Form990-PF
Click to see attachment
Click to see attachmentClick to see attachment

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
LUCILLE AND JOHN B DOUGHERTY TRUST
% WELLS FARGO BANK NA
Number and street (or P.O. box number if mail is not delivered to street address)6325 S RAINBOW BLVD 3RD FL
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS, NV89118
A Employer identification number

26-1444071
B Telephone number (see instructions)

(979) 776-3267
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$5,743,885J 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... 119,687 119,687  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 247,786
b Gross sales price for all assets on line 6a 2,193,814
7 Capital gain net income (from Part IV, line 2)... 247,786
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)....... Click to see attachment 12,872 12,865  
12 Total. Add lines 1 through 11........ 380,345 380,338  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 66,849 50,137   16,712
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 575 0   575
c Other professional fees (attach schedule).... Click to see attachment 5,629 0   5,629
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 3,000 3,000   0
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 787 787   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 76,840 53,924   22,916
25 Contributions, gifts, grants paid....... 217,000 217,000
26 Total expenses and disbursements. Add lines 24 and 25 293,840 53,924   239,916
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 86,505
b Net investment income (if negative, enter -0-) 326,414
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 Savings and temporary cash investments......... 107,306 124,063 124,063
3 Accounts receivable bullet5,339
Less: allowance for doubtful accounts bullet   6,672 5,339 5,339
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 bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 254,534 Click to see attachment339,540 339,002
b Investments—corporate stock (attach schedule)....... 890,782 Click to see attachment928,029 1,735,617
c Investments—corporate bonds (attach schedule)....... 834,195 Click to see attachment844,345 841,922
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 2,307,014 Click to see attachment2,253,235 2,697,942
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) 4,400,503 4,494,551 5,743,885
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 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........ 4,400,503 4,494,551
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 0 0
29 Total net assets or fund balances (see instructions)..... 4,400,503 4,494,551
30 Total liabilities and net assets/fund balances (see instructions). 4,400,503 4,494,551
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
4,400,503
2
Enter amount from Part I, line 27a .....................
2
86,505
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
10,965
4
Add lines 1, 2, and 3 ..........................
4
4,497,973
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
3,422
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
4,494,551
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 AT&T P 2020-04-13 2021-04-08
b ABBVIE P 2020-12-10 2021-02-23
c AMGEN P 2020-10-21 2021-10-12
d AMGEN P 2021-07-06 2021-10-12
e AMGEN P 2020-09-14 2021-02-23
BLACKROCK INC P 2021-10-18 2021-12-17
BLACKROCK INC P 2021-02-11 2021-02-23
BLACKROCK INC P 2020-04-13 2021-02-23
BLACKSTONE INC P 2021-10-18 2021-10-21
BLACKSTONE INC P 2021-02-11 2021-02-23
BLACKSTONE INC P 2020-05-28 2021-02-23
BLACKSTONE INC P 2021-07-29 2021-08-30
BOOKING HOLDINGS P 2020-03-04 2021-02-23
CELANESE CORP P 2020-04-13 2021-02-23
CISCO SYSTEMS P 2021-07-29 2021-08-30
DIAGEO PLC P 2021-10-18 2021-10-21
WALT DISNEY P 2020-12-10 2021-02-23
EV GL MACR ABS RTRN P 2020-12-09 2021-07-29
EV GL MACR ABS RTRN P 2021-02-23 2021-07-29
FIDELITY NATL INFORMATION SVCS P 2021-02-11 2021-02-23
HASBRO P 2021-04-08 2021-07-29
INTERPUBLIC GROUP COS P 2020-12-21 2021-02-23
INVESCO OPTIMUM YIELD DIVERS P 2020-04-09 2021-02-23
ISHARES RUSSELL 2000 ETF P 2021-02-23 2021-11-03
ISHARES RUSSELL 2000 ETF P 2021-02-23 2021-12-13
ISHARES RUSSELL 2000 ETF P 2021-02-23 2021-07-29
ISHARES CORE S&P SMALL CAP P 2021-03-25 2021-11-03
ISHARES CORE S&P SMALL CAP P 2021-07-29 2021-11-03
ISHARES CORE MSCI EMERGING ETF P 2021-02-23 2021-10-18
ISHARES CORE MSCI EMERGING ETF P 2021-03-25 2021-10-18
ISHARES CORE MSCI EMERGING ETF P 2021-07-29 2021-10-18
ELI LILLY & CO P 2020-04-09 2021-02-23
MERCK & CO P 2020-04-13 2021-02-23
MERCK & CO P 2020-07-20 2021-02-23
MICROSOFT P 2021-10-18 2021-12-17
NIKE P 2021-10-18 2021-12-17
NIKE P 2021-07-29 2021-12-17
ORGANON P 2020-07-20 2021-06-14
PIMCO HIGH YIELD P 2021-07-29 2021-10-18
PIMCO HIGH YIELD P 2020-10-01 2021-03-25
PIMCO HIGH YIELD P 2020-12-09 2021-03-25
PIMCO HIGH YIELD P 2021-02-23 2021-03-25
PGIM HIGH YIELD P 2020-10-01 2021-03-25
SYSCO CORP P 2020-05-28 2021-02-23
SYSCO CORP P 2020-08-25 2021-02-23
SYSCO CORP P 2020-05-28 2021-04-08
TORONTO DOMINION BK P 2020-12-10 2021-02-23
UNITED PARCEL SERVICE P 2020-04-13 2021-02-23
UNITEDHEALTH GROUP P 2020-04-13 2021-02-23
VANGUARD MIDCAP VIPER P 2020-09-25 2021-07-29
VISA INC P 2020-04-13 2021-02-23
WASTE MANAGEMENT P 2020-03-03 2021-02-23
WASTE MANAGEMENT P 2020-03-04 2021-02-23
EATON CORP P 2020-11-30 2021-02-23
EATON CORP P 2021-02-11 2021-02-23
GARMIN LTD P 2020-10-21 2021-02-23
GARMIN LTD P 2020-05-29 2021-02-23
GARMIN LTD P 2021-07-29 2021-08-30
TE CONNECTIVITY P 2020-04-09 2021-02-23
TE CONNECTIVITY P 2020-04-09 2021-03-25
FLEX LTD P 2021-10-18 2021-11-19
FLEX LTD P 2021-07-29 2021-11-19
AT&T P 2018-05-01 2021-02-23
AT&T P 2019-08-08 2021-02-23
AT&T P 2018-10-30 2021-04-08
AT&T P 2019-02-26 2021-04-08
AT&T P 2019-04-26 2021-04-08
AT&T P 2018-05-01 2021-04-08
AT&T P 2018-07-12 2021-04-08
ALPHABET INC P 2019-04-26 2021-02-23
AMGEN P 2020-09-14 2021-10-12
APPLE P 2019-08-08 2021-10-12
APPLE P 2019-08-08 2021-02-23
BB&T CORP 2.05% P 2017-01-30 2021-04-09
BB&T CORP 2.05% P 2019-08-08 2021-04-09
BB&T CORP 2.05% P 2016-09-12 2021-04-09
BANK OF NY MELLON 2.50% P 2019-05-20 2021-03-15
BANK OF NY MELLON 2.50% P 2018-07-16 2021-03-15
BANK OF NY MELLON 2.50% P 2019-08-08 2021-03-15
BLACKSTONE INC P 2020-05-28 2021-10-21
BLACKSTONE INC P 2020-05-28 2021-12-17
BLACKSTONE INC P 2020-05-28 2021-08-30
BOEING P 2019-10-24 2021-02-23
BOEING P 2019-11-06 2021-02-23
BOEING P 2019-03-13 2021-02-23
BOEING P 2019-04-26 2021-02-23
BOEING P 2019-05-23 2021-02-23
BP CAP MARKETS AMER 3.245% P 2018-12-13 2021-07-13
BROADCOM P 2019-07-02 2021-02-11
BROADCOM P 2019-07-02 2021-02-23
BROADCOM P 2019-09-10 2021-02-23
BROADCOM P 2019-08-13 2021-03-25
BROADCOM P 2019-09-10 2021-03-25
CVS HEALTH CORP P 2019-08-08 2021-02-23
CELANESE CORP P 2019-02-26 2021-02-23
CELANESE CORP P 2019-04-26 2021-02-23
CISCO SYSTEMS P 2019-12-23 2021-02-23
CISCO SYSTEMS P 2019-08-08 2021-02-23
CISCO SYSTEMS P 2019-09-27 2021-02-23
CISCO SYSTEMS P 2019-12-23 2021-08-30
CISCO SYSTEMS P 2020-04-13 2021-08-30
CITIGROUP P 2019-04-22 2021-02-23
CITIGROUP P 2019-04-26 2021-02-23
COGNIZANT TECH SOLUTIONS P 2016-03-16 2021-02-23
COGNIZANT TECH SOLUTIONS P 2016-09-06 2021-02-23
DIAGEO PLC P 2018-11-30 2021-02-23
DIAGEO PLC P 2018-12-21 2021-02-23
DIAGEO PLC P 2018-04-19 2021-02-23
DIAGEO PLC P 2019-08-08 2021-02-23
DIAGEO PLC P 2019-09-27 2021-02-23
WALT DISNEY P 2019-08-08 2021-02-23
EV GL MACR ABS RTRN P 2017-10-26 2021-07-29
EV GL MACR ABS RTRN P 2019-02-27 2021-07-29
EV GL MACR ABS RTRN P 2018-02-09 2021-07-29
EV GL MACR ABS RTRN P 2020-05-28 2021-07-29
ELECTRONIC ARTS P 2019-10-21 2021-02-23
ELECTRONIC ARTS P 2019-09-27 2021-02-23
FIDELITY NATL INFORMATION SVCS P 2019-08-08 2021-02-23
GOLDMAN SACHS GROUP 3.00% P 2017-08-11 2021-01-28
GOLDMAN SACHS GROUP 3.00% P 2019-08-08 2021-01-28
GOLDMAN SACHS GROUP 3.00% P 2019-09-27 2021-01-28
HAIN CELESTIAL GROUP P 2019-04-26 2021-02-23
HAIN CELESTIAL GROUP P 2019-08-08 2021-02-23
HAIN CELESTIAL GROUP P 2019-09-27 2021-02-23
INVESCO OPTIMUM YIELD DIVERS P 2020-04-09 2021-07-29
JPMORGAN CHASE & CO P 2019-04-26 2021-02-23
JPMORGAN CHASE & CO P 2019-04-08 2021-02-23
JPMORGAN CHASE & CO P 2019-08-08 2021-02-23
LAM RESEARCH CORP P 2019-08-08 2021-02-11
LAM RESEARCH CORP P 2018-07-24 2021-02-23
LAM RESEARCH CORP P 2019-08-08 2021-02-23
LAM RESEARCH CORP P 2018-07-24 2021-04-08
LAS VEGAS SANDS CORP P 2019-02-26 2021-02-23
LAS VEGAS SANDS CORP P 2019-04-26 2021-02-23
LAS VEGAS SANDS CORP P 2019-09-10 2021-02-23
ELI LILLY & CO P 2019-04-26 2021-02-23
ELI LILLY & CO P 2016-10-03 2021-07-06
ELI LILLY & CO P 2019-04-26 2021-07-06
ELI LILLY & CO P 2019-08-08 2021-07-06
ELI LILLY & CO P 2019-09-27 2021-07-06
MANULIFE FINANCIAL P 2019-04-22 2021-02-11
MANULIFE FINANCIAL P 2019-04-26 2021-02-11
MANULIFE FINANCIAL P 2019-09-27 2021-02-11
MANULIFE FINANCIAL P 2019-10-31 2021-02-23
MANULIFE FINANCIAL P 2019-04-26 2021-02-23
MANULIFE FINANCIAL P 2019-05-02 2021-02-23
MANULIFE FINANCIAL P 2019-07-31 2021-02-23
MANULIFE FINANCIAL P 2019-08-08 2021-02-23
MICROSOFT P 2019-04-26 2021-02-23
MICROSOFT P 2019-08-08 2021-02-23
MONDELEZ INTERNATIONAL P 2019-04-26 2021-02-23
NIKE P 2018-02-15 2021-02-23
NIKE P 2019-08-08 2021-02-23
ORGANON P 2018-10-05 2021-06-14
ORGANON P 2016-02-05 2021-06-14
ORGANON P 2019-04-26 2021-06-14
ORGANON P 2018-10-05 2021-06-28
PRINCIPAL HIGH YIELD P 2019-10-11 2021-03-25
PRINCIPAL HIGH YIELD P 2019-10-11 2021-07-29
PRINCIPAL HIGH YIELD P 2020-05-28 2021-07-29
RAYTHEON TECHNOLOGIES P 2019-10-31 2021-02-23
RAYTHEON TECHNOLOGIES P 2019-10-05 2021-02-23
RAYTHEON TECHNOLOGIES P 2019-08-13 2021-02-23
RAYTHEON TECHNOLOGIES P 2019-09-10 2021-02-23
SUNCOR ENERGY P 2018-11-30 2021-02-23
SUNCOR ENERGY P 2019-08-08 2021-02-23
SUNCOR ENERGY P 2019-09-27 2021-02-23
TARGET P 2019-04-26 2021-02-23
TARGET P 2019-08-08 2021-02-23
TARGET P 2019-04-26 2021-06-14
THERMO FISHER SCIENTIFIC P 2011-04-13 2021-02-23
TORONTO DOMINION BK P 2019-05-14 2021-02-23
TOTALENERGIES P 2019-04-26 2021-02-23
TOTALENERGIES P 2012-08-30 2021-02-23
TOTALENERGIES P 2017-08-09 2021-02-23
TOTALENERGIES P 2019-09-27 2021-02-23
UNILEVER PLC P 2020-02-03 2021-02-23
UNION PACIFIC CORP P 2015-10-23 2021-02-23
UNION PACIFIC CORP P 2015-09-06 2021-02-23
UNITEDHEALTH GROUP P 2019-08-08 2021-02-23
UNITEDHEALTH GROUP P 2019-04-26 2021-07-06
UNITEDHEALTH GROUP P 2019-08-08 2021-07-06
VANGUARD FTSE DEVELOPED ETF P 2015-10-06 2021-02-23
VANGUARD FTSE DEVELOPED ETF P 2014-12-15 2021-02-23
VANGUARD FTSE DEVELOPED ETF P 2013-02-05 2021-02-23
VANGUARD FTSE DEVELOPED ETF P 2013-03-08 2021-02-23
VANGUARD FTSE DEVELOPED ETF P 2013-07-02 2021-02-23
VANGUARD MIDCAP VIPER P 2020-09-25 2021-10-18
VANGUARD MIDCAP VIPER P 2020-09-25 2021-11-03
VANGUARD MIDCAP VIPER P 2020-02-14 2021-02-23
VANGUARD MIDCAP VIPER P 2020-02-14 2021-07-29
WALGREENS BOOTS ALLIANCE 3.80% P 2019-11-04 2021-04-26
WASTE MANAGEMENT P 2020-02-22 2021-02-23
MEDTRONIC PLC P 2019-07-19 2021-02-23
GARMIN LTD P 2020-05-29 2021-08-30
TE CONNECTIVITY P 2017-06-08 2021-02-23
TE CONNECTIVITY P 2016-11-08 2021-03-25
FLEX LTD P 2020-04-09 2021-11-19
FLEX LTD P 2019-06-12 2021-11-19
FLEX LTD P 2019-08-08 2021-11-19
FLEX LTD P 2019-09-27 2021-11-19
FLEX LTD P 2019-08-08 2021-03-25
CAPITAL GAINS DIVIDENDS P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 6,482   6,599 -117
b 2,990   3,013 -23
c 2,414   2,766 -352
d 3,219   3,907 -688
e 3,946   4,183 -237
3,683   3,592 91
3,502   3,600 -98
1,401   934 467
4,629   4,304 325
4,071   4,154 -83
1,242   1,015 227
501   458 43
7,045   5,174 1,871
546   333 213
472   440 32
2,590   2,578 12
4,655   3,701 954
9,620   9,892 -272
12,178   12,017 161
950   945 5
1,206   1,156 50
3,415   3,013 402
13,773   9,582 4,191
9,283   8,501 782
56,221   56,234 -13
95,695   93,506 2,189
5,186   4,559 627
2,475   2,313 162
124,033   130,539 -6,506
72,077   70,831 1,246
43,488   43,620 -132
5,007   3,651 1,356
1,730   1,892 -162
1,429   1,507 -78
7,117   6,760 357
3,409   3,335 74
487   498 -11
33   42 -9
109,595   110,445 -850
79,470   77,341 2,129
8,638   8,705 -67
7,065   7,160 -95
107,080   103,381 3,699
2,595   1,899 696
1,888   1,393 495
3,446   2,474 972
3,871   3,577 294
4,318   2,666 1,652
1,976   1,577 399
53,972   38,460 15,512
3,110   2,584 526
893   893 0
2,902   3,027 -125
653   605 48
4,443   4,183 260
3,783   2,957 826
2,144   1,542 602
535   472 63
3,214   1,775 1,439
2,490   1,420 1,070
1,614   1,743 -129
532   521 11
1,368   1,545 -177
3,480   4,005 -525
2,251   2,273 -22
3,001   3,130 -129
2,881   2,947 -66
1,921   2,149 -228
3,301   3,544 -243
12,150   7,589 4,561
8,248   10,089 -1,841
3,490   1,304 2,186
16,053   6,568 9,485
10,000   9,922 78
10,000   9,993 7
10,000   10,074 -74
5,000   5,000 0
20,000   20,000 0
5,000   5,038 -38
2,248   954 1,294
4,931   2,257 2,674
2,757   1,235 1,522
1,074   2,126 -1,052
1,718   2,843 -1,125
429   896 -467
429   763 -334
1,503   2,927 -1,424
20,483   19,866 617
3,803   2,355 1,448
2,793   1,766 1,027
2,793   1,757 1,036
910   568 342
2,729   1,757 972
3,346   2,849 497
1,365   1,034 331
2,458   1,949 509
498   529 -31
4,122   4,814 -692
227   245 -18
2,892   2,357 535
767   535 232
2,495   2,632 -137
4,465   4,708 -243
946   766 180
4,877   3,928 949
828   723 105
1,655   1,413 242
331   278 53
2,317   2,260 57
828   817 11
582   414 168
117,116   117,888 -772
12,489   11,477 1,012
7,607   7,428 179
3,322   3,219 103
2,073   1,432 641
1,658   1,165 493
3,528   3,518 10
20,124   20,274 -150
5,031   5,057 -26
5,031   5,053 -22
2,039   1,052 987
1,699   870 829
1,147   589 558
127,969   76,338 51,631
5,608   4,221 1,387
1,516   1,138 378
1,667   1,203 464
3,447   1,198 2,249
3,339   1,041 2,298
1,113   400 713
3,327   868 2,459
2,519   2,498 21
2,016   2,173 -157
1,449   1,349 100
2,003   1,195 808
469   161 308
234   120 114
234   112 122
2,108   1,010 1,098
628   586 42
6,041   5,606 435
1,667   1,553 114
135   126 9
154   146 8
984   895 89
3,455   3,245 210
2,548   2,249 299
14,264   8,035 6,229
2,531   1,505 1,026
3,831   3,510 321
2,280   1,150 1,130
2,146   1,312 834
40   44 -4
471   365 106
125   150 -25
6   7 -1
11,264   11,077 187
133,934   129,554 4,380
152,786   139,256 13,530
114   121 -7
58   63 -5
3,319   3,548 -229
2,177   2,434 -257
308   484 -176
2,649   3,668 -1,019
349   536 -187
5,078   2,092 2,986
1,693   754 939
2,781   930 1,851
3,178   386 2,792
1,844   1,650 194
555   661 -106
1,064   1,134 -70
2,776   3,088 -312
139   156 -17
3,647   3,938 -291
2,695   1,262 1,433
1,244   575 669
5,269   3,944 1,325
2,855   1,655 1,200
3,263   1,972 1,291
14,630   11,051 3,579
69,272   52,573 16,699
28,966   21,494 7,472
29,260   21,909 7,351
21,356   15,681 5,675
25,277   17,513 7,764
23,701   15,968 7,733
34,729   29,526 5,203
32,287   24,883 7,404
25,284   24,331 953
1,563   1,563 0
4,437   3,861 576
3,563   1,814 1,749
129   80 49
872   457 415
6,383   3,216 3,167
4,273   2,279 1,994
1,489   895 594
585   347 238
2,644   1,683 961
717     717
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       -117
b       -23
c       -352
d       -688
e       -237
      91
      -98
      467
      325
      -83
      227
      43
      1,871
      213
      32
      12
      954
      -272
      161
      5
      50
      402
      4,191
      782
      -13
      2,189
      627
      162
      -6,506
      1,246
      -132
      1,356
      -162
      -78
      357
      74
      -11
      -9
      -850
      2,129
      -67
      -95
      3,699
      696
      495
      972
      294
      1,652
      399
      15,512
      526
      0
      -125
      48
      260
      826
      602
      63
      1,439
      1,070
      -129
      11
      -177
      -525
      -22
      -129
      -66
      -228
      -243
      4,561
      -1,841
      2,186
      9,485
      78
      7
      -74
      0
      0
      -38
      1,294
      2,674
      1,522
      -1,052
      -1,125
      -467
      -334
      -1,424
      617
      1,448
      1,027
      1,036
      342
      972
      497
      331
      509
      -31
      -692
      -18
      535
      232
      -137
      -243
      180
      949
      105
      242
      53
      57
      11
      168
      -772
      1,012
      179
      103
      641
      493
      10
      -150
      -26
      -22
      987
      829
      558
      51,631
      1,387
      378
      464
      2,249
      2,298
      713
      2,459
      21
      -157
      100
      808
      308
      114
      122
      1,098
      42
      435
      114
      9
      8
      89
      210
      299
      6,229
      1,026
      321
      1,130
      834
      -4
      106
      -25
      -1
      187
      4,380
      13,530
      -7
      -5
      -229
      -257
      -176
      -1,019
      -187
      2,986
      939
      1,851
      2,792
      194
      -106
      -70
      -312
      -17
      -291
      1,433
      669
      1,325
      1,200
      1,291
      3,579
      16,699
      7,472
      7,351
      5,675
      7,764
      7,733
      5,203
      7,404
      953
      0
      576
      1,749
      49
      415
      3,167
      1,994
      594
      238
      961
      717
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 2 247,786
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 4,537
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 4,537
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 4,537
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)
    bulletTX
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletWELLS FARGO BANK NA Telephone no.bullet (704) 590-2828

    Located atbullet100 NORTH MAIN STREET 6TH FLOORWINSTONSALEMNC ZIP+4bullet27101
    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)
    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
    WELLS FARGO BANK NA TRUSTEE
    1.00     		66,849 0 0
    100 NORTH MAIN STREET 6TH FLOOR
    WINSTONSALEM,NC27101
    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.........................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
    5,525,217
    b
    Average of monthly cash balances.......................
    1b
    149,807
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    5,675,024
    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
    5,675,024
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    85,125
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    5,589,899
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    279,495
    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
    279,495
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    4,537
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    4,537
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    274,958
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    274,958
    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
    274,958
    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 7 274,958
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 215,223
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 239,916
    a Applied to 2020, but not more than line 2a 215,223
    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..... 24,693
    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 ..........     		250,265
    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....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    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:
    WELLS FARGO BANK TRUST DEPARTMENT
    100 NORTH MAIN STREET 6TH FLOOR
    WINSTONSALEM,NC27101
    (704) 590-2828
    bThe form in which applications should be submitted and information and materials they should include:
    ORGANIZATIONS ARE TO SUBMIT REQUESTS ON BANK TRUST DEPARTMENT'S GRANT APPLICATION AVAILABLE AT: HTTPS://WWW.WELLSFARGO.COM/PRIVATEFOUNDATIONGRANTS/DOUGHERTY.
    cAny submission deadlines:
    JULY 31
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    AS PROVIDED FOR IN THE WILL, THE FOLLOWING ARE TO RECEIVE AT LEAST 10 PERCENT OF THE ANNUAL NET INCOME: FIRST UNITED METHODIST CHURCH, BRYAN, TX; METHODIST RETIREMENT SERVICES, INC, THE WOODLANDS, TX; BRAZOS VALLEY REHABILITATION CENTER, BRYAN, TX; COLLEGE OF SCIENCE, TEXAS A&M UNIVERSITY, COLLEGE STATION, TX. THE REMAINING CONTRIBUTIONS ARE RESTRICTED TO CHARITABLE ORGANIZATIONS IN THE BRAZOS COUNTY, TX AREA
    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
    BRAZOS VALLEY FOOD BANK
    1514 SHILOH AVE
    BRYAN,TX77803     		  CHARITY FOR CHARITABLE PURPOSES 10,000
    BRAZOS VALLEY REHABILITATION CENTER
    1318 MEMORIAL DRIVE
    BRYAN,TX77802     		  CHARITY FOR CHARITABLE PURPOSES 15,000
    BRYAN ISD EDUCATION FOUNDATION
    101 N TEXAS AVENUE
    BRYAN,TX77803     		  EDUCATIONAL FOR EDUCATIONAL PURPOSES 10,000
    FIRST UNITED METHODIST CHURCH
    506 28TH STREET
    BRYAN,TX77803     		  CHARITY FOR CHARITABLE PURPOSES 35,000
    HEALTH FOR ALL
    1328A MEMORIAL DR
    BRYAN,TX77802     		  CHARITY FOR CHARITABLE PURPOSES 15,000
    HOSPICE OF BRAZOS VALLEY
    502 W 26TH STREET
    BRYAN,TX77803     		  CHARITY FOR CHARITABLE PURPOSES 30,000
    METHODIST RETIREMENT COMMUNITIES FBO CRESTVIEW RETIREMENT BUILDING FUND
    2202 TIMBERLOCH PLACE STE 200
    THE WOODLANDS,TX77830     		  CHARITY FOR CHARITABLE PURPOSES 20,000
    SALVATION ARMY
    2506 CAVITT AVE
    BRYAN,TX77801     		  CHARITY FOR CHARITABLE PURPOSES 5,000
    ST JOSEPH FOUNDATION
    PO BOX 993
    BRYAN,TX77805     		  CHARITY FOR CHARITABLE PURPOSES 30,000
    UNITED WAY OF THE BRAZOS VALLEY
    1716 BRIARCREST DR STE 155
    BRYAN,TX77802     		  CHARITY FOR CHARITABLE PURPOSES 3,500
    A HOME BASE FOR TRANSITIONING FOSTER YOUTH
    4001 E 29TH ST STE 118
    BRYAN,TX77802     		  CHARITY FOR CHARITABLE PURPOSES 10,000
    COLLEGE STATION ISD EDUCATION FOUNDATION
    1812 WELSH AVE
    COLLEGE STATION,TX77840     		  CHARITY FOR EDUCATIONAL PURPOSES 5,000
    PATRIOT PAWS SERVICE DOGS
    12575 SH 30
    COLLEGE STATION,TX77845     		  CHARITY FOR CHARITABLE PURPOSES 8,500
    REACH PROJECT
    104 N HOUSTON ST
    COLLEGE STATION,TX77841     		  CHARITY FOR CHARITABLE PURPOSES 5,000
    TEXAS RAMP PROJECT
    9477 BARROW CT
    COLLEGE STATION,TX77845     		  CHARITY FOR CHARITABLE PURPOSES 10,000
    UNITED SERVICE ORGANIZATIONS
    701 SOUTH SAN JACINTO
    HOUSTON,TX77052     		  CHARITY FOR CHARITABLE PURPOSES 5,000
    Total .................................bullet 3a 217,000
    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 ...........     		         
    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 ............     		    18 247,786  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aCLASS ACTION SETTLEMENT     		      7  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 380,345 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    380,345
    (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:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 575 0   575

    TY 2021 GeneralExplanationAttachment
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Identifier Return Reference Explanation
    INFORMATION ABOUT OFFICERS PART VIII 1(B) INFORMATION ABOUT OFFICERS, DIRECTORS, TRUSTEES, FOUNDATION MANAGERS, HIGHLY PAID EMPLOYEES AND CONTRACTORS. THE CORPORATE TRUSTEE'S COMPENSATION REPORTED IN COLUMN (C) IS CALCULATED BASED ON PERIODIC MARKET VALUES AND/OR THE APPLICABLE FEE AGREEMENT. IT IS NOT DETERMINED ON AN HOURLY BASIS AND THE REFERENCE TO ONE HOUR PER WEEK IS AN ESTIMATED ONLY. CORPORATE TRUSTEE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, ADMINISTRATIVE SERVICES SUCH AS FIDUCIARY ACCOUNTING, CUSTODY OF ASSETS, CIMPLYING WITH TAX FILING REQUIREMENTS, COMPLYING WITH DISTRIBUTION PROVISIONS, AND COMPLYING WITH FEDERAL AND STATE LAWS APPLICABLE TO PRIVATE FOUNDATIONS, PLUS ASSET MANAGEMENT SERVICES SUCH AS CREATING ASSET ALLOCATION STRATEGIES, INVESTMENT REPORTING AND REALLOCATING AND REBALANCING OF PORTFOLIIOS AS NECESSARY.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Name of Bond End of Year Book Value End of Year Fair Market Value
    ABBVIE 3.75% 11/14/23 25,910 26,174
    APPLE 1.80% 9/11/24 29,756 30,656
    AT&T 4.45% 4/1/24 22,349 21,348
    BANK OF AMERICA MED TERM NOTE 3.30% 1/11/23 29,867 30,821
    BANK OF MONTREAL MED TERM NOTE 2.35% 9/11/22 29,798 30,384
    BECTON DICKINSON 3.734% 12/15/24 22,145 21,259
    CELANESE US HOLDINGS LLC 3.50% 5/8/24 12,506 12,534
    CHARLES SCHWAB .90% 3/11/26 29,703 29,257
    CHEVRON CORP 1.554% 5/11/25 27,157 27,229
    CIGNA CORP 1.25% 3/15/26 20,006 19,711
    CITIGROUP 2.75% 4/25/22 30,990 30,163
    COMCAST 3.375% 8/15/25 22,335 21,376
    CUMMINS .75% 9/1/25 28,079 27,456
    DOLLAR GENERAL 3.25% 4/15/23 24,806 25,604
    DOWDUPONT 4.205% 11/15/23 26,291 26,437
    EQUINIX 1.00% 9/15/25 24,940 24,250
    EXXON MOBIL 2.992% 3/19/25 27,356 26,273
    GOLDMAN SACHS GROUP 3.50% 4/1/25 27,620 26,436
    HP ENTERPRISE 1.45% 4/1/24 20,414 20,128
    JP MORGAN CHASE & CO 3.20% 1/25/23 26,571 25,678
    KLA-TENCOR CORP 4.65% 11/1/24 25,225 24,935
    MCCORMICK & CO .90% 2/15/26 19,973 19,329
    MITSUBISHI UFJ FIN GRP 3.407% 3/7/24 30,466 31,405
    MORGAN STANLEY 3.875% 4/29/24 31,223 31,803
    PAYPAL HOLDINGS 2.40% 10/1/24 25,151 25,874
    PPG INDUSTRIES 1.20% 3/15/26 24,853 24,453
    ROPER TECHNOLOGIES 1.00% 9/15/25 27,270 26,379
    ROYAL BANK OF CANADA 1.60% 4/17/23 30,787 30,337
    SHELL INTERNATIONAL FIN 2.00% 11/7/24 30,311 30,746
    SUMITOMO MITSUI FINL GRP 3.748% 7/19/23 30,302 31,252
    UNITEDHEALTH GROUP 2.875% 3/15/23 29,537 30,765
    WESTPAC BANKING CORP 3.30% 2/26/24 30,648 31,470

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBVIE INC 24,830 30,871
    ALPHABET INC 42,112 118,637
    APPLE INC 18,571 140,103
    BLACKROCK INC 16,893 39,369
    BLACKSTONE GROUP 12,401 29,113
    BOEING CO 19,158 20,736
    BOOKING HOLDINGS 17,859 23,992
    BROADCOM 19,585 43,252
    CELANESE CORP 17,328 37,813
    CISCO SYSTEMS INC 14,768 35,931
    CITIGROUP 34,933 38,831
    COGNIZANT TECH SOLUTIONS 21,869 31,318
    CVS HEALTH CORPORATION 14,629 30,122
    DIAGEO PLC - ADR 17,643 33,021
    EATON CORP. 31,612 42,341
    ELECTRONIC ARTS 18,914 25,325
    ELI LILLY & CO. 15,156 37,290
    FIDELITY NATL INFORMATION SVCS 27,674 24,886
    GARMIN LTD 19,460 25,464
    HAIN CELESTIAL GROUP 8,307 16,064
    HASBRO INC 23,560 25,140
    INTERPUBLIC GROUP COS 16,538 29,024
    JP MORGAN CHASE & CO 28,987 55,898
    LAM RESEARCH CORP 7,120 28,766
    LAS VEGAS SAND CORP 27,279 20,664
    MANULIFE FINANCIAL CORP 26,918 34,364
    MEDTRONIC PLC 17,687 18,104
    MERCK & CO. 23,310 28,050
    META PLATFORMS 15,568 16,481
    MICROSOFT CORP 30,478 140,918
    MONDELEZ INTERNATIONAL 19,202 27,983
    NIKE 9,720 28,834
    RAYTHEON TECHNOLOGIES 27,789 32,100
    SUNCOR ENERGY 27,039 28,534
    SYSCO CORP 16,198 23,643
    TARGET CORP 9,091 28,004
    TE CONNECTIVITY 18,419 28,880
    THERMO FISHER SCIENTIFIC INC 2,037 24,688
    TORONTO DOMINION BK ONT 25,025 35,426
    TOTALENERGIES SE 25,212 26,362
    UNILEVER PLC 16,684 16,567
    UNION PACIFIC CORP 7,295 28,720
    UNITED PARCEL SERVICE-CL B 15,573 33,866
    UNITEDHEALTH GROUP 12,576 56,240
    VISA INC 24,873 29,689
    WALT DISNEY CO 13,263 26,641
    WASTE MANAGEMENT 26,886 37,552

    TY 2021 InvestmentsGovtObligationsSch
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    US Government Securities - End of Year Book Value:

    339,540
    US Government Securities - End of Year Fair Market Value:

    339,002
    State & Local Government Securities - End of Year Book Value:


    0
    State & Local Government Securities - End of Year Fair Market Value:


    0


    TY 2021 InvestmentsOtherSchedule2
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    AGILITY MULTI ASSET INCOME FUND AT COST 150,000 149,442
    BRAZOS COUNTY, TX MINERALS AT COST 1 31,318
    FIDELITY NEW MARKETS INCOME FUND CLASS Z AT COST 112,658 106,911
    GOLDMAN SACHS ACTIVEBETA INTERNATIONAL EQUITY AT COST 111,873 111,065
    GRIMES COUNTY, TX MINERALS AT COST 1 22,407
    ISHARES CORE MSCI EMERGING MARKETS ETF AT COST 326,367 361,794
    ISHARES CORE S&P SMALL CAP AT COST 98,947 109,357
    ISHARES MBS ETF AT COST 64,830 64,458
    ISHARES RUSSELL 2000 ETF AT COST 187,212 272,724
    PGIM HIGH YIELD FUND CLASS Q AT COST 385,494 379,808
    PIMCO COMMODITY REAL RETURN STRATEGY FUND AT COST 158,997 157,507
    TCW EMRG MKTS INCM AT COST 161,280 156,141
    VANGUARD MIDCAP VIPER AT COST 495,575 775,010

    TY 2021 OtherDecreasesSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Description Amount
    ACCRETION 822
    2021 FIT ES PAYMENTS 2,600


    TY 2021 OtherExpensesSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADR FEES 25 25   0
    OIL & GAS FEES 698 698   0
    OIL & GAS OPERATING FEES 64 64   0


    TY 2021 OtherIncomeSchedule2
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    NET ROYALTIES 12,865 12,865 12,865
    CLASS ACTION SETTLEMENT 7   7


    TY 2021 OtherIncreasesSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Description Amount
    NONDIVIDENDS DISTRIBUTIONS/RETURN OF PRINCIPAL 622
    2020 FIT REFUND 203
    PREMIUM AMORTIZATION 9,457
    BASIS ADJUSTMENT 298
    ACCRUED INTEREST CARRIED OVER FROM 2020 385


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    GRANT ADMINISTRATION FEES 5,629 0   5,629


    TY 2021 TaxesSchedule
    Name:
    LUCILLE AND JOHN B DOUGHERTY TRUST
     
    % WELLS FARGO BANK NA
    EIN:
    26-1444071
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 2,419 2,419   0
    PROPERTY TAXES 581 581   0