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
BROUSSARD CHARITABLE FOUNDATION TR
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 630858
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CINCINNATI, OH452630858
A Employer identification number

35-6634227
B Telephone number (see instructions)

(513) 534-5310
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$22,912,372J 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... 450,528 450,528  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,315,635
b Gross sales price for all assets on line 6a 2,407,714
7 Capital gain net income (from Part IV, line 2)... 1,315,635
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)....... Click to see attachment 3,342    
12 Total. Add lines 1 through 11........ 1,769,505 1,766,163  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 46,209 46,209    
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)....... Click to see attachment 1,175 588 0 588
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 27,578     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)....... Click to see attachment 67 67    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 75,029 46,864 0 588
25 Contributions, gifts, grants paid....... 1,018,567 1,018,567
26 Total expenses and disbursements. Add lines 24 and 25 1,093,596 46,864 0 1,019,155
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 675,909
b Net investment income (if negative, enter -0-) 1,719,299
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............. 1 1 1
2 Savings and temporary cash investments......... 407,056 1,269,195 1,269,195
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) 229,177 Click to see attachment229,177 260,050
b Investments—corporate stock (attach schedule)....... 4,355,204 Click to see attachment4,007,220 12,535,647
c Investments—corporate bonds (attach schedule)....... 2,005,856 Click to see attachment1,704,508 1,771,832
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 4,910,484 Click to see attachment5,364,580 7,075,647
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) 11,907,778 12,574,681 22,912,372
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........ 11,907,778 12,574,681
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)..... 11,907,778 12,574,681
30 Total liabilities and net assets/fund balances (see instructions). 11,907,778 12,574,681
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
11,907,778
2
Enter amount from Part I, line 27a .....................
2
675,909
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
13
4
Add lines 1, 2, and 3 ..........................
4
12,583,700
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
9,019
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
12,574,681
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 3.04 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-01-15
b 107.5 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-01-20
c 107.97 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-01-25
d 100000. PHILIP MORRIS INTL INC 02/25/16 1.875 02/25/21   2018-05-17 2021-01-25
e 3.06 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-02-15
102.91 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-02-20
79.76 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-02-25
100000. STATE STREET CORP 03/07/11 4.375 03/07/21   2016-12-19 2021-03-07
3.08 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-03-15
116.64 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-03-20
80.98 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-03-25
3.1 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-04-15
161.56 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-04-20
92.36 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-04-25
3.12 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-05-15
178.38 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-05-20
131.24 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-05-25
3.14 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-06-15
152.81 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-06-20
31.08 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-06-25
726.744 INVESCO OPPENHEIMER DEVELOPING MARKETS FUND - CLASS R6   2017-05-08 2021-07-12
38. ALPHABET INC CAP STK CL C   2016-02-17 2021-07-12
12. ALPHABET INC CAP STK CL C   2011-12-19 2021-07-12
104. APPLE COMPUTER INC   2008-11-10 2021-07-12
1896. APPLE COMPUTER INC   2009-02-25 2021-07-12
5681.818 ISHARES RUSSELL SM MID CAP INDEX INST BLACKROCK   2020-07-08 2021-07-12
210. DANAHER CORPORATION   2018-10-26 2021-07-12
494. ECOLAB INC COM   2011-12-19 2021-07-12
985.221 HARDING LOEVNER INTL EQUITY INST   2019-07-09 2021-07-12
2404.424 PRINCIPAL MIDCAP INST FUND   2020-07-08 2021-07-12
60. THERMO ELECTRON CORP COM   2017-12-13 2021-07-12
3.16 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-07-15
187.73 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-07-20
71.64 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-07-25
3.18 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-08-15
15. ALPHABET INC CAP STK CL C   2011-12-19 2021-08-19
10. AMAZON COM INC COM   2017-12-26 2021-08-19
500. APPLE COMPUTER INC   2009-02-25 2021-08-19
85. BERKSHIRE HATHAWAY INC DEL CL B NEW   2015-12-03 2021-08-19
2085.816 ISHARES RUSSELL SM MID CAP INDEX INST BLACKROCK   2020-07-08 2021-08-19
25. BLACKROCK INC   2017-12-26 2021-08-19
45. BROADCOM INC   2017-12-26 2021-08-19
95. CHEVRONTEXACO CORP   2019-07-09 2021-08-19
415. CISCO SYS INC   2015-12-03 2021-08-19
40. CINTAS CORP   2020-07-07 2021-08-19
35. COSTCO WHOLESALE CORP   2020-07-07 2021-08-19
105. DANAHER CORPORATION   2018-10-26 2021-08-19
140. DISNEY WALT CO (HOLDING COMPANY)   2008-06-11 2021-08-19
70. DUKE ENERGY CORP   2018-10-26 2021-08-19
85. ECOLAB INC COM   2002-04-24 2021-08-19
175. EXXON MOBIL CORP   2003-04-17 2021-08-19
80. META PLATFORMS INC CL A   2018-06-22 2021-08-19
65. FEDEX CORPORATION   2013-06-27 2021-08-19
825.629 HARDING LOEVNER INTL EQUITY INST   2019-07-09 2021-08-19
60. HOME DEPOT INC   2016-02-17 2021-08-19
415. INTEL CORP COM   2021-07-12 2021-08-19
330. ISHARES CORE MSCI EAFE   2016-11-03 2021-08-19
145. J P MORGAN CHASE & CO   2014-02-12 2021-08-19
150. JOHNSON & JOHNSON   2011-12-19 2021-08-19
120. MASTERCARD INC   2014-11-25 2021-08-19
75. MCDONALDS CORP   2018-06-22 2021-08-19
210. MICROSOFT CORP   1994-07-19 2021-08-19
130. NEXTERA ENERGY INC   2011-12-19 2021-08-19
250. NIKE INC CL B   2011-12-19 2021-08-19
380. ORACLE CORP   2011-12-19 2021-08-19
85. PNC BANK CORP   2015-12-03 2021-08-19
140. PEPSICO INC   2011-12-19 2021-08-19
837.321 PRINCIPAL MIDCAP INST FUND   2020-07-08 2021-08-19
100. PROCTER & GAMBLE CO COM   2018-10-26 2021-08-19
50. S&P GLOBAL INC   2019-07-09 2021-08-19
145. SPDR S&P BIOTECH ETF   2018-06-22 2021-08-19
70. SHERWIN WILLIAMS CO   2020-07-07 2021-08-19
50. THERMO ELECTRON CORP COM   2017-12-13 2021-08-19
20. 3M CO   2011-12-19 2021-08-19
50. 3M CO   2005-04-27 2021-08-19
295. TRUIST FINL CORP   2020-07-07 2021-08-19
65. UNION PAC CORP COM   2020-07-07 2021-08-19
45. UNITEDHEALTH GROUP INC   2018-06-22 2021-08-19
305. VERIZON COMMUNICATIONS   2020-07-07 2021-08-19
115. WAL MART STORES INC COM   2018-10-26 2021-08-19
105. WASTE MANAGEMENT INC   2020-07-07 2021-08-19
155. MEDTRONIC PLC SEDOL BTN1Y11 [QDI]   2020-07-07 2021-08-19
181.98 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-08-20
32.04 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-08-25
3.2 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-09-15
128.99 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-09-20
30.98 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-09-25
. WELLS FARGO COMPANY     2021-10-05
3.22 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-10-15
150.69 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-10-20
18.12 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-10-25
3.25 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-11-15
158.32 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-11-20
48.35 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-11-25
100000. COSTCO WHSL CORP SR NT 05/18/17 2.300 05/18/22   2018-10-26 2021-12-01
3.27 GOV NATL MTG ASSN POOL #536334 7.5% DUE 10/15/30 [MBS]   2000-10-25 2021-12-15
156.86 GN 004169 06/01/08 5.500 06/20/38 [MBS]   2008-07-15 2021-12-20
65.87 FN 255770 06/01/05 5.500 07/01/35 [MBS]   2006-01-05 2021-12-25
CAPITAL GAIN DIVIDENDS P    
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CAPITAL GAIN DIVIDENDS P    
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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    
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CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
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(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 3   3  
b 108   107 1
c 108   108  
d 100,000   96,894 3,106
e 3   3  
103   103  
80   79 1
100,000   107,415 -7,415
3   3  
117   116 1
81   81  
3   3  
162   161 1
92   92  
3   3  
178   178  
131   131  
3   3  
153   152 1
31   31  
40,000   26,817 13,183
98,944   26,890 72,054
31,246   3,725 27,521
15,030   356 14,674
274,009   6,249 267,760
100,000   66,420 33,580
58,300   20,435 37,865
105,358   26,730 78,628
30,000   22,099 7,901
100,000   71,772 28,228
30,865   11,503 19,362
3   3  
188   187 1
72   71 1
3   3  
40,639   4,656 35,983
31,978   11,684 20,294
72,480   1,648 70,832
24,221   11,382 12,839
35,000   24,383 10,617
22,314   12,834 9,480
20,984   11,577 9,407
9,014   11,724 -2,710
22,729   11,342 11,387
15,469   10,876 4,593
15,495   11,129 4,366
32,866   10,217 22,649
24,354   4,729 19,625
7,491   5,775 1,716
18,527   1,838 16,689
9,348   15,321 -5,973
28,085   16,156 11,929
17,547   6,460 11,087
25,000   18,519 6,481
19,125   7,249 11,876
21,576   23,499 -1,923
24,733   17,668 7,065
22,324   8,359 13,965
26,487   9,530 16,957
42,823   10,371 32,452
17,748   12,381 5,367
60,622   662 59,960
10,911   1,870 9,041
41,730   5,836 35,894
33,653   10,876 22,777
15,607   8,098 7,509
21,808   9,012 12,796
35,000   24,994 10,006
14,323   8,848 5,475
21,243   11,575 9,668
17,478   14,298 3,180
20,907   13,720 7,187
27,200   9,586 17,614
3,899   1,556 2,343
9,748   3,841 5,907
16,240   10,392 5,848
14,499   11,064 3,435
18,690   11,476 7,214
16,854   16,826 28
17,064   11,363 5,701
15,588   11,030 4,558
19,924   14,348 5,576
182   181 1
32   32  
3   3  
129   129  
31   31  
126     126
3   3  
151   150 1
18   18  
3   3  
158   158  
48   48  
100,814   99,594 1,220
3   3  
157   156 1
66   66  
      119,065
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      119,065
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      119,065
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      119,065
      119,065
      119,065
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      119,065
      119,065
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      119,065
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      119,065
      119,065
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      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
      119,065
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a        
b       1
c        
d       3,106
e        
       
      1
      -7,415
       
      1
       
       
      1
       
       
       
       
       
      1
       
      13,183
      72,054
      27,521
      14,674
      267,760
      33,580
      37,865
      78,628
      7,901
      28,228
      19,362
       
      1
      1
       
      35,983
      20,294
      70,832
      12,839
      10,617
      9,480
      9,407
      -2,710
      11,387
      4,593
      4,366
      22,649
      19,625
      1,716
      16,689
      -5,973
      11,929
      11,087
      6,481
      11,876
      -1,923
      7,065
      13,965
      16,957
      32,452
      5,367
      59,960
      9,041
      35,894
      22,777
      7,509
      12,796
      10,006
      5,475
      9,668
      3,180
      7,187
      17,614
      2,343
      5,907
      5,848
      3,435
      7,214
      28
      5,701
      4,558
      5,576
      1
       
       
       
       
      126
       
      1
       
       
       
       
      1,220
       
      1
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 1,315,635
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 23,898
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 23,898
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 26,372
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 9,500
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 35,872
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 10
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 11,964
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet11,964 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
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
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)
    bulletIN
    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 .Click to see attachment
    8b
     
    No
    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 ofbulletFIFTH THIRD BANK NA Telephone no.bullet (812) 456-3215

    Located atbulletPO BOX 719EVANSVILLEIN ZIP+4bullet477050719
    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)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........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
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    FIFTH THIRD BANK N A TRUSTEE
    1     		46,209    
    PO BOX 719
    EVANSVILLE,IN477050719
    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  
    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
    20,456,188
    b
    Average of monthly cash balances.......................
    1b
    836,913
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    21,293,101
    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
    21,293,101
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    319,397
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    20,973,704
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,048,685
    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
    1,048,685
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    23,898
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    23,898
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,024,787
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,024,787
    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
    1,024,787
    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 1,024,787
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 529,083
    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$ 1,019,155
    a Applied to 2020, but not more than line 2a 529,083
    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..... 490,072
    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 ..........     		534,715
    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
    Partners In Health A Nonprofit
    Corporation
    800 BOYLSTON ST SUITE 300
    Boston,MA02199     		NONE PC ANNUAL DONATION 5,000
    WHITEFISH LEGACY PARTNERS
    PO BOX 1895
    WHITEFISH,MT59937     		N/A PC PROGRAM SUPPORT 3,000
    United States Eventing Association
    525 OLD WATERFORD RD NW
    Leesburg,VA20176     		NONE PC ANNUAL DONATION 80,000
    Kalispell Regional Medical Center
    310 SUNNYVIEW LANE
    Kalispel,MT59901     		NONE PC ANNUAL DONATION 12,000
    Flathead Valley Roller Derby
    PO BOX 2967
    Kalispell,MT59903     		NONE PC ANNUAL DONATION 5,000
    SHEPARD'S HAND CLINIC
    5150 RIVER LAKES PKWY
    WHITEFISH,MT59937     		NONE PC ANNUAL DONATION 10,000
    Montana Wounded Warriors
    PO BOX 5519
    Kalispell,MT59903     		NONE PC ANNUAL DONATION 11,500
    Dance Downtown LA Inc
    2245 E WASHINTGON BLVD
    Los Angeles,CA90021     		NONE PC ANNUAL DONATION 10,000
    West Valley Volunteer Fire Fighters
    Association
    4180 FARM TO MARKET RD
    Kalispell,MT59901     		NONE PC ANNUAL DONATION 2,000
    Northwest Montana Back Country Horsemen
    PO BOX 23
    Kalispell,MT59903     		NONE PC ANNUAL DONATION 5,000
    Pets For Vets South Florida Inc
    21725 SW 99TH AVE
    Miami,FL33190     		NONE PC ANNUAL DONATION 2,500
    Dian Fossey Grokka Gorilla
    Fund International
    800 CHEROKEE AVE SE
    Atlanta,GA30315     		NONE PC ANNUAL DONATION 5,000
    AMERICAN HORSE TRIALS
    FOUNDATION
    363 N LOOMIS STREET
    Southwick,MD01077     		NONE PC ANNUAL DONATION 150,000
    Davidson College Trust
    PO BOX 7162
    Davidson,NC28036     		NONE PC ANNUAL DONATION 15,000
    Servants of Relief for Incurable Cancer
    760 POLLARD BLVD SW
    Atlanta,GA30315     		NONE PC ANNUAL DONATION 6,000
    SOCIETY OF ST VINCENT DE PAUL
    2050-C CHAMBLEE TUCKER RD
    Atlanta,GA30341     		N/A PC PROGRAM SUPPORT 7,000
    MUST MINISTRIES INC
    PO BOX 1717
    Marietta,GA30061     		N/A PC PROGRAM SERVICES 1,000
    Mckenna Farms Therapy Service Inc
    3044 DUE WEST RD
    Dallas,GA30157     		NONE PC ANNUAL DONATION 1,000
    APALACHICOLA RIVERKEEPER
    232 B WATER ST
    APALACHICOLA,FL32320     		NONE PC PROGRAM SERVICES 5,000
    Mat-Su Valley Interfaith Hospitality Net
    PO BOX 870587
    Wasilla,AR99687     		NONE PC ANNUAL DONATION 3,000
    Tulane University Office of Development
    1555 POYDRAS-10TH FLOOR
    New Orleans,LA70112     		NONE PC ANNUAL DONATION 25,000
    CHEZ HOPE INC
    PO BOX 98
    FRANKLIN,LA70538     		NONE PC PROGRAM SUPPORT 2,000
    ST FRANCIS DINER INC
    P O BOX 9106
    NEW IBERIA,LA70562     		NONE PC PROGRAM SUPPORT 2,000
    New Iberia Museum Foundation
    211 E MAIN STREET
    New Iberia,LA70560     		NONE PC ANNUAL DONATION 8,000
    Northwest Montana United Way
    PO BOX 7217
    Kalispell,MT59904     		NONE PC ANNUAL DONATION 10,000
    Intermountain Planned Parenthood Inc
    1116 GRAND AVE SUITE 201
    Billings,MT59102     		NONE PC ANNUAL DONATION 27,500
    FLATHEAD VALLEY COMM
    COLLEGE
    777 GRANDVIEW DRIVE
    KALISPELL,MT59901     		NONE PC ANNUAL DONATION 441,567
    GLACIER SYMPHONY AND CHORALE
    ATTN ALAN SATTERLEE
    PO BOX 2491
    KALISPELL,MT59903     		NONE PC ANNUAL DONATION 10,000
    Humane Society of Northwest Montana
    100 ADOPT A PET WAY
    Kalispell,MT59903     		NONE PC ANNUAL DONATION 15,500
    Crossroads Christian Fellowship of
    Bigfok
    PO BOX 2078
    Bigfork,MT59911     		NONE PC ANNUAL DONATION 5,000
    Boys and Girls Club of Glacier County
    PO BOX 961
    Columbia Falls,MT59901     		NONE PC ANNUAL DONATIONS 12,500
    WHITEFISH COMMUNITY FOUNDATION
    PO BOX 1060
    WHITEFISH,MT59937     		N/A PC PROGRAM SUPPORT 14,000
    WHITEFISH HIGH SCHOOL
    1143 4TH ST
    WHITEFISH,MT59937     		N/A PC PROGRAM SUPPORT 10,000
    Flathead Warming Center Inc
    PO BOX 7142
    Kalispell,MT59904     		NONE PC ANNUAL DONATION 3,000
    Cowboy and Rousseau Animal Assistance Fu
    59595 KGKJ RANCH RD
    Anza,GA92539     		NONE PC ANNUAL DONATION 5,000
    COLORADO SCHOOL OF MINES FDN
    PO BOX 4005
    GOLDEN,CO804020005     		NONE PC PROGRAM SERVICES 25,000
    SOUTHERN COLORADO SPAY & NEUTER
    1700 S PRARIE AVE
    PUEBLO,CO81005     		NONE PC PROGRAM SUPPORT 7,500
    Nature and Wildlife and Discovery Center
    PO BOX 99
    Beulah,CO81023     		NONE PC ANNUAL DONATION 7,500
    Longhopes Donkey Shelter Inc
    66 N DUTCH VALLEY RD
    Bennett,CO80102     		NONE PC ANNUAL DONATION 1,000
    Sisters United
    2300 4TH AVE S
    Great Falls,MT59405     		NONE PC ANNUAL DONATION 5,000
    Planned Parenthood Association of Utah
    654 SOUTH 900 EAST
    Salt Lake City,UT84102     		NONE PC ANNUAL DONATION 25,000
    Canine Companions for Independence
    PO BOX 446
    Santa Rosa,CA95402     		NONE PC GENERAL 12,500
    Back Country Horsemen
    Columbia Falls Chapter
    PO BOX 1192
    Columbia Falls,MT59912     		NONE PC ANNUAL DONATION 5,000
    Total .................................bullet 3a 1,018,567
    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 1,315,635  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aSTATE TAX REFUND -     		    14 3,260  
    bFEDERAL TAX REFUND     14 82  
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   1,769,505  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,769,505
    (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

    TY 2021 AccountingFeesSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,175 588   588

    TY 2021 ExplnOfNonFilingWithAGStmt
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Statement:
    INDIANA DOES NOT REQUIRE A COPY OF FORM 990-PF.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Name of Bond End of Year Book Value End of Year Fair Market Value
    037833AS9 APPLE INC SR GLBL NT 107,672 105,781
    084670BR8 BERKSHIRE HATHAWAY I 99,314 102,110
    166764AB6 CHEVRON CORP NEW NT 98,153 101,268
    22160KAK1 COSTCO WHSL CORP SR    
    437076AZ5 HOME DEPOT INC SR NT 98,340 102,004
    458140AS9 INTEL CORP SR NT 07/ 103,809 107,948
    459200HU8 INTERNATIONAL BUSINE 207,532 210,858
    532457BQ0 LILLY ELI & CO 05/09 97,638 100,762
    57636QAB0 MASTERCARD INC NT 03 103,820 105,241
    58933YAR6 MERCK & CO INC 02/10 197,482 209,510
    68389XAS4 ORACLE CORP 07/16/13 109,027 103,630
    713448DF2 PEPSICO INC 02/24/16 196,996 210,798
    718172BS7 PHILIP MORRIS INTL I    
    857477AG8 STATE STREET CORP 03    
    872540AQ2 TJX COS INC NEW SR 0 90,823 103,295
    911312BK1 UNITED PARCEL SVC IN 96,058 101,995
    92826CAD4 VISA INC SR GLBL NT 97,844 106,632

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Name of Stock End of Year Book Value End of Year Fair Market Value
    02079K107 ALPHABET INC CAP STK 36,521 535,314
    023135106 AMAZON.COM INC 105,156 300,091
    037833100 APPLE INC 18,098 976,635
    084670702 BERKSHIRE HATHAWAY I 97,653 273,585
    09247X101 BLACKROCK, INC 136,043 242,623
    11135F101 BROADCOM INC 129,921 336,032
    166764100 CHEVRON CORPORATION 94,620 120,871
    17275R102 CISCO SYSTEMS INC 125,308 290,551
    172908105 CINTAS CORP 125,073 203,858
    22160K105 COSTCO WHOLESALE COR 122,418 218,565
    235851102 DANAHER CORP 111,419 376,716
    254687106 DISNEY WALT CO 52,000 241,628
    26441C204 DUKE ENERGY CORP 56,332 80,249
    278865100 ECOLAB INC 19,790 214,650
    30231G102 EXXON MOBIL CORP 159,430 118,709
    30303M102 META PLATFORMS INC C 156,160 290,943
    31428X106 FEDEX CORPORATION 74,045 192,687
    437076102 HOME DEPOT INC 83,359 286,357
    458140100 INTEL CORP 250,274 236,128
    46625H100 JPMORGAN CHASE & CO 92,528 254,152
    478160104 JOHNSON & JOHNSON 43,380 284,147
    57636Q104 MASTERCARD INC 116,154 485,082
    580135101 MCDONALDS CORP 136,166 221,158
    594918104 MICROSOFT CORP 7,216 770,173
    65339F101 NEXTERA ENERGY INC 20,574 133,505
    654106103 NIKE INC 37,114 458,343
    68389X105 ORACLE CORPORATION 36,265 362,794
    693475105 PNC FINANCIAL SERVIC 87,167 183,476
    713448108 PEPSICO INC 39,600 265,429
    742718109 PROCTER & GAMBLE CO 89,784 178,302
    78409V104 S&P GLOBAL INC 114,779 259,562
    824348106 SHERWIN WILLIAMS CO 156,800 281,728
    883556102 THERMO FISHER SCIENT 100,652 350,301
    88579Y101 3M CO 57,611 133,223
    89832Q109 TRUIST FINL CORP 115,194 191,459
    907818108 UNION PAC CORP 119,152 176,351
    91324P102 UNITEDHEALTH GROUP I 131,335 258,602
    92343V104 VERIZON COMMUNICATIO 117,560 173,910
    931142103 WALMART INC 127,266 186,361
    94106L109 WASTE MGMT INC DEL 120,279 191,101
    9940338Y7 FARMERS MERCHANTS BA 49,397 1,021,845
    G5960L103 MEDTRONIC PLC 137,627 178,451

    TY 2021 InvestmentsGovtObligationsSch
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    US Government Securities - End of Year Book Value:

    229,177
    US Government Securities - End of Year Fair Market Value:

    260,050
    State & Local Government Securities - End of Year Book Value:


     
    State & Local Government Securities - End of Year Fair Market Value:


     


    TY 2021 InvestmentsOtherSchedule2
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    00143W859 INVESCO OPPENHEIMER AT COST 293,183 373,431
    04314H717 ARTISAN HIGH INCOME AT COST 170,000 183,615
    091936237 ISHARES RUSSELL SM M AT COST 659,196 961,445
    258620103 DOUBLELINE TOTAL RET AT COST 300,000 293,061
    31371MCF2 FN 255770 06/01/05 5 AT COST 3,579 4,098
    31428Q747 FEDERATED HERMES ULT AT COST 249,321 248,621
    36202ET25 GN 004169 06/01/08 5 AT COST 5,313 6,150
    36212KY72 GN 536334 10/01/00 7 AT COST 479 487
    412295107 HARDING LOEVNER INTL AT COST 359,383 481,794
    464287200 ISHARES CORE S&P 500 AT COST 587,909 1,070,843
    46432F842 ISHARES CORE MSCI EA AT COST 320,705 447,094
    46434G103 ISHARES CORE MSCI EM AT COST 277,090 353,773
    74253Q747 PRINCIPAL MIDCAP INS AT COST 653,234 915,841
    78464A870 SPDR S&P BIOTECH ETF AT COST 152,829 180,815
    89154Q596 TOUCHSTONE FLEXIBLE AT COST 204,225 251,337
    89155T664 TOUCHSTONE ULTRA SHO      
    922908553 VANGUARD REAL ESTATE AT COST 481,652 664,157
    57630C580 MASSMUTUAL SHORT-DUR AT COST 400,000 395,741
    89155T656 TOUCHSTONE ULTRA SHO AT COST 246,482 243,344

    TY 2021 OtherDecreasesSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Description Amount
    RETURN OF CAPITAL ADJUSTMENT 6,347
    2021 TRANSACTION POSTED IN 2022 2,672


    TY 2021 OtherExpensesSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OTHER EXPENSE (NON-DEDUCTIBLE 67 67   0


    TY 2021 OtherIncomeSchedule2
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    STATE TAX REFUND 3,260 0  
    FEDERAL TAX REFUND 82 0  


    TY 2021 OtherIncreasesSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Description Amount
    ROUNDING 13


    TY 2021 TaxesSchedule
    Name:
    BROUSSARD CHARITABLE FOUNDATION TR
    EIN:
    35-6634227
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL TAX PAYMENT - PRIOR YE 1,206 0   0
    FEDERAL ESTIMATES - PRINCIPAL 26,372 0   0