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
The James T and Valeria B Robertson
Foundation
% FOUNDATION SOURCE
Number and street (or P.O. box number if mail is not delivered to street address)Foundation Source 501 Silverside Rd
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Wilmington, DE198091377
A Employer identification number

64-6214992
B Telephone number (see instructions)

(800) 839-1754
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$4,182,350J 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) 0
2 Check bullet.............
3 Interest on savings and temporary cash investments 107 107  
4 Dividends and interest from securities... 40,376 40,376  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 530,153
b Gross sales price for all assets on line 6a 3,091,344
7 Capital gain net income (from Part IV, line 2)... 535,802
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 2,117 1,453  
12 Total. Add lines 1 through 11........ 572,753 577,738  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 45,748 45,748    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 17,605 1,145    
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 20,571 36   20,535
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 83,924 46,929   20,535
25 Contributions, gifts, grants paid....... 310,420 310,420
26 Total expenses and disbursements. Add lines 24 and 25 394,344 46,929   330,955
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 178,409
b Net investment income (if negative, enter -0-) 530,809
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......... 159,984 250,636 250,636
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
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)      
b Investments—corporate stock (attach schedule)....... 3,262,581 Click to see attachment3,350,338 3,931,714
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) 3,422,565 3,600,974 4,182,350
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........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 3,422,565 3,600,974
29 Total net assets or fund balances (see instructions)..... 3,422,565 3,600,974
30 Total liabilities and net assets/fund balances (see instructions). 3,422,565 3,600,974
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
3,422,565
2
Enter amount from Part I, line 27a .....................
2
178,409
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
3,600,974
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
3,600,974
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 Publicly-traded Securities      
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 3,091,344   2,555,542 535,802
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       535,802
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 2 535,802
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  
3 Add lines 1 and 2........................... 3 7,378
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 7,378
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 5,878
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 1,600
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 7,478
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 100
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet100 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$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMS
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletFOUNDATION SOURCE Telephone no.bullet (800) 839-1754

    Located atbullet501 SILVERSIDE ROAD SUITE 123WilmingtonDE ZIP+4bullet198091377
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    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
     
     
    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
    Roberta R Beach Trustee
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Daniel P Robertson Trustee
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    James T Robertson Jr Trustee
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    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
     
    Total number of other employees paid over $50,000...................bullet  
    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
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    4,009,912
    b
    Average of monthly cash balances.......................
    1b
    192,788
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    4,202,700
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    4,202,700
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    63,041
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    4,139,659
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    206,983
    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
    206,983
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    7,378
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    7,378
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    199,605
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    199,605
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    199,605
    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 7 199,605
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:2019, 2018, 2017  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 17,396
    b From 2017...... 64,428
    c From 2018...... 101,337
    d From 2019......  
    e From 2020...... 26,837
    f Total of lines 3a through e ........ 209,998
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 330,955
    a Applied to 2020, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount..... 199,605
    e Remaining amount distributed out of corpus 131,350
    5 Excess distributions carryover applied to 2021.    
    (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 5 341,348
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    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......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    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) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		17,396
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		323,952
    10 Analysis of line 9:
    a Excess from 2017.... 64,428
    b Excess from 2018.... 101,337
    c Excess from 2019....  
    d Excess from 2020.... 26,837
    e Excess from 2021.... 131,350
    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).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    BREVARD MUSIC CENTER INCORPORATED
    PO BOX 312
    BREVARD,NC28712     		N/A PC Student Scholarship Fund 15,000
    BREVARD MUSIC CENTER INCORPORATED
    PO BOX 312
    BREVARD,NC28712     		N/A PC James T and Valeria B Robertson Room of the Parker Concert Hall 33,500
    FLORIDA INTERNATIONAL UNIVERSITY FOUNDATION INC
    11200 SW 8TH ST MARC 531
    MIAMI,FL33199     		N/A PC The Valeria B and James T Robertson MD Memorial Scholarship Fund in The Herbert Wertheim College of Medicine 33,720
    HENDERSON COUNTY EDUCATION FOUNDATION INC
    PO BOX 1267
    HENDERSONVLLE,NC28793     		N/A PC Early College Science Olympiad Team 2,000
    HENDERSON COUNTY FREE MEDICAL CLINIC INC
    841 CASE ST
    HENDERSONVLLE,NC28792     		N/A PC General & Unrestricted 2,500
    ST GILES CHAPEL
    1617 HENDERSONVILLE RD
    ASHEVILLE,NC28803     		N/A PC Annual Fund 35,000
    ST GILES CHAPEL
    1617 HENDERSONVILLE RD
    ASHEVILLE,NC28803     		N/A PC Annual Fund 30,000
    THE ROTARY CLUB OF HENDERSONVILLE NC CHARITABLE CO
    PO BOX 901
    HENDERSONVLLE,NC28793     		N/A PC General & Unrestricted 6,000
    THE ROTARY FOUNDATION OF ROTARY INTERNATIONAL
    1560 SHERMAN AVE
    EVANSTON,IL60201     		N/A PC General & Unrestricted 10,000
    THE UNIVERSITY OF TENNESSEE FOUNDATION INC
    1525 UNIVERSITY AVE
    KNOXVILLE,TN37921     		N/A PC The James T and Valeria B Robertson Family Scholarship Fund at the University of Tennessee Health Science Center College of Medicine 37,700
    UNC HEALTH FOUNDATION INC
    123 W FRANKLIN ST STE 510
    CHAPEL HILL,NC27516     		N/A PC Annual Scholarship Fund for the UNC School of Medicine 35,000
    UNIVERSITY OF CENTRAL FLORIDA FOUNDATION INC
    12424 RESEARCH PKWY STE 250
    ORLANDO,FL32826     		N/A PC The James T and Valeria B Robertson Scholarship Fund 30,000
    UNIVERSITY OF MEMPHIS FOUNDATION
    635 NORMAL ST ALUMNI CENTER NO 1
    MEMPHIS,TN38152     		N/A PC To establish The James T and Valeria B Robertson Foundation Scholarship fund for the benefit of the Herff College of Engineering Technology 40,000
    Total .................................bullet 3a 310,420
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 107  
    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 ............     		    18 530,153  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aCLASS ACTION LAWSUIT PROCEEDS     		    01 1,453  
    bFederal Tax Refund     01 664  
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   572,753  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    572,753
    (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


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    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

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    TY 2021 DepreciationSchedule
    Name:
    The James T and Valeria B Robertson
     
    Foundation
    EIN:
    64-6214992
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    The James T and Valeria B Robertson
     
    Foundation
    EIN:
    64-6214992
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBVIE INC 5,094 6,635
    ACADIA HEALTHCARE CO INC 40,319 42,369
    ACCENTURE PLC 19,672 21,971
    ADVANCED DRAINAGE SYSTEMS INC 9,419 31,718
    AGILENT TECHNOLOGIES INC 18,862 16,923
    ALPHABET INC CL C 20,267 20,255
    AMERESCO INC CL A 18,798 21,663
    AMERICAN ELECTRIC POWER INC 4,395 6,495
    AMGEN INC 6,123 7,874
    ARES MANAGEMENT CORPORATION 32,026 65,097
    ASGN INC 18,998 22,829
    ASML HOLDING NV NY REG SHS 29,692 76,429
    ATMOS ENERGY CORP 7,266 8,382
    AUTONATION INC 32,389 44,520
    AVATAR HOLDINGS INC. 18,812 19,089
    AXONICS MODULATION TECHNOLOGIE 18,873 13,440
    AYATLANTICA YIELD ORD SHS 4,384 8,797
    BATH & BODY WORKS, INC 19,703 17,936
    BAYER A G SPONSORED ADR 6,545 4,097
    BHP BILLITON SP ADR 4,662 4,722
    BROADCOM INC 3,507 7,320
    BRUKER CORPORATION 46,864 47,493
    BUNGE LTD 14,521 15,404
    CASELLA WASTE SYSTEMS INC 26,340 25,797
    CBRE GROUP 18,896 20,942
    CDW CORP 18,904 19,454
    CEMEX SA DE CV A ADS 27,908 23,513
    CHARLES RIV LABORATORIES INTL 18,495 24,491
    CHART INDUSTRIES, INC 35,717 37,480
    CHENIERE ENERGY INC 34,171 32,353
    CHEVRON CORP 5,923 6,689
    CISCO SYSTEMS INC 5,372 8,745
    CONAGRA FOODS INC 5,133 4,644
    CONTINENTAL RESOURCES INC 7,494 7,206
    COTERRA ENERGY INC 18,753 20,349
    CROWDSTRIKE HOLDINGS, INC 25,016 19,656
    CROWN CASTLE INTL 3,958 7,932
    DANAHER CORP 18,830 18,754
    DECKERS OUTDOOR CORPORATION 47,445 74,361
    DEVON ENERGY CORPORATION 48,110 53,829
    DIGITAL RLTY TR INC 4,654 8,667
    DOCUSIGN INC 3,196 6,702
    DOVER CORP 19,610 20,521
    DYNATRACE 18,871 16,113
    EASTMAN CHEMICAL CO 7,384 11,849
    EATON CORP PLC 7,261 12,097
    ELEMENT SOLUTIONS INC 37,869 40,572
    ENPHASE ENERGY ORD SHS 9,303 12,806
    EPAM SYSTEMS INC 26,279 62,834
    ESSEX PRTY TR INC 3,807 5,988
    EXELON CORPORATION 3,197 4,101
    EXLSERVICE HOLDINGS INC 26,481 28,085
    EXTRA SPACE STORAGE 48,166 55,776
    EXXON MOBIL CORP 6,272 5,079
    FIFTH THIRD BANCORP 3,691 5,444
    FIRST REPUBLIC BANK 19,640 18,379
    FLOOR AND DECOR HOLDINGS 31,488 56,294
    FORTINET INC 66,534 81,224
    FRANKLIN RES INC 5,099 6,464
    FREEPORT-MCMORAN COPPER & GOLD 13,805 23,285
    FT-PREFERRED SECUR & INC ETF 6,571 10,465
    GARTNER INC 66,548 75,891
    GENERAC HOLDING INC 20,548 75,663
    GREENS PLAINS INC 13,482 11,158
    HCA INC 19,277 23,894
    HERC HOLDINGS, INC 43,695 58,863
    HIBBETT SPORTS, INC 59,047 53,876
    HORIZON THERAPEUTICS PUBLIC OR 6,626 19,074
    HUBSPOT INC 18,421 17,797
    ICON PLC - AMERICAN DEPOSITARY 26,134 30,041
    INSPIRE MEDICAL SYSTEMS 13,014 22,776
    INTERNATIONAL BUSINESS MACHINE 5,458 4,277
    IQVIA HOLDINGS INC 18,746 20,032
    ISHARES 20+ YR TREAS BD 10,751 12,893
    ISHARESLEHMAN 7-10YR 12,791 12,995
    KEYCORP 3,775 5,320
    KEYSIGHT TECHNOLOGIES INC 24,908 27,879
    LOCKHEED MARTIN CORP 5,222 4,976
    LYONDELLBASELL INDUSTRIES NV 6,748 7,378
    MARVELL TECHNOLOGY, INC 27,771 68,592
    MORGAN STANLEY 51,893 63,608
    NOVA MEASURING INSTRUMENTS LTD 27,260 31,205
    OLD DOMINION FREIGHT LINE 7,006 20,428
    ORGANON & CO 4,434 4,385
    PAYPAL HOLDINGS, INC 13,217 15,841
    PDC ENERGY INC 8,541 7,610
    PEPSICO INC 6,975 8,338
    PFIZER INC 4,813 9,507
    PRINCIPAL FINANCIAL GROUP 3,753 5,569
    PROGYNY ORD SHS 18,944 16,062
    QORVO INC 18,146 16,890
    ROBERT HALF INTL INC 29,716 27,545
    ROKU INC 9,164 6,846
    SAIA, INC 41,320 89,313
    SCHLUMBERGER LTD 19,232 18,479
    SELECT MEDICAL 24,999 18,287
    SHOCKWAVE MEDICAL ORD SHS 63,326 61,167
    SHUTTERSTOCK INC 19,833 17,741
    SIGNATURE BANK 18,355 24,907
    SIGNET GROUP PLC SPONS ADR NAS 19,810 15,926
    SK TELECOM ADS ADS 1,544 2,694
    SPDR GOLD SHARES 88,745 90,096
    SPDR S&P 500 ETF TRUST 14,950 15,199
    SVB FINANCIAL GROUP 43,594 73,250
    TC ENERGY CORPORATION 4,896 4,933
    TELETECH HOLDINGS, INC 34,665 38,755
    TENET HEALTHCARE CORP 43,747 50,893
    TERNIUM S.A. ADS 11,791 13,274
    TEXAS INSTRUMENTS INC 8,975 13,004
    TEXTRON INC 19,176 22,542
    THE BLACKSTONE GROUP INC CL A 4,790 11,516
    THE COCA-COLA CO 5,607 7,993
    THE MOSAIC CO 13,082 13,869
    TORONTO DOMINION 5,338 7,898
    TOTAL FINA ELF S.A 4,436 5,144
    TRITON INTL LTD 5,974 9,878
    UNITED RENTALS INC 55,664 66,126
    VANGUARD GOVT BOND ETF INTERME 281,723 270,134
    VANGUARD LT GOV BOND ETF 410,960 388,082
    VANGUARD SHOR-TERM GOV BOND 211,780 207,978
    VERIZON COMMUNICATIONS 6,868 7,222
    VICI PROPERTIES INC 4,137 5,299
    VIRTUS INVESTMENT PTNRS, INC 43,401 63,282
    WEST PHARMA SVCS INC 18,641 18,760
    YETI HOLDINGS, INC. 55,321 60,466

    TY 2021 OtherExpensesSchedule
    Name:
    The James T and Valeria B Robertson
     
    Foundation
    EIN:
    64-6214992
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 20,535     20,535
    Bank Charges 36 36    


    TY 2021 OtherIncomeSchedule2
    Name:
    The James T and Valeria B Robertson
     
    Foundation
    EIN:
    64-6214992
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Class Action Lawsuit Proceeds 1,453 1,453  
    Federal Tax Refund 664    


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    The James T and Valeria B Robertson
     
    Foundation
    EIN:
    64-6214992
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Services 45,748 45,748    


    TY 2021 TaxesSchedule
    Name:
    The James T and Valeria B Robertson
     
    Foundation
    EIN:
    64-6214992
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    4720 Extension for 2020 7,000      
    990-PF Estimated Tax for 2021 4,000      
    990-PF Extension for 2020 5,460      
    Foreign Tax Paid 1,145 1,145