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
AMERICAN WARRIOR INITIATIVE INC
 
Number and street (or P.O. box number if mail is not delivered to street address)4750 S BILTMORE LN
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MADISON, WI53718
A Employer identification number

47-3566126
B Telephone number (see instructions)

(608) 571-0508
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$3,298,583J 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) 1,804,321
2 Check bullet.............
3 Interest on savings and temporary cash investments 2,325 2,325  
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 59
b Gross sales price for all assets on line 6a 8,492
7 Capital gain net income (from Part IV, line 2)... 59
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,806,705 2,384  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 19,299 0   19,299
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 10,263 234   10,029
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 29,562 234   29,328
25 Contributions, gifts, grants paid....... 1,772,750 1,772,750
26 Total expenses and disbursements. Add lines 24 and 25 1,802,312 234   1,802,078
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 4,393
b Net investment income (if negative, enter -0-) 2,150
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 2,089,902 511,758 511,758
2 Savings and temporary cash investments......... 1,077,784 2,084,792 2,084,792
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet702,033
Less: allowance for doubtful accounts bullet   83,497 702,033 702,033
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 bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
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) 3,251,183 3,298,583 3,298,583
Liabilities 17 Accounts payable and accrued expenses.......... 5,778  
18 Grants payable................. 466,036 514,821
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)......... 471,814 514,821
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........... 1,163,618 1,118,615
25 Net assets with donor restrictions............ 1,615,751 1,665,147
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 2,779,369 2,783,762
30 Total liabilities and net assets/fund balances (see instructions). 3,251,183 3,298,583
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
2,779,369
2
Enter amount from Part I, line 27a .....................
2
4,393
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
2,783,762
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,783,762
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 SECURITIES D    
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 8,492   8,433 59
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       59
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 59
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 30
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 30
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 0
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 0
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 30
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11  
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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletAL, AK, AR, CA, CO, CT, DC, FL, GA, HI, IL, KS, KY, ME, MD, MA, MI, MN, MS, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, UT, VA, WA, WV, WI
    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. Click to see attachment...............................
    10
    Yes
     
    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 addressbulletAMERICANWARRIORINITIATIVE.COM
    14
    The books are in care ofbulletPAULA WILCOX Telephone no.bullet (608) 571-0508

    Located atbullet4750 S BILTMORE LNMADISONWI ZIP+4bullet53718
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
    Yes
     
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........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
    Yes
     
    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
    STEVEN JACOBSON PRESIDENT
    1.00     		0 0 0
    4750 S BILTMORE LANE
    MADISON,WI537182108
    TODD GAVINSKI TREASURER
    1.00     		0 0 0
    4750 S BILTMORE LANE
    MADISON,WI537182108
    LEONARD KRUPINSKI DIRECTOR
    1.00     		0 0 0
    4750 S BILTMORE LANE
    MADISON,WI537182108
    SEAN PARNELL DIRECTOR
    1.00     		0 0 0
    4750 S BILTMORE LANE
    MADISON,WI537182108
    LOUISE THAXTON DIRECTOR
    1.00     		0 0 0
    4750 S BILTMORE LANE
    MADISON,WI537182108
    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 AMERICAN WARRIOR INITIATIVE (AWI) HAS REACHED OVER 25,000 REAL ESTATE AGENTS AROUND THE COUNTRY AT THE AMERICAN WARRIOR REAL ESTATE PROFESSIONAL (AWREP) BOOT CAMPS, BRINGING AWARENESS TO THE CHALLENGES FACING MEN AND WOMEN WHO HAVE SERVED IN THE MILITARY WHEN RETURNING FROM WAR. IN 2018, AWI LAUNCHED FREEDOM TOURS WITH GOLD STAR MOM KAREN VAUGHN. FROM HER UNIQUE PERSPECTIVE--AS A MOM WHOSE SON WAS KILLED IN ACTION IN AFGHANISTAN--KAREN SHARES A POWERFUL MESSAGE ON OUR OBLIGATION AS EVERYDAY CITIZENS TO HONOR THE SACRIFICE OF THOSE WHO'VE GIVEN SO MUCH FOR OUR FREEDOM.AWI HAS SPEARHEADED MORE THAN 100 GIVE-BACK INITIATIVES TO THE WOUNDED HEROES OF AMERICA. THESE WOUNDED HEROES HAVE BEEN SERVED THROUGH MORTGAGE-FREE HOUSING, BUSINESS GRANTS, HOME UPGRADES, SERVICE DOGS, AND MORE. AWI ALSO SUPPORTS NONPROFIT ORGANIZATIONS THAT PROVIDE ASSISTANCE TO MILITARY VETERANS. TO HELP WITH COVID RELIEF EFFORTS, AWI PROVIDED MASKS TO HOSPITALS AND FIRST RESPONDERS THROUGHOUT THE UNITED STATES. 1,772,750
    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.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    0
    b
    Average of monthly cash balances.......................
    1b
    2,880,167
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,880,167
    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
    2,880,167
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    43,203
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    2,836,964
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    141,848
    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
    141,848
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    30
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    30
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    141,818
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    141,818
    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
    141,818
    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 7 141,818
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 341,942
    b From 2017...... 289,961
    c From 2018...... 588,293
    d From 2019...... 586,810
    e From 2020...... 963,825
    f Total of lines 3a through e ........ 2,770,831
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 1,802,078
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 141,818
    e Remaining amount distributed out of corpus 1,660,260
    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 4,431,091
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		341,942
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		4,089,149
    10 Analysis of line 9:
    a Excess from 2017.... 289,961
    b Excess from 2018.... 588,293
    c Excess from 2019.... 586,810
    d Excess from 2020.... 963,825
    e Excess from 2021.... 1,660,260
    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 e-mail address of the person to whom applications should be addressed:
    AMERICAN WARRIOR INITIATIVE
    4750 S BILTMORE LN
    MADISON,WI53718
    (724) 900-6045
    AWI@FAIRWAYMC.COM
    bThe form in which applications should be submitted and information and materials they should include:
    SEE VETERAN SUPPORT FORM AT WWW.AMERICANWARRIORINITIATIVE.COM/VETERAN-SUPPORT-FORM
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    A VETERAN MUST HAVE BEEN HONORABLY DISCHARGED TO APPLY FOR ASSISTANCE. AWI DOES NOT MAKE GRANTS OUTSIDE ITS FUNDING PRIORITIES.
    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
    A TRIBUTE TO VETERANS OF ADAMS COUNTY
    PO BOX 404
    FRIENDSHIP,WI53934     		N/A PC DONATION 60,000
    ADRIAN DARCY THOMPSON SR
    768 DURR SCHOOL ROAD
    ROBELINE,LA71469     		NONE I GENERATOR 5,179
    ADRIAN THOMPSON JR
    2571 SANDPIPER CIRCLE
    MARRIERO,LA70072     		NONE I FAMILY GRANT 5,000
    ADRIAN THOMPSON SR
    768 DURR SCHOOL RD
    ROBELINE,LA71469     		NONE I GIFT CARD 206
    ALEXANDER LOPEX
    1139 SOUTH CENTER
    BENSENVILLE,IL60106     		NONE I GIFT CARD 206
    ANDREW SABIN
    7612 30TH AVENUE
    KENOSHA,WI53142     		NONE I FAMILY GRANT 5,000
    ANDREW SIEVILLA
    7750 W STONEWOOD DRIVE
    FRANKLIN,WI53132     		NONE I FAMILY GRANT 5,000
    ANGELINA SUE MARTINEZ
    8221 44TH PLACE
    LYONS,IL46970     		NONE I GIFT CARD 206
    ANN MARIE DUREN
    1254 BURNSIDE PLACE
    DUPONT,WA98327     		NONE I FAMILY GRANT 300
    ANTOINETTE CONFIDENT CANINES LLC
    1257 SW CALAPOOIA ST
    ALBANY,OR97321     		N/A NC SERVICE DOGS 20,000
    ASHLEY SANDERS
    16400 CR 3302
    BOWNSBORO,TX75756     		NONE I FUNERAL EXPENSES 1,105
    BANKS COUNTY AMERICAN LEGION POST 215
    1350 HISTORIC HOMER HWY
    HOMER,GA30547     		N/A PC DONATION 250
    BEN LUNAK
    9720 ARBOR WALK LANE
    PEYTON,CO80831     		NONE I FAMILY GRANT 3,123
    BILL BUECKERS
    4504 VALLEY TRACE DR
    INDIANAPOLIS,IN46237     		NONE I FAMILY GRANT 5,000
    BOBBIE HENDERSHOTT
    171502 W JOHNSON ROAD
    PROSSER,WA98930     		NONE I FENCE FOR SERVICE DOG 3,114
    BOBBY LAYNE SANDERS
    16400 CR 3302
    BROWNSBORO,TX75756     		NONE I FUNERAL EXPENSES 975
    BRANDON LUNT
    12116 NE 172ND PLACE APT K302
    BOTHELL,WA98011     		NONE I FAMILY GRANT 1,000
    BRENT MCKEAG
    2007 STATE ROOM DR
    STAFFORD,VA22554     		NONE I FAMILY GRANT 5,000
    BRETT GARCIA
    3056 STRAND RD
    ROCKIN,CA95765     		NONE I GIFT CARD 205
    BRUCE VALENZUELA
    7730 EAST BROADWAY BLVD 914
    TUCSON,AZ86710     		NONE I FAMILY GRANT 5,000
    BRYAN WESTERFIELD
    129 E CHURCH ST
    GOSPORT,IN47433     		NONE I FAMILY GRANT 10,000
    BUCKEYE K9
    6871 BUSEY RD
    PICKERINGTON,OH43147     		N/A NC SERVICE DOG 5,950
    CAMERON MORROW
    209 BUCK BURR ROAD
    MERRYVILLE,LA70653     		NONE I FAMILY GRANT 5,000
    CARROLL ELLZEY
    4747 PLAINVIEW RD
    FLORIEN,LA71429     		NONE I GENERATOR 5,179
    CHAD BROWNELL
    207 CHURCH ST
    WAUSAUKEE,WI54177     		NONE I FAMILY GRANT 5,000
    CHANCE RUFFINO
    10520 HUFFMEISTER RD
    HOUSTON,TX77065     		NONE I GIFT CARD 206
    CHERYL WEBBER
    3714 LAKE GROVE STREET SOUTHWEST
    TACOMA,WA98499     		NONE I FAMILY GRANT 12,000
    CHRIS BARNSON
    8918 107TH ST SW
    LAKEWOOD,WA98498     		NONE I GIFT CARD 206
    CHRIS JONES
    500 4TH AVE
    DOTHAN,AL36301     		NONE I FAMILY GRANT 5,000
    CHRISTOPHER BERCU
    4339 E JOEY AVE
    FLAGSTAFF,AZ86004     		NONE I GIFT CARD 206
    CHRISTOPHER BROUGHTON
    4812 MAIN STREET
    TACOMA,WA98407     		NONE I FAMILY GRANT 4,000
    CHRISTOPHER CHAPUT
    828 AIKEN AVE
    PERRYVILLE,MD21903     		NONE I GIFT CARD 206
    CHRISTOPHER RUNNELLS
    1506 E 15TH ST
    CHEYENNE,WY82001     		NONE I FAMILY GRANT 10,000
    CHRISTY BAHR
    454 S MAIN ST
    MARKESAN,WI53946     		NONE I FAMILY GRANT 5,000
    COMPASS KEY LLC
    1315 LLOYDS ROAD
    NOTTINGHAM,PA19362     		N/A NC SERVICE DOGS/TRAINING 14,005
    CORNELIUS TWOHIG
    42785 GENERATION DR APT 621
    ASHBURN,VA20147     		NONE I FAMILY GRANT 5,000
    CROSSPOINT CHURCH
    13678 SILVERSTON DR
    FISHERS,IN46037     		N/A PC DONATION 1,000
    CUSTOM CANINES
    2310 MUSTANG WAY
    MADISON,WI53718     		N/A PC SERVICE DOGS 340,000
    DANA LAMAR TOLSON BLAKE
    13207 OLD MARLBORO PIKE
    UPPER MARLBORO,MD20772     		NONE I GIFT CARD 206
    DANIEL EDWARDS
    55 HOLE IN THE WALL ROAD
    CANON CITY,CO81212     		NONE I GIFT CARD 206
    DANIELLE SHOOK
    1024 HWY 145
    EASTANOLLE,GA30538     		NONE I GIFT CARD 221
    DAVID HAWKINS
    526 AZALEA ST
    THOUSAND OAKS,CA91360     		NONE I GIFT CARD 206
    DAVID KELLY
    2710 158TH ST E
    TACOMA,WA98445     		NONE I GIFT CARD 206
    DAVID KOSS
    494 ALVIN CUTIS ROAD
    MANY,LA71449     		NONE I FUNERAL EXPENSES 3,418
    DAVID MILLER
    114 TAYLOR BEND ST
    HAUGHTON,LA71037     		NONE I FAMILY GRANT 15,000
    DAVID TOTH JR
    17 BELLEVIEW TERRANCE
    ANSONIA,CT06401     		NONE I FAMILY GRANT 5,205
    DENNIS FLICKINGER
    11598 EAST D AVE
    RICHLAND,MI49083     		NONE I GIFT CARD 206
    DERRICK BARKER JR
    1368 MARION ST SE
    ATLANTA,GA30315     		NONE I GIFT CARD 206
    DFW CANINES FOR VETERANS
    719 BRANDING IRON
    GRANBURY,TX76049     		N/A PC SERVICE DOGS 30,000
    DOG TAG BUDDIES
    PO BOX 250
    SHEPHERD,MT59079     		N/A PC SERVICE DOGS 10,000
    DOMONIQUE ANDERSON
    167 BETHESDA CIRCLE
    WESTCLIFFE,CO81252     		NONE I FAMILY GRANT 5,000
    DOUG MUSTAPICK
    9103 CHAPMAN OAKS COURT
    PALM BEACH,FL33410     		NONE I FAMILY GRANT 11,381
    DOUGLAS REYNOLDS
    10541 WASHINGTON BLVD
    INDIANAPOLIS,IN46280     		NONE I GIFT CARD 103
    DUCK UP BREEDERS
    477 N 300 W
    BRIGHAM,UT84302     		N/A NC SERVICE DOG 1,450
    DUNFUR KENNEL
    10420 S GRANITE LAKE RD
    CHENEY,WA99004     		N/A NC SERVICE DOG TRAINING 2,266
    DWAIN WILLIAMS JR
    63 IVY SPRING LN
    FREDERICKSBURG,VA22406     		NONE I GIFT CARD 206
    ELIZABETH EMERSON
    37 PARAISO ST
    COTTONWOOD,AL36320     		NONE I FAMILY GRANT 5,000
    ELIZABETH STEPHENS
    819 176TH AVE NE
    BELLEVUE,WA98008     		NONE I FAMILY GRANT 10,205
    ERICA CHIAZZESE
    88 W CAMINO RIO
    CEBOLLA SAHUARITA,AZ85629     		NONE I FAMILY GRANT 5,000
    ERICH VANAMAN
    1804 BROADSTREET ROAD
    HAMPTON,VA23666     		NONE I FAMILY GRANT 6,000
    FORGOTTEN COAST K9
    249 NW ROLLING HILLS DR
    MADISON,FL32340     		N/A PC SERVICE DOGS 85,000
    GERALDINE LAMB
    110 NORTH COOPERS HAWK RD
    PALM COAST,FL32164     		NONE I GIFT CARD 206
    GLEN HAPEMAN
    2475 N HASKELL DR
    TUCSON,AZ85716     		NONE I FAMILY GRANT 5,000
    GORDON GOOLSBY
    836 175TH
    HAMMOND,IN46324     		NONE I FAMILY GRANT 15,000
    HERO PUPS INC
    20 PORTSMOUTH AVE 127
    STRAHAM,NH03885     		N/A PC SERVICE DOG DONATION 20,000
    HORSE CART SMALL ANIMAL HOSPITAL
    9111 346TH ST S SUITE 5
    ROY,WA98580     		N/A NC SERVICE DOG VET BILL 384
    HUGH LANSDEN
    4936 CULLEN RD
    VIRGINIA BEACH,VA23455     		NONE I FAMILY GRANT 15,000
    HUGH SCOTT LANDRETH
    924 WATERFORD TRAIL
    CALERA,AL35040     		NONE I FAMILY GRANT 22,000
    INGLEMOOR ANIMAL HOSPITAL
    16900 JUANITA DR NE
    KENMORE,WA98028     		N/A NC SERVICE DOG VET BILL 620
    JAMES ALLEN HOOKS SR
    2430 HONEYCUTT SIMPSON ROAD
    MONROE,NC28110     		NONE I FAMILY GRANT 6,000
    JAMES FOSLER
    11700 FENCE POST TRAIL
    AUSTIN,TX78750     		NONE I FAMILY GRANT 15,550
    JAMES WABLINGTON
    113 C DEES ST
    ANACOCO,LA71446     		NONE I FAMILY GRANT 5,700
    JASMINE SMITH
    68 N CHICAGO ST APT 303
    JOLIET,IL60432     		NONE I GIFT CARD 206
    JASON ROSEBROUGH
    2408 HAZELTON ETNA RD SW
    PATASKALA,OH43062     		NONE I GIFT CARD 205
    JAYD BOSIACKI
    4900 SAPPHIRE DR
    KILEEN,TX76542     		NONE I GIFT CARD 205
    JEFF BACON
    345 DUBUQUE ST
    MANCHESTER,NH03102     		NONE I FAMILY GRANT 8,342
    JOHN ISLAS
    800 S PANTANO ROAD
    TUCSON,AZ85710     		NONE I FAMILY GRANT 5,158
    JOHN PALMER
    1732 OAKTON ST
    EVANSTON,IL60202     		NONE I GIFT CARD 207
    JONATHAN EVAN SHANKS
    1301 BRAY CENTRAL DR APT 10102
    ALLEN,TX75013     		NONE I GIFT CARD 221
    JOSEPH BARDWELL
    4312 E ANTELOPE DR USAF ACADEMY
    COLORADO SPRINGS,CO80840     		NONE I FAMILY GRANT 3,000
    JOSEPH KUNICKI
    1108 CORDOBA WAY
    VISTA,CA92080     		NONE I GIFT CARD 205
    JOSH GARDNER
    128 ALTON MT ROAD
    ALTON BAY,NH03810     		NONE I FAMILY GRANT 7,500
    JOSH VANN
    719 BRANDING IRON
    GRANBURY,TX76049     		NONE I FAMILY GRANT 5,000
    JOSHUA LICKEY
    5 HOLDEN ROAD
    COLUMBIA CITY,IN46725     		NONE I FAMILY GRANT 5,385
    JOY HORAN
    1450 IDLEWILD DR 221
    RENO,NV89509     		NONE I GIFT CARD 205
    JUAN ANTONIO GOMEZ
    6572 GLEBVIEH ROAD
    FORT RILEY,KS80831     		NONE I GIFT CARD 411
    JULIE GRIMES
    114 E RAMSEY CANYON ROAD
    HEREFORD,AZ85615     		NONE I FAMILY GRANT 8,900
    JUSTIN COSTA
    11432 CHURCHILL PARK WAY APT 137
    FORT WORTH,TX76244     		NONE I FAMILY GRANT 5,000
    K9S FOR VETERANS
    2312 OLDE MILL ROAD
    PLAINFIELD,IL60586     		N/A PC SERVICE DOGS 22,400
    KAIT CLEMENS
    1 SOUTH HAYWARD ROAD
    SPARTA,NJ07871     		NONE I FAMILY GRANT 5,000
    KARA ELIZABETH CORNELIA
    9035 E SADDLEBACK DR
    TUCSON,AZ85749     		NONE I FAMILY GRANT 5,000
    KAYLEIGH SNEDEGER
    1474 W OLD CYPRUS CT
    SOUTH JORDAN,UT84095     		NONE I FUNERAL TRAVEL EXPENSES 2,000
    KEIL CRONAUER
    10425 S PAINTED MARE DR
    VAIL,AZ85641     		NONE I FAMILY GRANT 5,000
    KEVIN KING
    3716 HIDDEN FOREST DRIVE
    LAKE ORION,MI48359     		NONE I FAMILY GRANT 3,039
    KIRSTEN LYONS
    504 S MAIN ST
    CUBA CITY,WI53807     		NONE I FAMILY GRANT 5,000
    KNIGHTWATCH K-9
    6617 E VALLEY DR
    SIERRA VISTA,AZ85650     		N/A NC SERVICE DOGS 81,471
    KYLE LANDON HATCH
    77 HAWTHORNE DR
    HATTISBURG,MS39402     		NONE I FAMILY GRANT 5,000
    LABS FOR LIBERTY
    23811 MARSHALL GULCH RD
    HILL CITY,SD57745     		N/A PC SERVICE DOGS 7,000
    LATOYA YOUNG
    114 HALEY DR
    ENTERPRISE,AL36330     		NONE I FAMILY GRANT 10,000
    LAURA ALBILENE
    5351 NOBEL DR 310
    FITCHBURG,WI53711     		NONE I FAMILIY GRANT 5,000
    LAURA ALLEY
    924 PINE RIDGE LN UNIT 4
    BILLINGS,MT59105     		NONE I FAMILY GRANT/SERVICE DOG 15,000
    LEE PHILLIPS
    354 BAYOU SCIE RD
    ZWOLLE,LA71486     		NONE I FAMILY GRANT 5,000
    LIBERTY HOUSENEW HAMPSHIRE CATHOLIC CHARITIES
    221 ORANGE STREET
    MANCHESTER,NH03104     		N/A PC DONATION 10,000
    LINDA SMITH
    9001 GUNSTON RD UNIT 1457
    FT BELVOIR,VA22060     		NONE I GIFT CARD 205
    LISA LYNN NORRIS
    4282 S 350 W
    HARTFORDCITY,IN47348     		NONE I GIFT CARD 205
    LOLA UNDERWOOD
    1700 CLAIRE ST
    PRESCOTT,AZ86301     		NONE I GIFT CARD 205
    LORI ELLEN ANKABRANDT
    8616 2ND AVE APT 133
    SILVER SPRING,MD20910     		NONE I GIFT CARD 205
    MARCUS KELLY
    PO BOX 3546
    RAMONA,CA92065     		NONE I FAMILY GRANT 5,000
    MARVALEE DAVIDSON
    514 WEST MAIN ST
    ELMA,WA98541     		NONE I FAMILY GRANT 6,595
    MASSACHUSETTS FALLEN HEROES DONATION
    12 CHANNEL ST SUITE 703
    BOSTON,MA02210     		N/A PC DUFFY GOLD STAR FAMILY FIRE FUND DONATION 3,090
    MATT SPARKS
    11240 E MCGREGOR RD
    INDIANAPOLIS,IN46259     		NONE I FAMILY GRANT 5,000
    MELINDA MATTHEWS
    308 FORBES AVE
    OAKLAND,PA15213     		NONE I FAMILY GRANT 1,500
    MELISSA RIZZO
    41835 FRONT HALL ROAD
    BERMUDA DUNES,CA92203     		NONE I GIFT CARD 205
    MICHAEL CHERMANIE
    12360 MILL-HOUSE DR
    GEISMAR,LA70734     		NONE I FAMILY GRANT 10,000
    MICHAEL GORDON
    234 BUECHNER DR
    MT HOREB,WI53572     		NONE I FAMILY GRANT 5,000
    MICHAEL MOORE
    PO BOX 1438
    WESTCLIFFE,CO81252     		NONE I FAMILY GRANT 5,000
    MICHAEL TERRANCE MEHLBRECH
    125 W BRIAN ST
    TEA,SD57064     		NONE I GIFT CARD 205
    MICHELLE BELL
    650 N CHESTNUT ST
    PALMYRA,PA17078     		NONE I GIFT CARD 205
    MICHELLE WALTON
    109 CHESTNUT ST 2
    NEW BEDFORD,MA02740     		NONE I FAMILY GRANT 10,000
    NEADS
    305 REDEMPTION ROCK TRAIL SOUTH
    PRINCETON,MA01541     		N/A PC SERVICE DOGS 45,000
    NEXT STEP SERVICE DOGS
    PO BOX 3930
    DANA POINT,CA92629     		N/A PC DONATION 40,150
    NICHOLAS HENRY
    1373 S MISSION AVE 518
    FALLBROOK,CA92028     		NONE I GIFT CARD 207
    OPERATION 300
    PO BOX 3
    PORT SALERNO,FL34992     		N/A PC SERVICE DOGS 10,000
    PAM PARKER DOG TRAINER
    12727 SE 95TH WAY
    RENTON,WA98056     		NONE NC SERVICE DOG TRAINING 429
    PARA LEA THAXTON
    6211 PLAINVIEW RD
    FLORIEN,LA71469     		NONE I FAMILY GRANT/GENERATOR 5,000
    PATTY IBHOLM
    148 E 6740 S
    MIDVALE,UT84047     		NONE I FAMILY GRANT 5,000
    PAUL LACHANCE
    501 RIVERVIEW DR
    GRAND JUNCTION,CO81507     		NONE I RACE FEES/TRAVEL 5,221
    PETER KOLEHMAINEN
    125 BAYWOOD DR
    DRIGGS,ID83422     		NONE I FAMILY GRANT 10,000
    PIKES PEAK COMMUNTIY COLLEGE FOUNDATION INC
    5675 S ACADEMY BLVD C-68
    COLORADO SPRINGS,CO80906     		N/A PC DONATION 20,000
    PTSD TBI DOGS & TAGS OF WYOMING
    7618 AZTEC DR
    CHEYENNE,WY82009     		N/A PC SERVICE DOG DONATION 25,000
    RAINBOW SERVICE DOGS
    1013 EAST SIMMONS ST UNIT 1
    TUSCON,AZ85719     		N/A PC SERVICE DOG DONATION 80,350
    REBECCA ROE BROWN
    1509 N ONEIDA ST
    APPLETON,WI54911     		NONE I FAMILY GRANT 5,000
    RICHARD ANTHONY GIARDINE
    15103 SUN SPUR ST
    SAN ANTONIO,TX78232     		NONE I GIFT CARD 205
    RICHARD LANE HOPKINS
    397 DUG LECKIE CUT OFF
    POLLOCK,LA71467     		NONE I GIFT CARD 205
    RICHARD REBENNACK
    6159E SAINT JOSEPH ST
    INDIANAPOLIS,IN46219     		NONE I GIFT CARD 103
    RICHARD TROTTER
    20539 BLOOM ST
    DETROIT,MI48234     		NONE I GIFT CARD 205
    RODOLFO REYES
    300 N STATE ST SUITE 5235
    CHICAGO,IL60654     		NONE I FAMILY GRANT 15,205
    ROLANDO POBLETE
    897 GENEVIEVE AVE
    CHULA VISTA,CA91913     		NONE I FUNERAL SERVICES 6,084
    SARA RILEY
    1804 VIRGINIA AVE
    GREAT LAKES,IL60088     		NONE I FAMILY GRANT 5,000
    SCOTT DAVID LAMB
    306 N LOUISIANNA DR
    CELINA,TX75009     		NONE I GIFT CARD 205
    SEAN ETHIER
    615 S 17TH ST
    TACOMA,WA98405     		NONE I GRANT FUNERAL TRAVEL EXPENSES 1,309
    SENACA CATHERINE LUCERO
    6300 RAWHIDE RDG
    CHEYENNE,WY82007     		NONE I FAMILY GRANT 5,000
    SERENITY SHAW
    547 COLONNADE DR APT A
    CHARLOTTE,NC28205     		NONE I FAMILY GRANT 6,000
    SHANE ONLEY
    312 WARREN AVE
    CHARLOTTE,NC27288     		NONE I GIFT CARD 205
    SHARON HARDIN
    2730 CENCHREA ROAD
    FLORIEN,LA71429     		NONE I GENERATOR 5,179
    SOUTHSIDE CREW
    326 RIO DRIVE
    CHESAPEAKE,VA23322     		N/A PC SPONSORSHIP/DONATION FUNDRAISER FOR VETERAN 800
    STEVEN THOMAS BOHLING
    1237 CHANUTE AVE
    PERU,IN46970     		NONE I GIFT CARD 205
    STILLWATER RANCH
    8511 COYOTE RUN
    LOVELAND,CO80537     		N/A PC DONATION 40,000
    TAILS OF VALOR PAWS OF HONOR
    PO BOX 127
    COOPERSBURG,PA18036     		N/A PC SERVICE DOG DONATIONS 60,000
    TAMARA NICOLE STEWART
    546 RAVEN AVE APT 2426
    GALTHERSBURG,MD20877     		NONE I GIFT CARD 205
    THE VETERAN'S SPOUSE PROJECT
    PO BOX 4216
    OAKRIDGE,TN37831     		N/A PC DONATION OF GIFT CARDS FOR VETERAN FAMILIES 38,232
    THOMAS PIERCE
    121 CHURCH STREET
    CHARLES TOWN,WV25414     		NONE I FAMILY GRANT 800
    THOMAS ROBITAILLE
    2 ED LEBLEAU ROAD
    CHESTER,MA01011     		NONE I GIFT CARD 207
    THOMAS SEROCKI
    W8129 MANCHESTER LAND APT 23
    LAKE MILLS,WI53551     		NONE I FUNERAL EXPENSES 13,828
    TIMOTHY COMMES
    5244 SCENIC RIDGE TRAIL
    MIDDLETON,WI53562     		NONE I FAMILY GRANT 5,000
    TOMMY ELLIOTT
    4703 TARA DR
    FAIRFAX,VA22032     		NONE I GIFT CARD 206
    TRAVIS SMITH
    210 NORTHWOOD LANE
    NATCHITOCHES,LA71457     		NONE I FAMILY GRANT 5,000
    TYLER MOODY
    2121 S STATE HWY 123
    NEWTON,AL36352     		NONE I FAMILY GRANT 5,628
    ULTIMATE CANINE
    15859 LITTLE EAGLE CREEK AVE
    WESTFIELD,IN46074     		N/A NC SERVICE DOGS 35,805
    USA HOMEOWNERSHIP FOUNDATION
    495 E RINCON STE 110
    CORONA,CA92879     		N/A PC DONATION 2,500
    VET SERVICE DOGS NFP
    8024 CHRISTIE AVE
    LYONS,IL60534     		N/A PC SERVICE DOGS 36,000
    VALECIA HATCHETT
    6701 E RIVERDALE ST
    MESA,AZ85215     		NONE I GIFT CARD 208
    VETERAN'S HELP FOUNDATION
    34964 SARAH LANE
    DENHAM SPRINGS,LA70706     		N/A PC DONATION 10,000
    VICTOR ELLIOTT
    2348 FIR ST
    JANESVILLE,WI53546     		NONE I FAMILY GRANT 5,000
    WARREN REPPOND
    174 COUNTY ROAD 1330
    VINEMONT,AL35179     		NONE I FAMILY GRANT 22,000
    WARRIOR CANINE CONNECTION
    14934 SCHAEFFER ROAD
    BOYDS,MD20841     		N/A PC SERVICE DOGS 30,000
    WEST ALLIS MONOGRAM CLUB
    N24W22587 MEADOWOOD LANE
    WAUKESHA,WI53186     		N/A PC DONATION 5,000
    WILLIAM GAPPMAYER
    8721 CIRCLE DR
    WESTMINSTER,CO80031     		NONE I GIFT CARD 206
    WILLIAM GAVIN
    127 NORTH WALNUT ST
    BATH,PA18014     		NONE I FAMILY GRANT 5,000
    WILLIAM JOSA
    1440 BURGANDY DRIVE
    CHULA VISTA,CA91913     		NONE I FAMILY GRANT 5,000
    WILLIAM SHUMAKER
    253 BRENLAND RD
    OSHKOSH,WI54902     		NONE I FAMILY GRANT 5,000
    Total .................................bullet 3a 1,772,750
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 2,325  
    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 59  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 2,384 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    2,384
    (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
    Schedule B
    (Form 990)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    AMERICAN WARRIOR INITIATIVE INC
     
    Employer identification number

    47-3566126
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number
    47-3566126
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    FAIRWAY INDEPENDENT MORTGAGE CORPORATION
     
    4750 S BILTMORE LANE
     
    MADISON, WI53718

    		$ 296,648


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    IGNITE
     
    4750 S BILTMORE LANE
     
    MADISON, WI53718

    		$ 10,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
    BARRY SCOLES
    6582 CRYSTAL DOWNS DR 201
     
    WINDSOR, CO80550

    		$ 5,600


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    4
    BRADLEY SMITH
    11394 LONG SOTTON LANE
     
    FISHERS, IN46037

    		$ 14,859


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    5
    BRIANA VANDLEN
    6928 HIGHWAY 76
     
    ADAMS, TN37010

    		$ 5,275


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    6
    CARRIE GUARRERO
    801 FREEMONT STREET EAST 2
     
    WATERVILLE, MN56096

    		$ 13,311


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number
    47-3566126
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    7
    CARRIE UBERUAGA
    2436 E SANTO STEFANO DR
     
    MERIDIAN, ID83642

    		$ 5,825


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    8
    CHAD CRILE
    1958 W 132ND AVE
     
    CROWN POINT, IN46307

    		$ 7,184


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    9
    CHRISTOPHER COLLINS
    9448 LOHRER LN SE
     
    OLYMPIA, WA98516

    		$ 21,200


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    10
    CINDY PORTERFIELD
    2533 FM 1519N
     
    LEESBURG, TX75451

    		$ 12,650


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    11
    CRAIG BARBER
    48 KENILWORTH ROAD
     
    WELLESLEY, MA02482

    		$ 5,800


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    12
    CRAIG TASHJIAN
    99 WASHINGTON ST
     
    WELLESLEY, MA02481

    		$ 5,240


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number
    47-3566126
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    13
    DANIEL WHITE
    6456 E CYPRESS ST
     
    SCOTTSDALE, AZ85257

    		$ 9,500


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    14
    DENISE MCDONOUGH
    20-306 LEDGEWOOD HILLS DR
     
    NASHUA, NH03062

    		$ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    15
    JILL ALLEN
    4016 HIGHLAND OAKS LANE
     
    CLEBURNE, TX76031

    		$ 6,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    16
    JOHN MILLS JR
    2110 PAUL EDWIN TER
     
    FALLS CHURCH, VA22043

    		$ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    17
    KENNETH PEDERSON
    801 ESTELLE DR
     
    LACASTER, PA17601

    		$ 10,025


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    18
    LORI MARTIN
    100 SUNSET STRIP
     
    DAGSBORO, DE19939

    		$ 10,575


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number
    47-3566126
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    19
    MICHAEL DEL PRETO
    1511 N BOSWORTH AVE APT 1
     
    CHICAGO, IL60642

    		$ 6,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    20
    NICKOLAS SMITH
    13002 S FORT ST
     
    DRAPER, UT84020

    		$ 5,022


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    21
    PAOLA KIELBLOCK
    5117 MOHEGAN LANE
     
    FRISCO, TX75034

    		$ 8,250


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    22
    PAUL WALNICK
    6006 SPRING FLOWER TRAIL
     
    DALLAS, TX75248

    		$ 15,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    23
    SARAH MIDDLETON
    36 FAIRWAY LANE
     
    LITTELTON, CO80123

    		$ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    24
    SELENA STAGNER
    300 MEADOWLARK DR
     
    RICHARDSON, TX75080

    		$ 21,235


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number
    47-3566126
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    25
    SERGIO SZYRKO
    343 SHELTERWOOD CT
     
    DANVILLE, CA94506

    		$ 17,800


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    26
    STEPHEN WHIPPLE
    585 AMBERIDGE TRAIL NW
     
    SANDY SPRINGS, GA30328

    		$ 28,025


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    27
    TANJA ALLEN
    1126 CR 220
     
    KILLEEN, TX76549

    		$ 8,700


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    28
    THOMAS DEBENEDICTIS
    10 LISA DRIVE
     
    NASHUA, NH03062

    		$ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    29
    VICKI PITMAN WILLIAMS
    219 SCENIC GOLF DRIVE UNIT 850
     
    MIRAMAR BEACH, FL32550

    		$ 10,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    30
    SCOTT JACOBS
    375 HIGHLAND GATE CIRCLE
     
    SUWANEE, GA30024

    		$ 13,116


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number

    47-3566126
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    30
    		 STOCK $ 13,116 2021-12-30
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    AMERICAN WARRIOR INITIATIVE INC
          		Employer identification number

    47-3566126
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    AMERICAN WARRIOR INITIATIVE INC
    EIN:
    47-3566126
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING 19,299 0   19,299

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    TY 2021 ExpenditureResponsibilityStmt
    Name:
    AMERICAN WARRIOR INITIATIVE INC
    EIN:
    47-3566126
    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
    ANTOINETTE CONFIDENT CANINES LLC
          		1257 SW CALAPOOIA ST
    ALBANY,OR97321     		2021-08-17 20,000 SERVICE DOGS 20,000 NO 08/17/21 2021-08-17 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG.
    BUCKEYE K9
          		6871 BUSEY RD
    PICKERINGTON,OH43147     		2021-03-02 5,950 SERVICE DOG 5,950 NO 03/02/21 2021-03-02 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG.
    COMPASS KEY LLC
          		1315 LLOYDS ROAD
    NOTTINGHAM,PA19362     		2021-02-04 14,005 SERVICE DOGS/TRAINING 14,005 NO 02/04/21 2021-02-04 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG/TRAINING.
    DUCK UP BREEDERS
          		477 N 300 W
    BRIGHAM,UT84302     		2021-09-13 1,450 SERVICE DOG 1,450 NO 09/13/21 2021-09-13 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG.
    DUNFUR KENNEL
          		10420 S GRANITE LAKE RD
    CHENEY,WA99004     		2021-10-27 2,266 SERVICE DOGS/TRAINING 2,266 NO 10/27/21 2021-10-27 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG/TRAINING.
    HORSE CART SMALL ANIMAL HOSPITAL
          		9111 346TH ST S SUITE 5
    ROY,WA98580     		2021-07-15 384 SERVICE DOG VET BILL 384 NO 07/15/21 2021-07-15 THE GRANT WAS MADE AFTER RECEIVING THE VET BILL.
    INGLEMOOR ANIMAL HOSPITAL
          		16900 JUANITA DR NE
    KENMORE,WA98028     		2021-05-01 620 SERVICE DOG VET BILL 620 NO 05/01/21 2021-05-01 THE GRANT WAS MADE AFTER RECEIVING THE VET BILL.
    KNIGHTWATCH K-9
          		6617 E VALLEY DR
    SIERRA VISTA,AZ85650     		2021-12-13 81,471 SERVICE DOGS 81,471 NO 12/13/21 2021-12-13 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG.
    ULTIMATE CANINE
          		15859 LITTLE EAGLE CREEK AVE
    WESTFIELD,IN46074     		2021-07-14 35,805 SERVICE DOGS 35,805 NO 07/14/21 2021-07-14 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG.
    PAM PARKER DOG TRAINER 12727 SE 95TH WAY
    RENTON,WA98056     		2021-05-01 429 SERVICE DOG TRAINING 429 NO 05/1/21 2021-05-01 THE GRANT WAS MADE AFTER RECEIVING AN INVOICE FOR THE SERVICE DOG TRAINING.
    BANKS COUNTY AMERICAN LEGION POST 215
          		1350 HISTORIC HOMER HWY
    HOMER,GA30547     		2021-06-04 250 INTERIOR AND EXTERIOR MAINTENANCE OF BUILDING 250 NO 06/04/21 2021-06-04 DONATION
    WEST ALLIS MONOGRAM CLUB
          		N24W22587 MEADOWOOD LANE
    WAUKESHA,WI53186     		2021-08-23 5,000 CHICKEN DINNERS FOR VETS 5,000 NO 08/23/21 2021-08-23 EMAIL VERIFICATION OF 1200 FREE CHICKEN DINNERS SERVED

    TY 2021 OtherExpensesSchedule
    Name:
    AMERICAN WARRIOR INITIATIVE INC
    EIN:
    47-3566126
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK FEES AND SERVICE CHARGES 10,163 234   9,929
    MEMBERSHIP DUES 100 0   100


    TY 2021 SubstantialContributorsSch
    Name:
    AMERICAN WARRIOR INITIATIVE INC
    EIN:
    47-3566126
    Name Address
    FAIRWAY INDEPENDENT MORTGAGE CORPORATION
          		4750 S BILTMORE LANE
    MADISON,WI53718