Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
M SCHINASI INTL HOSPITAL XXXXX7004
 
Number and street (or P.O. box number if mail is not delivered to street address)10 S DEARBORN IL1-0111
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL60603
A Employer identification number

13-6029118
B Telephone number (see instructions)

(800) 496-2583
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$3,955,437
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 115,998 115,664  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 220,075
b Gross sales price for all assets on line 6a 966,058
7 Capital gain net income (from Part IV, line 2)... 220,075
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........ 336,073 335,739  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 45,955 28,455   17,500
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule)......... 89,468 0 0 89,468
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... 5,752 1,866   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)....... 15,850 15,600   250
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 157,025 45,921 0 107,218
25 Contributions, gifts, grants paid....... 82,133 82,133
26 Total expenses and disbursements. Add lines 24 and 25 239,158 45,921 0 189,351
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 96,915
b Net investment income (if negative, enter -0-) 289,818
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 12,627 31,345 31,345
2 Savings and temporary cash investments......... 50,106 56,325 56,325
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
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)....... 1,389,453 Click to see attachment1,422,689 2,364,590
c Investments—corporate bonds (attach schedule)....... 1,481,866 Click to see attachment1,520,946 1,503,177
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........     0
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,934,052 3,031,305 3,955,437
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 2,934,052 3,031,305
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)..... 2,934,052 3,031,305
30 Total liabilities and net assets/fund balances (see instructions). 2,934,052 3,031,305
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
2,934,052
2
Enter amount from Part I, line 27a .....................
2
96,915
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
3,226
4
Add lines 1, 2, and 3 ..........................
4
3,034,193
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
2,888
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
3,031,305
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a 13. APPLE COMPUTER INC   2006-04-07 2021-01-08
b 1. FIDELITY NATL INFORMATION SVCS INC   2014-12-18 2021-01-11
c 13. FIDELITY NATL INFORMATION SVCS INC     2021-01-11
d 1. FIDELITY NATL INFORMATION SVCS INC   2015-01-15 2021-01-11
e 1. FIDELITY NATL INFORMATION SVCS INC   2015-01-15 2021-01-11
3. FIDELITY NATL INFORMATION SVCS INC   2014-12-17 2021-01-11
2. FIDELITY NATL INFORMATION SVCS INC     2021-01-12
9. CITIGROUP INC NEW   2020-06-30 2021-01-28
19. CITIGROUP INC NEW     2021-01-28
16. MERCK & CO INC   2016-08-12 2021-01-28
2. ABBVIE INC   2020-03-31 2021-02-01
4. ABBVIE INC   2019-11-11 2021-02-01
4. ADVANCED MICRO DEVICES INC   2020-11-06 2021-02-01
1. ALPHABET INC-CL C   2012-08-13 2021-02-01
4. AMERICAN EXPRESS CO   2020-12-03 2021-02-01
2. AMETEK INC NEW   2020-10-02 2021-02-01
3. ANALOG DEVICES INC   2020-12-17 2021-02-01
15. APPLE COMPUTER INC   2006-04-07 2021-02-01
15. BANK OF AMERICA CORPORATION   2012-10-23 2021-02-01
9. BOSTON SCIENTIFIC CORP   2016-12-05 2021-02-01
7. BRISTOL MYERS SQUIBB CO     2021-02-01
1. CHARTER COMMUNICATIONS INC-A     2021-02-01
3. CITIGROUP INC NEW   2012-01-23 2021-02-01
6. COCA-COLA CO   2020-08-04 2021-02-01
8. COMCAST CORP NEW CL A   2009-12-07 2021-02-01
3. FACEBOOK INC-A   2020-01-08 2021-02-01
6. FISERV INC     2021-02-01
2. HOME DEPOT INC   2011-09-29 2021-02-01
4. HONEYWELL INTL INC     2021-02-01
1. INTUIT   2020-02-25 2021-02-01
1. LAM RESEARCH CORPORATION COMMON   2020-12-17 2021-02-01
1. LAUDER ESTEE COS INC CL A   2021-01-08 2021-02-01
3. LILLY ELI & CO     2021-02-01
2. LOWES COS INC   2020-04-16 2021-02-01
2. LOWES COS INC   2011-09-22 2021-02-01
2. MASTERCARD INC - CLASS A   2009-07-16 2021-02-01
1. MCDONALDS CORP   2019-06-10 2021-02-01
3. MERCK & CO INC   2016-08-12 2021-02-01
12. MICROSOFT CORP   2009-01-15 2021-02-01
6. MONDELEZ INTERNATIONAL-W/I   2011-09-09 2021-02-01
10. MORGAN STANLEY DEAN WITTER & CO NEW   2013-04-19 2021-02-01
9. NEXTERA ENERGY INC   2020-09-30 2021-02-01
2. NORFOLK SOUTHN CORP   2020-08-04 2021-02-01
2. NORTHROP GRUMMAN CORP     2021-02-01
1. NVIDIA CORP   2017-10-03 2021-02-01
1. O'REILLY AUTOMOTIVE INC   2020-06-30 2021-02-01
2. PPG INDS INC   2020-11-03 2021-02-01
5. PAYPAL HOLDINGS INC   2020-03-04 2021-02-01
3. PEPSICO INC   2014-10-13 2021-02-01
2483.194 PIMCO INV GRD CRD BND-INST   2018-03-15 2021-02-01
3. PIONEER NAT RES CO     2021-02-01
3. PROCTER & GAMBLE CO   2019-06-05 2021-02-01
7. RAYTHEON TECHNOLOGIES CORP   2020-11-24 2021-02-01
1. REGENERON PHARMACEUTICALS INC   2021-01-28 2021-02-01
95. SPDR TR UNIT SER 1     2021-02-01
2. SALESFORCE.COM INC   2018-04-13 2021-02-01
8. SCHWAB CHARLES CORP NEW     2021-02-01
2. STANLEY BLACK & DECKER,INC.     2021-02-01
4. TEXAS INSTRS INC     2021-02-01
1. TEXAS INSTRS INC   2016-03-10 2021-02-01
1. THERMO ELECTRON CORP   2020-07-10 2021-02-01
2. UNION PAC CORP   2015-10-08 2021-02-01
3. UNITEDHEALTH GROUP INC   2010-12-01 2021-02-01
1. VERTEX PHARMACEUTICALS INC   2011-12-15 2021-02-01
3. WASTE CONNECTIONS INC   2021-01-08 2021-02-01
9. WELLS FARGO & CO NEW   2020-12-15 2021-02-01
2. WEX INC   2020-12-03 2021-02-01
4. YUM BRANDS INC   2020-10-16 2021-02-01
3. ZIMMER HLDGS INC   2020-06-30 2021-02-01
4. LINDE PLC   2019-04-25 2021-02-01
2. CHUBB LTD   2008-11-19 2021-02-01
1. ASML HOLDING NV-NY REG SHS   2020-03-05 2021-02-01
4. NXP SEMICONDUCTORS NV   2020-11-02 2021-02-01
222. ISHARES TR 20+ TREAS INDEX FD   2020-10-21 2021-02-10
34. ISHARES TR 20+ TREAS INDEX FD   2019-09-20 2021-02-10
9. COCA-COLA CO   2020-08-04 2021-02-17
32. COCA-COLA CO     2021-02-17
2. NORTHROP GRUMMAN CORP     2021-02-18
24. CITIGROUP INC NEW     2021-02-19
1. NORTHROP GRUMMAN CORP   2020-06-24 2021-02-19
2. NORTHROP GRUMMAN CORP   2020-07-10 2021-02-19
2. NORTHROP GRUMMAN CORP   2016-09-16 2021-02-19
2. NORTHROP GRUMMAN CORP     2021-02-19
1. NORTHROP GRUMMAN CORP   2016-09-16 2021-02-19
1. NORTHROP GRUMMAN CORP   2016-09-16 2021-02-19
1. NORTHROP GRUMMAN CORP   2016-09-16 2021-02-19
1. NORTHROP GRUMMAN CORP   2016-09-15 2021-02-19
2. HOME DEPOT INC   2011-09-29 2021-02-24
6. HOME DEPOT INC   2011-09-29 2021-02-24
18. MERCK & CO INC     2021-02-24
13. PROCTER & GAMBLE CO   2019-06-05 2021-03-03
3. PROCTER & GAMBLE CO     2021-03-03
3. SALESFORCE.COM INC   2018-04-13 2021-03-03
1. SALESFORCE.COM INC   2018-04-13 2021-03-03
1. SALESFORCE.COM INC   2018-04-13 2021-03-03
2. SALESFORCE.COM INC   2018-04-13 2021-03-04
1. SALESFORCE.COM INC   2018-04-13 2021-03-04
1. SALESFORCE.COM INC   2018-04-13 2021-03-04
1. SALESFORCE.COM INC   2018-04-13 2021-03-04
7. APPLE COMPUTER INC   2006-04-07 2021-03-05
1. PAYPAL HOLDINGS INC   2018-01-26 2021-03-05
1. PAYPAL HOLDINGS INC   2018-01-26 2021-03-05
4. PAYPAL HOLDINGS INC   2018-01-26 2021-03-05
1. NETFLIX.COM INC   2018-09-13 2021-03-18
1. NETFLIX.COM INC   2018-09-13 2021-03-18
. JPMORGAN BETABUILDERS EUROPE ETF     2021-04-15
. JPMORGAN BETABUILDERS CANADA     2021-04-15
2. CHARTER COMMUNICATIONS INC-A   2016-02-09 2021-04-16
6. CHUBB LTD   2008-11-19 2021-04-27
5. CHUBB LTD   2008-11-19 2021-04-28
3. CHUBB LTD   2008-11-19 2021-04-28
1. CHUBB LTD   2008-11-19 2021-04-28
16. ABBVIE INC     2021-04-29
10. ADVANCED MICRO DEVICES INC   2020-11-06 2021-04-29
2. ALPHABET INC-CL C   2012-07-11 2021-04-29
1. ALPHABET INC-CL A   2012-07-11 2021-04-29
2. AMAZON COM INC     2021-04-29
7. AMERICAN EXPRESS CO     2021-04-29
5. AMERICAN EXPRESS CO     2021-04-29
7. AMETEK INC NEW     2021-04-29
11. ANALOG DEVICES INC     2021-04-29
39. APPLE COMPUTER INC   2006-04-07 2021-04-29
38. BANK OF AMERICA CORPORATION     2021-04-29
2. BIOGEN IDEC INC   2020-03-11 2021-04-29
1. BOOKING HOLDINGS INC   2020-10-05 2021-04-29
24. BOSTON SCIENTIFIC CORP     2021-04-29
2. BRISTOL MYERS SQUIBB CO   2020-07-10 2021-04-29
15. BRISTOL MYERS SQUIBB CO   2019-11-21 2021-04-29
2. CHARTER COMMUNICATIONS INC-A     2021-04-29
27. COMCAST CORP NEW CL A   2021-04-16 2021-04-29
4. COMCAST CORP NEW CL A   2009-12-07 2021-04-29
7. FACEBOOK INC-A     2021-04-29
3. FACEBOOK INC-A   2014-07-25 2021-04-29
16. FISERV INC     2021-04-29
6. ARTHUR J GALLAGHER & CO     2021-04-29
7. HILTON WORLDWIDE HOLDINGS IN     2021-04-29
9. HONEYWELL INTL INC   2010-02-01 2021-04-29
3. INTUIT     2021-04-29
346. ISHARES TR 20+ TREAS INDEX FD   2019-09-20 2021-04-29
2. LAM RESEARCH CORPORATION COMMON     2021-04-29
3. LAUDER ESTEE COS INC CL A     2021-04-29
3. LILLY ELI & CO     2021-04-29
7. LILLY ELI & CO     2021-04-29
9. LOWES COS INC   2011-09-22 2021-04-29
6. MASTERCARD INC - CLASS A     2021-04-29
3. MASTERCARD INC - CLASS A   2009-07-16 2021-04-29
3. MCDONALDS CORP   2019-06-10 2021-04-29
30. MICROSOFT CORP     2021-04-29
16. MONDELEZ INTERNATIONAL-W/I     2021-04-29
28. MORGAN STANLEY DEAN WITTER & CO NEW   2013-04-19 2021-04-29
1. NETFLIX.COM INC   2019-05-16 2021-04-29
11. NEXTERA ENERGY INC     2021-04-29
15. NEXTERA ENERGY INC     2021-04-29
8. NIKE INC   2021-02-17 2021-04-29
2. NORFOLK SOUTHN CORP   2020-08-04 2021-04-29
6. NORFOLK SOUTHN CORP     2021-04-29
2. NVIDIA CORP   2017-10-03 2021-04-29
2. O'REILLY AUTOMOTIVE INC     2021-04-29
7. PPG INDS INC     2021-04-29
10. PAYPAL HOLDINGS INC   2018-01-26 2021-04-29
9. PEPSICO INC     2021-04-29
8. PIONEER NAT RES CO     2021-04-29
20. RAYTHEON TECHNOLOGIES CORP     2021-04-29
1. REGENERON PHARMACEUTICALS INC   2021-01-28 2021-04-29
22. SCHWAB CHARLES CORP NEW     2021-04-29
1. STANLEY BLACK & DECKER,INC.   2020-10-05 2021-04-29
5. STANLEY BLACK & DECKER,INC.     2021-04-29
13. TEXAS INSTRS INC     2021-04-29
2. THERMO ELECTRON CORP     2021-04-29
2. THERMO ELECTRON CORP   2020-01-13 2021-04-29
7. UNION PAC CORP     2021-04-29
9. UNITEDHEALTH GROUP INC   2010-12-01 2021-04-29
3. VERTEX PHARMACEUTICALS INC   2011-12-15 2021-04-29
5. WASTE CONNECTIONS INC   2021-01-08 2021-04-29
4. WASTE CONNECTIONS INC   2016-07-26 2021-04-29
53. WELLS FARGO & CO NEW     2021-04-29
3. WEX INC   2021-03-05 2021-04-29
4. WEX INC   2020-04-27 2021-04-29
6. YUM BRANDS INC     2021-04-29
5. YUM BRANDS INC   2018-11-27 2021-04-29
2. ZIMMER HLDGS INC   2020-06-30 2021-04-29
9. ZIMMER HLDGS INC     2021-04-29
8. EATON CORP PLC     2021-04-29
8. LINDE PLC     2021-04-29
7. TRANE TECHNOLOGIES PLC     2021-04-29
2. ASML HOLDING NV-NY REG SHS     2021-04-29
13. NXP SEMICONDUCTORS NV     2021-04-29
16576.282 BLCKRCK HI YLD BND PORT-K     2021-05-13
1. NEXTERA ENERGY INC   2016-10-18 2021-05-14
4. NEXTERA ENERGY INC   2016-10-18 2021-05-14
1. ASML HOLDING NV-NY REG SHS   2020-03-05 2021-05-14
1. NEXTERA ENERGY INC   2016-10-18 2021-05-17
1. NEXTERA ENERGY INC   2016-10-18 2021-05-17
3187.181 DOUBLELINE TTL RTRN BND-R6     2021-07-08
1851.728 SIX CIRCLES US UNCONSTR EQ   2019-04-03 2021-07-08
2950. ISHARES US TREASURY BOND ETF     2021-07-23
3208.37 SIX CIRCLES ULTR SHRT DUR   2021-07-08 2021-07-23
553. VANGUARD MORTGAGE-BACKED SEC   2020-10-29 2021-07-23
288. ISHARES 3-7 YEAR TREASURY BO   2021-02-10 2021-07-26
4227.545 JPMORGAN CORE BOND FUND ULTRA   2019-02-07 2021-07-26
2. HONEYWELL INTL INC   2010-02-01 2021-08-19
6. RAYTHEON TECHNOLOGIES CORP   2020-11-24 2021-08-19
1. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-08-20
1. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-08-23
1. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-08-24
7. FISERV INC   2019-01-24 2021-09-09
1. LAM RESEARCH CORPORATION COMMON   2020-11-03 2021-09-09
1. UNION PAC CORP   2015-09-29 2021-09-09
1. UNION PAC CORP   2015-09-29 2021-09-09
2. UNION PAC CORP   2015-09-29 2021-09-09
5. UNION PAC CORP   2015-09-29 2021-09-09
1. UNION PAC CORP   2015-09-29 2021-09-09
2. LILLY ELI & CO     2021-09-15
5. RAYTHEON TECHNOLOGIES CORP     2021-09-15
1. VERTEX PHARMACEUTICALS INC   2011-12-15 2021-09-15
2. VERTEX PHARMACEUTICALS INC   2011-12-15 2021-09-15
13. CONOCOPHILLIPS     2021-09-29
4. FISERV INC     2021-10-12
2. MASTERCARD INC - CLASS A   2009-07-16 2021-10-12
3. PAYPAL HOLDINGS INC   2018-01-26 2021-10-12
1. LAM RESEARCH CORPORATION COMMON   2020-11-03 2021-10-21
2. LAM RESEARCH CORPORATION COMMON   2020-11-03 2021-10-21
8. RAYTHEON TECHNOLOGIES CORP     2021-10-21
2. RAYTHEON TECHNOLOGIES CORP   2021-01-28 2021-10-21
1. RAYTHEON TECHNOLOGIES CORP   2021-01-28 2021-10-21
6. RAYTHEON TECHNOLOGIES CORP   2021-01-28 2021-10-21
154. ISHARES CORE MSCI EMERGING   2020-10-21 2021-10-26
25. ISHARES CORE MSCI EMERGING   2020-10-21 2021-10-26
7. ISHARES CORE MSCI EMERGING   2020-10-21 2021-10-26
275. ISHARES CORE MSCI EMERGING   2020-10-21 2021-10-26
186. ISHARES CORE MSCI EMERGING   2020-10-21 2021-10-26
403. ISHARES CORE MSCI EMERGING     2021-10-26
237. ISHARES CORE MSCI EMERGING   2020-10-21 2021-10-26
349. JPMORGAN BETABUILDERS JAPAN ETF   2021-02-01 2021-10-26
15. COMCAST CORP NEW CL A   2009-12-07 2021-10-27
1. YUM BRANDS INC   2018-11-27 2021-10-27
2. YUM BRANDS INC     2021-10-27
1. YUM BRANDS INC   2020-03-11 2021-10-27
3. YUM BRANDS INC   2020-03-11 2021-10-27
2. YUM BRANDS INC   2020-03-11 2021-10-27
2. YUM BRANDS INC   2020-03-11 2021-10-27
3. YUM BRANDS INC   2020-03-11 2021-10-28
1. YUM BRANDS INC   2020-03-11 2021-10-28
1. PAYPAL HOLDINGS INC   2018-01-26 2021-10-29
4. PAYPAL HOLDINGS INC   2018-01-26 2021-10-29
2. PAYPAL HOLDINGS INC     2021-11-01
20. COMCAST CORP NEW CL A   2009-12-07 2021-11-02
6. COMCAST CORP NEW CL A   2009-12-07 2021-11-02
1. ZIMMER HLDGS INC   2017-11-10 2021-11-02
2. ZIMMER HLDGS INC   2017-11-10 2021-11-02
1. ZIMMER HLDGS INC   2017-11-10 2021-11-02
1. ZIMMER HLDGS INC   2017-11-10 2021-11-02
1. ZIMMER HLDGS INC   2017-11-10 2021-11-03
3. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-11-05
1. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-11-08
1. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-11-08
1. STANLEY BLACK & DECKER,INC.   2016-02-11 2021-11-08
1. ANALOG DEVICES INC   2021-09-09 2021-11-19
1. ANALOG DEVICES INC   2021-09-09 2021-11-22
1. ANALOG DEVICES INC   2021-09-09 2021-11-22
2. ANALOG DEVICES INC   2021-09-09 2021-12-06
3. ANALOG DEVICES INC     2021-12-06
1. NETFLIX.COM INC   2019-05-16 2021-12-06
1. ANALOG DEVICES INC   2020-11-06 2021-12-07
252. ISHARES MISCI EAFE INDEX FUND   2011-10-13 2021-12-08
86. SPDR TR UNIT SER 1   2015-02-11 2021-12-08
1. ZIMMER HLDGS INC   2017-11-10 2021-12-29
1. ZIMMER HLDGS INC   2017-11-13 2021-12-29
2. ZIMMER HLDGS INC   2017-11-10 2021-12-29
4. ZIMMER HLDGS INC     2021-12-29
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    
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
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a 1,718   32 1,686
b 138   63 75
c 1,785   816 969
d 137   62 75
e 137   62 75
408   184 224
269   123 146
544   461 83
1,149   662 487
1,248   1,012 236
205   152 53
410   341 69
350   343 7
1,904   326 1,578
471   491 -20
229   202 27
456   431 25
2,020   37 1,983
450   142 308
325   186 139
437   402 35
603   230 373
175   90 85
290   280 10
401   68 333
788   642 146
642   529 113
540   68 472
782   153 629
375   289 86
502   486 16
242   260 -18
615   434 181
327   188 139
327   38 289
642   36 606
207   201 6
233   190 43
2,885   224 2,661
332   131 201
677   205 472
735   622 113
480   384 96
586   652 -66
529   179 350
438   420 18
277   274 3
1,210   573 637
411   286 125
27,688   25,438 2,250
361   389 -28
387   320 67
468   520 -52
508   509 -1
35,787   20,153 15,634
458   239 219
425   482 -57
347   339 8
687   497 190
172   55 117
518   383 135
397   192 205
1,007   113 894
232   31 201
296   315 -19
270   267 3
392   361 31
412   398 14
463   358 105
1,003   705 298
296   84 212
554   294 260
682   547 135
33,248   35,304 -2,056
5,092   4,802 290
452   419 33
1,607   1,425 182
595   627 -32
1,554   702 852
298   303 -5
595   582 13
595   423 172
595   422 173
298   211 87
297   211 86
297   211 86
297   210 87
519   68 451
1,563   203 1,360
1,346   1,125 221
1,602   1,388 214
370   320 50
627   358 269
207   119 88
211   119 92
412   238 174
207   119 88
206   119 87
204   119 85
834   17 817
234   85 149
230   85 145
948   340 608
507   371 136
505   371 134
28     28
30     30
1,283   398 885
1,000   253 747
820   211 609
500   127 373
162   42 120
1,776   1,200 576
834   857 -23
4,846   569 4,277
2,392   286 2,106
6,940   726 6,214
1,070   897 173
764   590 174
952   703 249
1,711   1,538 173
5,216   96 5,120
1,547   254 1,293
533   596 -63
2,501   1,707 794
1,052   496 556
126   115 11
947   839 108
1,344   397 947
1,516   1,488 28
225   34 191
2,277   1,810 467
976   226 750
1,945   1,338 607
843   845 -2
904   890 14
2,004   340 1,664
1,243   859 384
47,857   48,866 -1,009
1,274   855 419
948   772 176
542   433 109
1,264   519 745
1,787   172 1,615
2,321   2,174 147
1,161   54 1,107
702   603 99
7,505   552 6,953
973   349 624
2,319   575 1,744
501   362 139
844   687 157
1,151   470 681
1,058   1,152 -94
563   384 179
1,690   764 926
1,220   358 862
1,073   620 453
1,204   955 249
2,669   850 1,819
1,290   847 443
1,264   966 298
1,659   1,504 155
486   507 -21
1,572   1,317 255
209   169 40
1,047   451 596
2,397   668 1,729
929   731 198
929   664 265
1,572   634 938
3,590   338 3,252
636   94 542
588   525 63
470   198 272
2,425   2,114 311
627   637 -10
837   472 365
710   585 125
592   446 146
355   239 116
1,596   997 599
1,154   1,099 55
2,297   1,316 981
1,223   1,079 144
1,318   586 732
2,578   1,605 973
129,461   109,270 20,191
73   31 42
293   125 168
637   292 345
73   31 42
72   31 41
33,816   33,912 -96
29,905   18,906 10,999
79,089   77,717 1,372
32,148   32,148  
29,585   29,934 -349
37,862   38,143 -281
51,280   48,025 3,255
454   76 378
501   444 57
190   90 100
191   90 101
192   90 102
808   575 233
591   369 222
211   86 125
210   86 124
419   173 246
1,050   431 619
210   86 124
469   147 322
423   367 56
189   31 158
379   63 316
870   702 168
417   329 88
691   36 655
767   255 512
542   369 173
1,103   736 367
729   566 163
182   137 45
91   68 23
546   410 136
9,812   8,518 1,294
1,604   1,383 221
446   387 59
17,539   15,210 2,329
11,852   10,288 1,564
25,670   22,277 3,393
15,099   13,099 2,000
19,970   19,582 388
795   127 668
127   89 38
254   170 84
126   81 45
380   244 136
252   163 89
253   163 90
375   244 131
125   81 44
232   85 147
934   340 594
462   167 295
1,044   169 875
314   51 263
146   111 35
292   221 71
145   111 34
146   111 35
147   111 36
553   270 283
185   90 95
184   90 94
183   90 93
189   170 19
188   170 18
186   170 16
362   336 26
543   400 143
612   362 250
185   133 52
19,999   12,952 7,047
40,279   17,797 22,482
128   111 17
129   111 18
258   221 37
513   442 71
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
      29,436
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a       1,686
b       75
c       969
d       75
e       75
      224
      146
      83
      487
      236
      53
      69
      7
      1,578
      -20
      27
      25
      1,983
      308
      139
      35
      373
      85
      10
      333
      146
      113
      472
      629
      86
      16
      -18
      181
      139
      289
      606
      6
      43
      2,661
      201
      472
      113
      96
      -66
      350
      18
      3
      637
      125
      2,250
      -28
      67
      -52
      -1
      15,634
      219
      -57
      8
      190
      117
      135
      205
      894
      201
      -19
      3
      31
      14
      105
      298
      212
      260
      135
      -2,056
      290
      33
      182
      -32
      852
      -5
      13
      172
      173
      87
      86
      86
      87
      451
      1,360
      221
      214
      50
      269
      88
      92
      174
      88
      87
      85
      817
      149
      145
      608
      136
      134
      28
      30
      885
      747
      609
      373
      120
      576
      -23
      4,277
      2,106
      6,214
      173
      174
      249
      173
      5,120
      1,293
      -63
      794
      556
      11
      108
      947
      28
      191
      467
      750
      607
      -2
      14
      1,664
      384
      -1,009
      419
      176
      109
      745
      1,615
      147
      1,107
      99
      6,953
      624
      1,744
      139
      157
      681
      -94
      179
      926
      862
      453
      249
      1,819
      443
      298
      155
      -21
      255
      40
      596
      1,729
      198
      265
      938
      3,252
      542
      63
      272
      311
      -10
      365
      125
      146
      116
      599
      55
      981
      144
      732
      973
      20,191
      42
      168
      345
      42
      41
      -96
      10,999
      1,372
       
      -349
      -281
      3,255
      378
      57
      100
      101
      102
      233
      222
      125
      124
      246
      619
      124
      322
      56
      158
      316
      168
      88
      655
      512
      173
      367
      163
      45
      23
      136
      1,294
      221
      59
      2,329
      1,564
      3,393
      2,000
      388
      668
      38
      84
      45
      136
      89
      90
      131
      44
      147
      594
      295
      875
      263
      35
      71
      34
      35
      36
      283
      95
      94
      93
      19
      18
      16
      26
      143
      250
      52
      7,047
      22,482
      17
      18
      37
      71
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 220,075
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ...................
Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 4,028
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 4,028
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 2,848
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 3,194
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 6,042
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.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 2,014
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet2,014 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • 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)
    bulletNY
    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 addressbullet  
    14
    The books are in care ofbulletJP MORGAN CHASE BANK NA Telephone no.bullet (800) 496-2583

    Located atbullet10 S DEARBORN ST MC IL 1-0111CHICAGOIL ZIP+4bullet60603
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
    Yes
     
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
    No
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
    Yes
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d). Click to see attachment
    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
    JP MORGAN CHASE BANK N A TRUSTEE
    2
    45,955    
    10 S DEARBORN ST MC IL 1-0111
    CHICAGO,IL60603
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 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
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    3,846,081
    b
    Average of monthly cash balances.......................
    1b
    53,215
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    3,899,296
    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
    3,899,296
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    58,489
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    3,840,807
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    192,040
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    192,040
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    4,028
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    4,028
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    188,012
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    188,012
    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
    188,012
    Part XI
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus
    (b)
    Years prior to 2020
    (c)
    2020
    (d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 188,012
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 97,733
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 0
    b From 2017...... 0
    c From 2018...... 0
    d From 2019...... 0
    e From 2020...... 0
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 189,351
    a Applied to 2020, but not more than line 2a 97,733
    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..... 91,618
    e Remaining amount distributed out of corpus 0
    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).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    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 ..........
    96,394
    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) ...
    0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......
    0
    10 Analysis of line 9:
    a Excess from 2017.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 0
    d Excess from 2020.... 0
    e Excess from 2021.... 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..
             
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    MORRIS SCHINASI INTL HOSPITAL
    10 S DEARBORN ST MC
    CHICAGO,IL606032300
    NONE NC GENERAL 82,133
    Total .................................bullet 3a 82,133
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........
             
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............
        18 220,075  
    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) ..   336,073  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    336,073
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    Firm's EIN SmallBullet
    Firm's address SmallBullet


    Phone no.
    Form 990-PF (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2021 ExpenditureResponsibilityStmt
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Grantee's Name Grantee's Address Grant Date Grant Amount Grant Purpose Amount Expended By Grantee Any Diversion By Grantee? Dates of Reports By Grantee Date of Verification Results of Verification
    MORRIS SCHINASI INTL HOSPITAL
     
    AKESCIT MH
      MANISA45010
    TU
    2021-12-22 82,133 THE MINISTRY IS RESPONSIBLE FOR THE MANAGEMENT & OPERATION OF THE HOSPITAL.   TO THE KNOWLEDGE OF THE GRANTOR AS PER THE REPORT FURNISHED BY THE GRANTEE, FUNDS ARE USED FOR THEIR 12/30/2021 2022-10-18 NO VERIFICATION UNDERTAKEN AS THERE HAS NOT BEEN ANY REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORT.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Name of Bond End of Year Book Value End of Year Fair Market Value
    4812C0100 JPM CORE BD FD - USD 110,548 116,110
    92203J308 VANGUARD TTL INTL BN 361,095 359,562
    722005816 PIMCO INV GRD CRD BN 41,049 42,909
    72201F490 PIMCO INCOME FUND-IN 32,973 33,268
    83002G108 SIX CIRCLES ULTR SHR 39,746 39,500
    464287432 ISHARES 20+ YEAR TRE    
    09260B614 BLCKRCK HI YLD BND P    
    258620566 DOUBLELINE TTL RTRN    
    83002G702 SIX CIRCLES GLOBAL B 390,368 378,541
    83002G884 SIX CIRCLES CREDIT O 70,875 71,783
    92203J407 VANGUARD TOTAL INTL 155,582 148,877
    92206C771 VANGUARD MORTGAGE-BA 40,219 39,260
    921937827 VANGUARD SHORT-TERM 278,491 273,367

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Name of Stock End of Year Book Value End of Year Fair Market Value
    101137107 BOSTON SCIENTIFIC CO 1,024 1,742
    110122108 BRISTOL-MYERS SQUIBB 1,342 1,496
    172967424 CITIGROUP INC    
    437076102 HOME DEPOT INC    
    438516106 HONEYWELL INTERNATIO 415 2,294
    464287465 ISHARES MSCI EAFE ET 40,758 62,393
    532457108 ELI LILLY & CO 873 3,315
    548661107 LOWE'S COS INC 229 3,102
    594918104 MICROSOFT CORP 731 13,789
    609207105 MONDELEZ INTERNATION 478 1,459
    617446448 MORGAN STANLEY 760 3,632
    666807102 NORTHROP GRUMMAN COR    
    713448108 PEPSICO INC 1,118 2,085
    723787107 PIONEER NATURAL RESO 837 1,819
    854502101 STANLEY BLACK & DECK    
    882508104 TEXAS INSTRUMENTS IN 897 3,392
    907818108 UNION PACIFIC CORP    
    949746101 WELLS FARGO & CO 2,189 3,359
    988498101 YUM] BRANDS INC    
    02079K107 ALPHABET INC-CL C 854 8,681
    02079K305 ALPHABET INC-CL A 286 2,897
    09062X103 BIOGEN INC 868 720
    16119P108 CHARTER COMMUNICATIO 593 1,956
    20030N101 COMCAST CORP-CLASS A    
    30303M102 META PLATFORMS INC-C 1,047 4,709
    31620M106 FIDELITY NATIONAL IN    
    57636Q104 MASTERCARD INC - A 198 3,953
    58933Y105 MERCK & CO. INC.    
    65339F101 NEXTERA ENERGY INC 1,623 3,548
    67103H107 O'REILLY AUTOMOTIVE 749 2,119
    78462F103 SPDR S&P 500 ETF TRU 156,443 559,503
    91324P102 UNITEDHEALTH GROUP I 413 5,524
    92532F100 VERTEX PHARMACEUTICA    
    94106B101 WASTE CONNECTIONS IN 592 1,635
    96208T104 WEX INC 824 1,264
    H1467J104 CHUBB LTD    
    023135106 AMAZON.COM INC 1,085 10,003
    032654105 ANALOG DEVICES INC 1,332 1,758
    037833100 APPLE INC 131 9,411
    060505104 BANK OF AMERICA CORP 247 2,358
    655844108 NORFOLK SOUTHERN COR 1,931 3,870
    67066G104 NVIDIA CORP 537 3,529
    98956P102 ZIMMER BIOMET HOLDIN    
    025816109 AMERICAN EXPRESS CO 1,766 2,781
    191216100 COCA-COLA CO/THE    
    315911750 FIDELITY 500 INDEX-I 287,385 476,033
    46641Q688 JPM BTABLDRS DEV ASI    
    46641Q696 JPMORGAN BETABUILDER    
    46641Q712 JPMORGAN BETABUILDER    
    46641Q720 JPMORGAN BETABUILDER    
    64110L106 NETFLIX INC 362 602
    70450Y103 PAYPAL HOLDINGS INC 411 943
    79466L302 SALESFORCE.COM INC    
    83002G306 SIX CIRCLES US UNCON 237,898 365,764
    83002G405 SIX CIRCLES INTL UNC 275,997 317,333
    G5494J103 LINDE PLC 1,899 4,157
    00287Y109 ABBVIE INC 1,484 2,843
    337738108 FISERV INC 892 1,142
    580135101 MCDONALD'S CORP 1,289 1,608
    742718109 PROCTER & GAMBLE CO/    
    N6596X109 NXP SEMICONDUCTORS N 2,588 5,011
    007903107 ADVANCED MICRO DEVIC 1,667 2,446
    031100100 AMETEK INC 1,460 1,912
    09857L108 BOOKING HOLDINGS INC 1,615 2,399
    461202103 INTUIT INC 1,066 2,573
    46434G103 ISHARES CORE MSCI EM    
    512807108 LAM RESEARCH CORP    
    518439104 ESTEE LAUDER COMPANI 955 1,481
    693506107 PPG INDUSTRIES INC 1,214 1,552
    75513E101 RAYTHEON TECHNOLOGIE    
    883556102 THERMO FISHER SCIENT 1,654 3,336
    N07059210 ASML HOLDING NV-NY R 585 1,592
    20825C104 CONOCOPHILLIPS 963 1,299
    22160K105 COSTCO WHOLESALE COR 1,465 1,703
    244199105 DEERE & CO 2,120 2,057
    363576109 ARTHUR J GALLAGHER & 1,116 1,357
    43300A203 HILTON WORLDWIDE HOL 1,389 1,716
    45687V106 INGERSOLL RAND INC C 2,258 2,784
    46120E602 INTUITIVE SURGICAL I 1,411 1,437
    46641Q191 JPMORGAN BETABUILDER 117,631 130,771
    46641Q217 JPMORGAN BETABUILDER 101,690 116,329
    46641Q225 JPMORGAN BETABUILDER 67,785 92,938
    46641Q233 JPM BTABLDRS DEV ASI 64,211 65,906
    654106103 NIKE INC -CL B 1,684 2,000
    679580100 OLD DOMINION FREIGHT 2,029 2,509
    75886F107 REGENERON PHARMACEUT 1,698 1,895
    78486Q101 SVB FINANCIAL GROUP 1,404 1,356
    808513105 SCHWAB (CHARLES) COR 1,771 2,607
    82509L107 SHOPIFY INC - CLASS 1,509 1,377
    83304A106 SNAP INC - A 1,304 1,176
    98138H101 WORKDAY INC-CLASS A 1,676 1,639
    G29183103 EATON CORP PLC 1,422 1,901
    G6095L109 APTIV PLC 1,042 990
    G8994E103 TRANE TECHNOLOGIES P 1,520 2,020

    TY 2021 LegalFeesSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES - PRINCIPAL (ALLOCA 89,468     89,468


    TY 2021 OtherDecreasesSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Description Amount
    2021 TRANSACTIONS POSTED TO 2022 2,398
    COST BASIS ADJUSTMENT 490


    TY 2021 OtherExpensesSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ATTORNEY GENERAL FEE 250 0   250
    OTHER EXPENSE (NON-DEDUCTIBLE 15,600 15,600   0


    TY 2021 OtherIncreasesSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Description Amount
    2020 TRANSACTIONS POSTED TO 2021 3,225
    ROUNDING 1


    TY 2021 TaxesSchedule
    Name:
    M SCHINASI INTL HOSPITAL XXXXX7004
    EIN:
    13-6029118
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 27 27   0
    FEDERAL TAX PAYMENT - PRIOR YE 1,038 0   0
    FEDERAL ESTIMATES - INCOME 2,848 0   0
    FOREIGN TAXES ON QUALIFIED FOR 1,459 1,459   0
    FOREIGN TAXES ON NONQUALIFIED 380 380   0