COS INC		2020-12-21	2021-02-23
	333. INVESCO OPTIMUM YIELD DIVERS		2020-04-03	2021-02-23
	96. ISHARES CORE U.S. AGGREGATE ETF		2020-12-09	2021-02-23
	525. ISHARES CORE U.S. AGGREGATE ETF			2021-02-23
	20. JPMORGAN CHASE & CO		2019-08-16	2021-02-23
	3. LAM RESEARCH CORP COM		2019-08-16	2021-02-23
	23. LAS VEGAS SANDS CORP			2021-02-23
	7. ELI LILLY & CO COM		2020-04-03	2021-02-23
	89. MANULIFE FINANCIAL CORP			2021-02-23
	24. MICROSOFT CORP			2021-02-23
	23. MONDELEZ INTERNATIONAL INC		2018-07-17	2021-02-23
	11. NIKE INC CL B		2017-10-23	2021-02-23
	16. RAYTHEON TECHNOLOGIES CORP			2021-02-23
	83. SUNCOR ENERGY INC NEW F			2021-02-23
	19. SYSCO CORP			2021-02-23
	7. TARGET CORP		2011-09-08	2021-02-23
	4. THERMO FISHER SCIENTIFIC INC		2012-05-21	2021-02-23
	23. TORONTO DOMINION BK ONT COM NEW			2021-02-23
	25. TOTAL S.A. - ADR		2012-08-15	2021-02-23
	35. UNILEVER PLC - ADR		2020-02-04	2021-02-23
	6. UNION PACIFIC CORP		2012-05-21	2021-02-23
	8. UNITED PARCEL SERVICE-CL B			2021-02-23
	2. UNITEDHEALTH GROUP INC		2020-04-03	2021-02-23
	5. UNITEDHEALTH GROUP INC		2019-08-16	2021-02-23
	1851. VANGUARD FTSE DEVELOPED ETF		2013-02-13	2021-02-23
	11. VISA INC-CLASS A SHRS		2020-03-17	2021-02-23
	14. WASTE MANAGEMENT INC		2020-03-04	2021-02-23
	10. MEDTRONIC PLC		2019-07-19	2021-02-23
	12. GARMIN LTD		2020-10-21	2021-02-23
	17. TE CONNECTIVITY LTD		2016-11-09	2021-02-23
	93. FLEXTRONICS INTL LTD			2021-02-23
	11. ABBVIE INC		2020-12-10	2021-03-25
	1. ALPHABET INC CL C		2019-05-10	2021-03-25
	10. APPLE INC		2011-09-08	2021-03-25
	7. BOEING CO		2019-08-16	2021-03-25
	4. BROADCOM INC		2019-07-03	2021-03-25
	3. MERCK & CO INC NEW		2019-08-16	2021-03-25
	14. MERCK & CO INC NEW		2020-07-20	2021-03-25
	6. MICROSOFT CORP		2015-08-28	2021-03-25
	16202.518 PGIM HIGH YIELD-Q 1067			2021-03-25
	14. TE CONNECTIVITY LTD		2016-11-09	2021-03-25
	335. AT & T INC			2021-04-08
	2. LAM RESEARCH CORP COM		2019-08-16	2021-04-08
	22. SYSCO CORP		2020-05-19	2021-04-08
	3. ABBVIE INC		2020-12-10	2021-06-08
	2. AMGEN INC		2020-09-14	2021-06-08
	12. BLACKSTONE GROUP INC/THE			2021-06-08
	2. BOEING CO			2021-06-08
	1. BROADCOM INC		2019-07-03	2021-06-08
	10. CVS HEALTH CORPORATION		2019-08-14	2021-06-08
	22. CITIGROUP INC.			2021-06-08
	10. COGNIZANT TECH SOLUTIONS CRP COM		2016-08-25	2021-06-08
	3. DIAGEO PLC - ADR		2020-04-03	2021-06-08
	2. DIAGEO PLC - ADR		2020-08-25	2021-06-08
	6. ELECTRONIC ARTS INC		2021-04-08	2021-06-08
	1. FACEBOOK INC		2021-04-08	2021-06-08
	5. FIDELITY NATL INFORMATION SVCS INC		2020-02-21	2021-06-08
	12. HASBRO INC		2021-04-08	2021-06-08
	26. INTERPUBLIC GROUP COS INC			2021-06-08
	294. INVESCO OPTIMUM YIELD DIVERS		2020-04-03	2021-06-08
	10. ISHARES CORE S&P SMALL-CAP E		2021-03-25	2021-06-08
	70. ISHARES CORE MSCI EMERGING ETF		2021-02-23	2021-06-08
	15. LAS VEGAS SANDS CORP			2021-06-08
	55. MANULIFE FINANCIAL CORP		2016-03-01	2021-06-08
	5. MERCK & CO INC NEW		2020-04-03	2021-06-08
	14. MONDELEZ INTERNATIONAL INC		2018-07-17	2021-06-08
	11. RAYTHEON TECHNOLOGIES CORP			2021-06-08
	25. SUNCOR ENERGY INC NEW F			2021-06-08
	9. TORONTO DOMINION BK ONT COM NEW		2019-10-17	2021-06-08
	7. TORONTO DOMINION BK ONT COM NEW		2020-12-10	2021-06-08
	15. TOTAL S.A. - ADR		2012-08-15	2021-06-08
	10. UNILEVER PLC - ADR		2020-02-04	2021-06-08
	22. VANGUARD MIDCAP VIPER		2021-02-23	2021-06-08
	14. VANGUARD MIDCAP VIPER		2020-02-13	2021-06-08
	3. VISA INC-CLASS A SHRS		2020-03-17	2021-06-08
	7. WASTE MANAGEMENT INC		2020-02-21	2021-06-08
	1. EATON CORP PLC		2021-04-08	2021-06-08
	6. MEDTRONIC PLC		2019-07-19	2021-06-08
	2. GARMIN LTD		2020-10-21	2021-06-08
	4. GARMIN LTD		2020-05-29	2021-06-08
	10. ORGANON & CO			2021-06-14
	6. TARGET CORP		2011-09-08	2021-06-14
	.9 ORGANON & CO		2020-04-03	2021-06-28
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	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	1,724	1,621	103
b	1,042	1,044	-2
c	490	470	20
d	1,489	728	761
e	1,702	2,136	-434
	122	108	14
	1,748	2,099	-351
	1,584	1,107	477
	4,444	2,368	2,076
	474	321	153
	948	635	313
	1,593	1,007	586
	1,890	1,241	649
	1,433	1,407	26
	542	304	238
	1,627	774	853
	4,231	3,712	519
	28,221	27,831	390
	2,244	2,160	84
	9,099	9,269	-170
	1,424	1,085	339
	610	408	202
	4,276	4,314	-38
	8,494	8,274	220
	93,525	82,469	11,056
	3,713	3,406	307
	2,709	1,187	1,522
	1,753	2,380	-627
	608	669	-61
	4,867	1,744	3,123
	734	476	258
	1,224	553	671
	4,661	5,590	-929
	1,416	1,113	303
	1,156	1,541	-385
	2,116	6,268	-4,152
	1,476	155	1,321
	644	383	261
	1,128	672	456
	2,266	1,752	514
	358	168	190
	1,431	748	683
	1,334	1,577	-243
	1,819	1,276	543
	1,819	1,180	639
	3,860	805	3,055
	2,133	1,262	871
	1,670	2,394	-724
	2,100	1,423	677
	1,261	1,002	259
	790	662	128
	790	418	372
	1,689	1,791	-102
	2,123	2,584	-461
	1,445	1,051	394
	1,261	1,122	139
	1,246	1,081	165
	15,799	15,510	289
	1,181	871	310
	19,572	15,977	3,595
	2,331	2,091	240
	2,034	1,054	980
	996	1,015	-19
	527	601	-74
	1,237	1,333	-96
	1,894	1,897	-3
	1,168	1,187	-19
	3,443	2,174	1,269
	406	352	54
	1,043	784	259
	1,827	708	1,119
	1,565	1,765	-200
	149	188	-39
	1,151	870	281
	1,384	440	944
	1,293	1,333	-40
	1,268	1,430	-162
	204	141	63
	1,427	881	546
	1,505	861	644
	1,395	1,216	179
	1,395	980	415
	3,212	2,527	685
	28,139	25,573	2,566
	1,282	1,320	-38
	1,186	1,210	-24
	1,115	1,028	87
	4,782	2,692	2,090
	1,960	973	987
	1,470	619	851
	1,517	585	932
	769	1,153	-384
	913	998	-85
	1,819	494	1,325
	1,945	1,128	817
	1,745	179	1,566
	1,901	1,138	763
	1,723	619	1,104
	3,746	3,448	298
	1,219	1,504	-285
	4,050	2,360	1,690
	1,161	1,230	-69
	5,147	579	4,568
	1,401	1,440	-39
	2,553	2,466	87
	2,348	1,725	623
	1,862	1,138	724
	1,115	943	172
	956	417	539
	546	279	267
	1,585	1,644	-59
	2,298	2,475	-177
	1,165	920	245
	1,490	1,235	255
	1,746	1,388	358
	1,244	836	408
	1,085	1,105	-20
	678	744	-66
	543	595	-52
	1,742	1,109	633
	2,092	1,845	247
	5,820	3,961	1,859
	11,074	11,290	-216
	60,562	59,440	1,122
	3,032	2,151	881
	1,670	619	1,051
	1,449	1,361	88
	1,402	987	415
	1,718	1,366	352
	5,521	2,902	2,619
	1,259	986	273
	1,475	585	890
	1,178	1,329	-151
	1,704	2,334	-630
	1,494	1,097	397
	1,316	356	960
	1,816	207	1,609
	1,413	1,345	68
	1,157	1,231	-74
	1,905	2,055	-150
	1,244	329	915
	1,280	764	516
	659	477	182
	1,646	1,225	421
	90,873	67,789	23,084
	2,281	1,740	541
	1,563	1,680	-117
	1,168	1,012	156
	1,513	1,183	330
	2,185	1,110	1,075
	1,660	939	721
	1,129	1,184	-55
	2,045	1,164	881
	1,194	138	1,056
	1,639	2,309	-670
	1,820	1,138	682
	227	254	-27
	1,059	1,110	-51
	1,410	264	1,146
	89,114	86,620	2,494
	1,743	914	829
	10,053	10,798	-745
	1,331	412	919
	1,763	1,155	608
	338	323	15
	478	492	-14
	1,137	675	462
	509	639	-130
	468	285	183
	860	590	270
	1,715	1,511	204
	712	575	137
	584	364	220
	389	274	115
	879	848	31
	337	312	25
	718	741	-23
	1,138	1,156	-18
	863	509	354
	5,839	3,497	2,342
	1,152	1,036	116
	4,717	4,691	26
	852	879	-27
	1,139	767	372
	365	382	-17
	890	600	290
	981	876	105
	632	691	-59
	652	510	142
	507	397	110
	716	738	-22
	609	587	22
	5,180	4,762	418
	3,296	2,594	702
	696	474	222
	978	852	126
	147	140	7
	748	607	141
	288	197	91
	576	363	213
	304		304
	1,391	305	1,086
	28		28
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
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			146
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			146
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			146
			146
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			146
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			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
			146
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			146
			146
			146
			146
			146
			146

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			103
b			-2
c			20
d			761
e			-434
			14
			-351
			477
			2,076
			153
			313
			586
			649
			26
			238
			853
			519
			390
			84
			-170
			339
			202
			-38
			220
			11,056
			307
			1,522
			-627
			-61
			3,123
			258
			671
			-929
			303
			-385
			-4,152
			1,321
			261
			456
			514
			190
			683
			-243
			543
			639
			3,055
			871
			-724
			677
			259
			128
			372
			-102
			-461
			394
			139
			165
			289
			310
			3,595
			240
			980
			-19
			-74
			-96
			-3
			-19
			1,269
			54
			259
			1,119
			-200
			-39
			281
			944
			-40
			-162
			63
			546
			644
			179
			415
			685
			2,566
			-38
			-24
			87
			2,090
			987
			851
			932
			-384
			-85
			1,325
			817
			1,566
			763
			1,104
			298
			-285
			1,690
			-69
			4,568
			-39
			87
			623
			724
			172
			539
			267
			-59
			-177
			245
			255
			358
			408
			-20
			-66
			-52
			633
			247
			1,859
			-216
			1,122
			881
			1,051
			88
			415
			352
			2,619
			273
			890
			-151
			-630
			397
			960
			1,609
			68
			-74
			-150
			915
			516
			182
			421
			23,084
			541
			-117
			156
			330
			1,075
			721
			-55
			881
			1,056
			-670
			682
			-27
			-51
			1,146
			2,494
			829
			-745
			919
			608
			15
			-14
			462
			-130
			183
			270
			204
			137
			220
			115
			31
			25
			-23
			-18
			354
			2,342
			116
			26
			-27
			372
			-17
			290
			105
			-59
			142
			110
			-22
			22
			418
			702
			222
			126
			7
			141
			91
			213
			304
			1,086
			28

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	117,543
3	Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
	If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 ...................		3

Part V

Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income

SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE

1 Reserved

(a) Reserved	(b) Reserved	(c) Reserved	(d) Reserved

Reserved...........................

Reserved,..........................

Form 990-PF (2020)

Page 4

Part VI

Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)

1a	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	Reserved................................	1	1,944
c	All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2	Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	2	0
3	Add lines 1 and 2...........................	3	1,944
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	1,944
6	Credits/Payments:

a	2020 estimated tax payments and 2019 overpayment credited to 2020	6a	1,936
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

7	Total credits and payments. Add lines 6a through 6d..............		7	1,936
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	8
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 2021 estimated tax0	Refunded	11	0

Part VII-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),

and Part XV..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.

If "Yes," complete Part XIV .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2020)

Page 5

Part VII-A

Statements Regarding Activities (continued)

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

WELLS FARGO BANK NA Telephone no. bullet

(888) 730-4933

Located at bullet

100 N MAIN ST MAC D4001-117WINSTON SALEMNC ZIP+4 bullet

27101

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

16 At any time during calendar year 2020, 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 VII-B

Statements Regarding Activities for Which Form 4720 May Be Required

File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.

Yes

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? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?......................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(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)?...............YesNo

(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.).......YesNo

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 ........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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 2020?.............

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)):

At the end of tax year 2020, did the foundation have any undistributed income (lines 6d

and 6e, Part XIII) for tax year(s) beginning before 2020?.............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

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

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?......................YesNo

If "Yes," did it have excess business holdings in 2020 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 2020.)..................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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 2020?

Form 990-PF (2020)

Page 6

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?.............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions................YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?.....YesNo

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 ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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?..........YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?.....................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....

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? .................YesNo

Part VIII

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors

1 List all officers, directors, trustees, foundation managers and their compensation. See instructions

(a) Name and address	(b) Title, and average hours per week devoted to position	(c) Compensation (If not paid, enter -0-)	(d) Contributions to employee benefit plans and deferred compensation	(e) Expense account, other allowances
WELLS FARGO BANK N A	TRUSTEE 1	30,903
100 N MAIN ST MAC D4001-117 WINSTON SALEM,NC27101	TRUSTEE 1	30,903

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 (2020)

Page 7

Part VIII

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)

3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a) Name and address of each person paid more than $50,000	(b) Type of service	(c) Compensation
NONE

Total number of others receiving over $50,000 for professional services............. bullet

Part IX-A

Summary of Direct Charitable Activities

List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.	Expenses
1


2


3


4

Part IX-B

Summary of Program-Related Investments (see instructions)

Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.	Amount
1


2


All other program-related investments. See instructions.
3

Total. Add lines 1 through 3......................... bullet

Form 990-PF (2020)

Page 8

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

2,085,686

Average of monthly cash balances.......................

26,437

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

2,112,123

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

2,112,123

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

31,682

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

2,080,441

Minimum investment return. Enter 5% of line 5..................

104,022

Part XI

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.)

Minimum investment return from Part X, line 6....................

104,022

Tax on investment income for 2020 from Part VI, line 5......

1,944

Income tax for 2020. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

1,944

Distributable amount before adjustments. Subtract line 2c from line 1............

102,078

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

102,078

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...

102,078

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

143,550

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

143,550

Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment

income. Enter 1% of Part I, line 27b. See instructions.................

Adjusted qualifying distributions. Subtract line 5 from line 4..............

143,550

Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.

Form 990-PF (2020)

Page 9

Part XIII

Undistributed Income (see instructions)

		(a) Corpus	(b) Years prior to 2019	(c) 2019	(d) 2020
1 Distributable amount for 2020 from Part XI, line 7					102,078
2 Undistributed income, if any, as of the end of 2020:
a Enter amount for 2019 only.......				0
b Total for prior years:20, 20, 20			0
3 Excess distributions carryover, if any, to 2020:
a From 2015......	42,461
b From 2016......	28,900
c From 2017......	26,471
d From 2018......	27,796
e From 2019......	16,611
fTotal of lines 3a through e........		142,239
4Qualifying distributions for 2020 from Part
XII, line 4: $ 143,550
a Applied to 2019, 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 2020 distributable amount.....					102,078
e Remaining amount distributed out of corpus		41,472
5 Excess distributions carryover applied to 2020.		0			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		183,711
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 2020. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2021 ..........					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 2015 not applied on line 5 or line 7 (see instructions) ...		42,461
9Excess distributions carryover to 2021. Subtract lines 7 and 8 from line 6a ......		141,250
10 Analysis of line 9:
a Excess from 2016....	28,900
b Excess from 2017....	26,471
c Excess from 2018....	27,796
d Excess from 2019....	16,611
e Excess from 2020....	41,472

Form 990-PF (2020)

Page 10

Part XIV

Private Operating Foundations (see instructions and Part VII-A, question 9)

1a If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet

b Check box to indicate whether the organization is a private operating foundation described in section4942(j)(3) or4942(j)(5)

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2020	(b) 2019	(c) 2018	(d) 2017	(e) Total

b 85% of line 2a .........
c Qualifying distributions from Part XII, line 4 for each year listed .....
d Amounts included in line 2c not used directly for active conduct of exempt activities ..........
e Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c ....
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed...
c “Support" alternative test—enter:
(1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

Part XV

Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)

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).)

NONE

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.

NONE

2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here bullet

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

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 (2020)

Page 11

Part XV

Supplementary Information (continued)

3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient	If recipient is an individual, show any relationship to any foundation manager or substantial contributor	Foundation status of recipient	Purpose of grant or contribution	Amount
Name and address (home or business)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
ST HELENA HOSPITAL 10 WOODLAND RD ST HELENA,CA94574	NONE	PC	GENERAL OPERATING	139,443
Total ................................. 3a				139,443

bApproved for future payment

Total ................................. 3b

Form 990-PF (2020)

Page 12

Part XVI-A

Analysis of Income-Producing Activities

Enter gross amounts unless otherwise indicated.	Unrelated business income		Excluded by section 512, 513, or 514		(e) Related or exempt function income (See instructions.)
1Program service revenue:	(a) Business code	(b) Amount	(c) Exclusion code	(d) Amount	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments....
3 Interest on savings and temporary cash investments ...........
4 Dividends and interest from securities....			14	51,007
5 Net rental income or (loss) from real estate:
aDebt-financed property......
bNot debt-financed property.....
6 Net rental income or (loss) from personal property
7 Other investment income.....
8 Gain or (loss) from sales of assets other than inventory ............			18	117,543
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)..				168,550

13Total. Add line 12, columns (b), (d), and (e)..................

168,550

(See worksheet in line 13 instructions to verify calculations.)

Part XVI-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See instructions.)

Form 990-PF (2020)

Page 13

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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

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 (2020)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

Name of Stock	End of Year Book Value	End of Year Fair Market Value
512807108 LAM RESEARCH CORP CO	3,385	13,014
907818108 UNION PACIFIC CORP	2,799	11,216
460690100 INTERPUBLIC GROUP CO	6,028	10,364
532457108 ELI LILLY & CO COM	4,611	13,542
254687106 WALT DISNEY CO	4,176	13,534
11135F101 BROADCOM INC	7,400	12,875
00287Y109 ABBVIE INC	5,489	5,745
02079K107 ALPHABET INC CL C	8,343	42,607
Y2573F102 FLEX LTD	3,506	6,683
405217100 HAIN CELESTIAL GROUP	3,162	6,740
H84989104 TE CONNECTIVITY LTD	3,517	7,437
097023105 BOEING CO	5,585	10,062
09247X101 BLACKROCK INC	7,061	18,374
46625H100 JPMORGAN CHASE & CO	8,565	24,420
594918104 MICROSOFT CORP	6,066	51,742
871829107 SYSCO CORP	5,635	10,341
17275R102 CISCO SYSTEMS INC	6,408	15,264
56501R106 MANULIFE FINANCIAL C	8,713	13,160
609207105 MONDELEZ INTERNATION	7,462	10,865
87612E106 TARGET CORP	2,746	13,054
30303M102 FACEBOOK INC	6,249	6,954
25243Q205 DIAGEO PLC - ADR	7,000	13,035
418056107 HASBRO INC	8,375	8,223
94106L109 WASTE MANAGEMENT INC	10,516	13,030
192446102 COGNIZANT TECH SOLUT	6,426	8,450
031162100 AMGEN INC	6,059	6,094
G29183103 EATON CORP PLC	10,332	13,188
654106103 NIKE INC CL B	4,679	13,595
517834107 LAS VEGAS SANDS CORP	8,889	9,484
126650100 CVS HEALTH CORPORATI	5,723	10,013
911312106 UNITED PARCEL SERVIC	5,646	14,766
172967424 CITIGROUP INC.	12,390	18,749
150870103 CELANESE CORP	5,663	14,857
89151E109 TOTAL S.A. - ADR	8,684	8,418
G5960L103 MEDTRONIC PLC	6,849	8,937
09857L108 BOOKING HOLDINGS INC	8,872	10,940
904767704 UNILEVER PLC - ADR	6,971	7,430
58933Y105 MERCK & CO INC NEW	5,410	8,088
883556102 THERMO FISHER SCIENT	982	9,585
31620M106 FIDELITY NATL INFORM	7,389	8,500
037833100 APPLE INC	4,712	46,840
867224107 SUNCOR ENERGY INC NE	7,811	7,263
285512109 ELECTRONIC ARTS INC	6,600	11,363
92826C839 VISA INC-CLASS A SHR	5,965	8,885
75513E101 RAYTHEON TECHNOLOGIE	9,020	11,432
891160509 TORONTO DOMINION BK	10,225	13,310
91324P102 UNITEDHEALTH GROUP I	3,463	22,825
09260D107 BLACKSTONE GROUP INC	7,606	13,794
H2906T109 GARMIN LTD	6,710	10,703

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
405217100 HAIN CELESTIAL GROUP
126650100 CVS HEALTH CORPORATI
17275R102 CISCO SYSTEMS INC
254687106 WALT DISNEY CO
89151E109 TOTAL S.A. - ADR
87612E106 TARGET CORP
91324P102 UNITEDHEALTH GROUP I
09247X101 BLACKROCK INC
464287226 ISHARES CORE U.S. AG	AT COST	213,353	222,818
H84989104 TE CONNECTIVITY LTD
921943858 VANGUARD FTSE DEVELO
31620M106 FIDELITY NATL INFORM
848574109 SPIRIT AEROSYTSEMS H
25243Q205 DIAGEO PLC - ADR
037833100 APPLE INC
172967424 CITIGROUP INC.
Y2573F102 FLEX LTD
097023105 BOEING CO
285512109 ELECTRONIC ARTS INC
907818108 UNION PACIFIC CORP
46625H100 JPMORGAN CHASE & CO
58933Y105 MERCK & CO INC NEW
00206R102 AT & T INC
12572Q105 CME GROUP INC
594918104 MICROSOFT CORP
654106103 NIKE INC CL B
150870103 CELANESE CORP
277923264 EATON VANCE GLOB MAC
02079K107 ALPHABET INC CL C
532457108 ELI LILLY & CO COM
891160509 TORONTO DOMINION BK
911312106 UNITED PARCEL SERVIC
46090F100 INVESCO OPTIMUM YIEL	AT COST	27,473	46,589
31641Q755 FIDELITY NEW MRKTS I	AT COST	43,829	44,529
375558103 GILEAD SCIENCES INC
512807108 LAM RESEARCH CORP CO
883556102 THERMO FISHER SCIENT
56501R106 MANULIFE FINANCIAL C
464287655 ISHARES RUSSELL 2000	AT COST	143,230	186,019
87234N765 TCW EMRG MKTS INCM-I
517834107 LAS VEGAS SANDS CORP
921937819 VANGUARD INTERMEDIAT
867224107 SUNCOR ENERGY INC NE
609207105 MONDELEZ INTERNATION
46434G103 ISHARES CORE MSCI EM	AT COST	229,061	272,247
192446102 COGNIZANT TECH SOLUT
G5960L103 MEDTRONIC PLC
09260D107 BLACKSTONE GROUP INC
11135F101 BROADCOM INC
94106L109 WASTE MANAGEMENT INC
74440Y884 PGIM HIGH YIELD-Q 10	AT COST	140,171	156,486
92826C839 VISA INC-CLASS A SHR
871829107 SYSCO CORP
H2906T109 GARMIN LTD
75513E101 RAYTHEON TECHNOLOGIE
922908629 VANGUARD MIDCAP VIPE	AT COST	257,743	395,425
904784709 UNILEVER N.V. - ADR
09857L108 BOOKING HOLDINGS INC
872365713 TCW EMRG MRKTS INC-P	AT COST	85,746	88,150
46434V613 ISHARES CORE TOTAL B	AT COST	89,381	89,328
464287804 ISHARES CORE S&P SMA	AT COST	41,962	45,757
27830W108 EV GL MACR ABS RTRN	AT COST	44,780	45,038

Category	Amount	Net Investment Income
FOREIGN TAXES	592	592
FEDERAL TAX PAYMENT - PRIOR YE	344	0
FEDERAL ESTIMATES - PRINCIPAL	1,936	0
FOREIGN TAXES ON QUALIFIED FOR	79	79
FOREIGN TAXES ON NONQUALIFIED	167	167

Description	Revenue and Expenses per Books	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
FILING FEE/STATE TAX	10	0		10
INVESTMENT EXPENSES - ADR FEES	15	15		0

Description	Amount
MUTUAL FUND TIMING ADJ	235
ROUNDING	11