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 LABCORP CHARITABLE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)231 MAPLE AVENUE
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BURLINGTON, NC27215
A Employer identification number

81-0587320
B Telephone number (see instructions)

(336) 436-4144
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$23,524,836J 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) 10,000,000
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 4,204 4,204  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 10,004,204 4,204 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 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)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 297 59 0 238
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 297 59 0 238
25 Contributions, gifts, grants paid....... 1,497,088 1,497,088
26 Total expenses and disbursements. Add lines 24 and 25 1,497,385 59 0 1,497,326
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 8,506,819
b Net investment income (if negative, enter -0-) 4,145
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 17,010 3,844,625 3,844,625
2 Savings and temporary cash investments......... 15,001,007 19,680,211 19,680,211
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).......      
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) 15,018,017 23,524,836 23,524,836
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........... 15,018,017 23,524,836
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    
29 Total net assets or fund balances (see instructions)..... 15,018,017 23,524,836
30 Total liabilities and net assets/fund balances (see instructions). 15,018,017 23,524,836
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
15,018,017
2
Enter amount from Part I, line 27a .....................
2
8,506,819
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
23,524,836
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
23,524,836
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.)
1a
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
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
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  
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 58
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 58
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 58
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)
    bullet
    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 addressbulletLABCORP.COM
    14
    The books are in care ofbulletLABCORP CORPORATE TAX DEPARTMENT Telephone no.bullet (336) 436-4144

    Located atbullet231 MAPLE AVEBURLINGTONNC ZIP+4bullet27215
    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
    SANDRA D VAN DER VAART PRESIDENT & SECRETARY
    1.00     		0 0 0
    231 MAPLE AVE
    BURLINGTON,NC27215
    GLENN EISENBERG VICE PRESIDENT & TREASURER
    1.00     		0 0 0
    231 MAPLE AVE
    BURLINGTON,NC27215
    KATHRYN W KYLE ASSISTANT SECRETARY
    1.00     		0 0 0
    231 MAPLE AVE
    BURLINGTON,NC27215
    TERESA W MANSFIELD EXECUTIVE DIRECTOR
    1.00     		0 0 0
    231 MAPLE AVE
    BURLINGTON,NC27215
    JILL G MCCONNELL DIRECTOR
    1.00     		0 0 0
    231 MAPLE AVE
    BURLINGTON,NC27215
    MICHELE MAZUR DIRECTOR
    1.00     		0 0 0
    231 MAPLE AVE
    BURLINGTON,NC27215
    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
    13,080,738
    b
    Average of monthly cash balances.......................
    1b
    2,273,907
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    15,354,645
    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
    15,354,645
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    230,320
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    15,124,325
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    756,216
    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
    756,216
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    58
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    58
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    756,158
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    756,158
    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
    756,158
    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 7 756,158
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 23,021
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 1,724
    b From 2017...... 72,317
    c From 2018...... 24,896
    d From 2019...... 17,041
    e From 2020......  
    f Total of lines 3a through e ........ 115,978
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 1,497,326
    a Applied to 2020, but not more than line 2a 23,021
    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..... 756,158
    e Remaining amount distributed out of corpus 718,147
    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 5 834,125
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		1,724
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		832,401
    10 Analysis of line 9:
    a Excess from 2017.... 72,317
    b Excess from 2018.... 24,896
    c Excess from 2019.... 17,041
    d Excess from 2020....  
    e Excess from 2021.... 718,147
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    NEIGHBORHOODS FOCUSED ON AFRICAN-AMERICAN YOUTH
    PO BOX 72046
    MARIETTA,GA30007     		N/A PC GENERAL SUPPORT 2,500
    UNITED NEGRO COLLEGE FUND INC
    1805 7TH STREET
    WASHINGTON,DC20001     		N/A PC GENERAL SUPPORT 2,500
    THE BARACK OBAMA FOUNDATION
    5235 S HARPER CT STE 1140
    CHICAGO,IL60615     		N/A PC GENERAL SUPPORT 2,500
    JACKIE ROBINSON FOUNDATION INC
    75 VARICK ST FRNT 2
    NEW YORK,NY10013     		N/A PC GENERAL SUPPORT 2,500
    NATIONAL URBAN LEAGUE INC
    80 PINE STREET 9TH FLOOR
    NEW YORK,NY10005     		N/A PC GENERAL SUPPORT 2,500
    HEALTHSOURCE FOUNDATION
    5400 DUPONT CIRCLE STE A
    MILFORD,OH45150     		N/A PC GENERAL SUPPORT 10,000
    MY BROTHERS KEEPER
    407 ORCHARD PARK DRIVE
    RIDGELAND,MS39157     		N/A PC GENERAL SUPPORT 2,500
    CLINICS CAN HELP INC
    2560 WESTGATE AVE
    WEST PALM BEACH,FL33409     		N/A PC GENERAL SUPPORT 2,500
    THE LEUKEMIA & LYMPHOMA SOCIETY
    3 INTERNATIONAL DR SUITE 200
    RYE BROOK,NY10573     		N/A PC GENERAL SUPPORT 10,000
    NC ARTS IN ACTION
    PO BOX 51277
    DURHAM,NC27717     		N/A PC GENERAL SUPPORT 5,000
    SECOND HARVEST FOOD BANK OF SOUTHERN WI
    2802 DAIRY DRIVE
    MADISON,WI53718     		N/A PC GENERAL SUPPORT 4,920
    BOYS & GIRLS CLUBS OF ST LUCIE
    3104 AVENUE J
    FORT PIERCE,FL34947     		N/A PC GENERAL SUPPORT 2,500
    COMMUNITIES OF FAITH FOR HOUSING
    300 BLOOMFIELD ST
    HOBOKEN,NJ07030     		N/A PC GENERAL SUPPORT 5,000
    OPERATION HOMEFRONT
    PO BOX 51145
    DURHAM,NC27717     		N/A PC GENERAL SUPPORT 5,000
    MADELINE FIADINI LORE FOUNDATION FOR CANCER INC
    140B LEFANTE WAY
    BAYONNE,NJ07002     		N/A PC GENERAL SUPPORT 5,000
    BEACON HILL PREPARATORY INSTITUTE
    1402 CORINTH STE 257
    DALLAS,TX75215     		N/A PC GENERAL SUPPORT 7,500
    NASH HEALTH CARE FOUNDATION
    2460 CURTIS ELLIS DR
    ROCKY MOUNT,NC27804     		N/A PC GENERAL SUPPORT 1,500
    SUSSEX MONTESSORI SCHOOL (PUBLIC CHARTER SCHOOL)
    24960 DAIRY FARM RD
    SEAFORD,DE19973     		N/A PC GENERAL SUPPORT 5,000
    FOOD GATHERERS
    1 CARROT WAY
    ANN ARBOR,MI48105     		N/A PC GENERAL SUPPORT 1,200
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 24,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 15,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 20,100
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    BOYS & GIRLS CLUB OF HANCOCK COUNTY
    715 EAST LINCOLN ST
    GREENFIELD,IN46140     		N/A PC GENERAL SUPPORT 200
    MEALS ON WHEELS OF HANCOCK COUNTY
    1133 W MAIN ST STE C
    GREENFIELD,IN46140     		N/A PC GENERAL SUPPORT 200
    HANCOCK COUNTY FOOD PANTRY
    741 44563 S STATE ST
    GREENFIELD,IN46140     		N/A PC GENERAL SUPPORT 200
    HANCOCK COUNTY HOPE HOUSE
    35 E PIERSON ST
    GREENFIELD,IN46140     		N/A PC GENERAL SUPPORT 200
    KENNETH BUTLER MEMORIAL SOUP KITCHEN
    202 E MAIN ST
    GREENFIELD,IN46140     		N/A PC GENERAL SUPPORT 200
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    SOUTHERN ALAMANCE FAMILY EMPOWERMENT
    5950 NC HWY 87 S
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 5,000
    VIRTUA HEALTH FOUNDATION
    303 LIPPINCOTT DR 4TH FLOOR
    MARLTON,NJ08053     		N/A PC GENERAL SUPPORT 20,000
    BRYN MAWR COLLEGE
    101 N MERION AVE
    BRYN MAWR,PA19010     		N/A PC GENERAL SUPPORT 240
    ALAMANCE COMMUNITY COLLEGE FOUNDATION
    PO BOX 8000
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 25
    ALAMANCE COMMUNITY COLLEGE FOUNDATION
    PO BOX 8000
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 60
    ALAMANCE COMMUNITY COLLEGE FOUNDATION
    PO BOX 8000
    GRAHAM,NC27254     		N/A PC GENERAL SUPPORT 500
    ALICE LLOYD COLLEGE
    100 PURPOSE RD
    PIPPA PASSES,KY41844     		N/A PC GENERAL SUPPORT 25
    AUTHORA CARE COLLECTIVE
    914 CHAPEL HILL RD
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 3,500
    BISHOP HEELAN CATHOLIC SCHOOLS
    50 13TH ST
    SIOUX CITY,IA51103     		N/A PC GENERAL SUPPORT 25
    BURLINGTON CHRISTIAN ACADEMY
    621 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 50
    BURLINGTON CHRISTIAN ACADEMY
    622 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 500
    BURLINGTON CHRISTIAN ACADEMY
    623 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 100
    BURLINGTON CHRISTIAN ACADEMY
    624 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 100
    BURLINGTON CHRISTIAN ACADEMY
    625 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 100
    BURLINGTON CHRISTIAN ACADEMY
    626 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 500
    BURLINGTON CHRISTIAN ACADEMY
    627 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 75
    CANCER COUNCIL SA
    202 GREENHILL RD
      EASTWOOD SOUTH5063
    AS     		N/A PC GENERAL SUPPORT 100
    CORNELL UNIVERSITY
    130 SENECA ST STE 400
    ITHACA,NY14850     		N/A PC GENERAL SUPPORT 120
    DAVIDSON COLLEGE
    DAVIDSON COLLEGE BOX 7147
    DAVIDSON,NC28035     		N/A PC GENERAL SUPPORT 1,000
    DOCTORS WITHOUT BORDERS
    333 SEVENTH AVE 2ND FLOOR
    NEW YORK,NY10001     		N/A PC GENERAL SUPPORT 250
    DUKE UNIVERSITY
    PO BOX 90581
    DURHAM,NC27708     		N/A PC GENERAL SUPPORT 500
    ELON UNIVERSITY
    ELON UNIVERSITY 2600 CAMPUS BOX
    ELON,NC27244     		N/A PC GENERAL SUPPORT 5,000
    FRANKLIN COLLEGE
    101 BRANIGIN BLVD
    FRANKLIN,IN46131     		N/A PC GENERAL SUPPORT 250
    FRANKLIN COLLEGE
    101 BRANIGIN BLVD
    FRANKLIN,IN46131     		N/A PC GENERAL SUPPORT 750
    HAMPTON UNIVERSITY
    38 INDIAN RD
    HAMPTON,VA23668     		N/A PC GENERAL SUPPORT 5,000
    IOWA STATE UNIVERSITY FOUNDATION
    PO BOX 2230
    AMES,IA50010     		N/A PC GENERAL SUPPORT 5,000
    MACALESTER COLLEGE
    1600 GRAND AVE
    ST PAUL,MN55105     		N/A PC GENERAL SUPPORT 750
    MADONNA UNIVERSITY (GLADYS COLLINS SCHOLARSHIP)
    36600 SCHOOLCRAFT RD
    LIVONIA,MI48150     		N/A PC GENERAL SUPPORT 5,000
    MAGGIE'S CENTRES
    10 DUMBARTON RD
      GLASGOWG11 6PA
    UK     		N/A PC GENERAL SUPPORT 500
    METROPOLITAN STATE UNIVERSITY FOUNDATION
    700 EAST SEVENTH ST
    ST PAUL,MN55106     		N/A PC GENERAL SUPPORT 500
    NC CENTRAL UNIVERSITY FOUNDATION
    PO BOX 19363
    DURHAM,NC27707     		N/A PC GENERAL SUPPORT 250
    NORTH CAROLINA AGRICULTURAL FOUNDATION
    NCSU BOX 7474
    RALEIGH,NC27695     		N/A PC GENERAL SUPPORT 300
    OAK HILL ACADEMY
    2635 OAK HILL RD
    MOUTH WILSON,VA24363     		N/A PC GENERAL SUPPORT 750
    OHIO STATE UNIVERSITY FOUNDATION
    PO BOX 710811
    COLUMBUS,OH43271     		N/A PC GENERAL SUPPORT 5,000
    OHIO STATE UNIVERSITY FOUNDATION
    PO BOX 710811
    COLUMBUS,OH43272     		N/A PC GENERAL SUPPORT 5,000
    PHILLIPS EXETER ACADEMY
    20 MAIN ST
    EXETER,NH03833     		N/A PC GENERAL SUPPORT 35
    PIONEER VALLEY WALDORF SCHOOL ASSOCIATION
    193 BAY ROAD
    HADLEY,MA01035     		N/A PC GENERAL SUPPORT 100
    PRINCETON UNIVERSITY
    PO BOX 5357
    PRINCETON,NJ08543     		N/A PC GENERAL SUPPORT 25
    RIPON COLLEGE
    300 W SEWARD ST
    RIPON,WI54971     		N/A PC GENERAL SUPPORT 750
    RUTGERS UNIVERSITY FOUNDATION
    335 GEORGE ST LIBERTY PLAZA - STE
    400
    NEW BRUNSWICK,NJ08901     		N/A PC GENERAL SUPPORT 50
    SAINT JOHN SCHOOL
    2621 MCMENEMY ST
    LITTLE CANADA,MN55117     		N/A PC GENERAL SUPPORT 900
    ST CLOUD STATE UNIVERSITY FOUNDATION
    720 4TH AVE SOUTH
    ST CLOUD,MN56301     		N/A PC GENERAL SUPPORT 2,000
    ST JOSEPH'S INDIAN SCHOOL
    1301 N MAIN ST PO BOX 326
    CHAMBERLAIN,SD57326     		N/A PC GENERAL SUPPORT 250
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		N/A PC GENERAL SUPPORT 100
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		N/A PC GENERAL SUPPORT 250
    ST MARY'S DOMINICAN HIGH SCHOOL
    7701 WALMSLEY AVE
    NEW ORLEANS,LA70125     		N/A PC GENERAL SUPPORT 25
    UNIVERSITY OF WISCONSIN FOUNDATION
    1848 UNIVERSITY AVE
    MADISON,WI53726     		N/A PC GENERAL SUPPORT 350
    WAKE FOREST UNIVERSITY - WFDD
    1834 WAKE FOREST RD
    WINSTONSALEM,NC27109     		N/A PC GENERAL SUPPORT 1,000
    WAKEMED FOUNDATION
    3000 NEW BERN AVE
    RALEIGH,NC27610     		N/A PC GENERAL SUPPORT 1,000
    WEST VIRGINIA UNIVERSITY FOUNDATION
    PO BOX 1650
    MORGANTOWN,WV26507     		N/A PC GENERAL SUPPORT 500
    WITTENBERG UNIVERSITY
    PO BOX 720
    SPRINGFIELD,OH45501     		N/A PC GENERAL SUPPORT 5,000
    DURHAM CRISIS RESPONSE CENTER
    2715 DURHAM-CHAPEL HILL BLVD
    DURHAM,NC27707     		N/A PC GENERAL SUPPORT 500
    ALAMANCE COMMUNITY FOUNDATION
    PO BOX 726
    BURLINGTON,NC27216     		N/A PC GENERAL SUPPORT 1,000
    ANURAAG FOUNDATION
    155 PRESIDENTS WALK LANE
    CARY,NC27519     		N/A PC GENERAL SUPPORT 500
    ARAM COMMUNITY
    61 BIRMINGHAM
    IRVINE,CA92620     		N/A PC GENERAL SUPPORT 1,000
    BAPS SWAMI SANSTHA
    4N739 IL ROUTE 59
    BARTLETT,IL60103     		N/A PC GENERAL SUPPORT 500
    BAPS SWAMI SANSTHA
    4N739 IL ROUTE 59
    BARTLETT,IL60103     		N/A PC GENERAL SUPPORT 500
    BAPS SWAMI SANSTHA
    4N739 IL ROUTE 59
    BARTLETT,IL60103     		N/A PC GENERAL SUPPORT 500
    BOY SCOUT TROOP 9
    1407 E GILBREATH ST
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 500
    BRAVE
    PO BOX 13591
    BIRMINGHAM,AL35202     		N/A PC GENERAL SUPPORT 500
    DUNEAN MILLS COMMUNITY ALLIANCE
    33 SEYLE ST
    GREENVILLE,SC29605     		N/A PC GENERAL SUPPORT 1,000
    FIRST PRESBYTERIAN DAY SCHOOL
    305 E MAIN ST
    DURHAM,NC27701     		N/A PC GENERAL SUPPORT 1,000
    HOSPICE & PALLIATIVE CARE
    4277 MIDDLE SETTLEMEN RD
    NEW HARTFORD,NY13413     		N/A PC GENERAL SUPPORT 1,000
    KINDRED SPIRITS
    PO BOX 1222
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 1,000
    KINDRED SPIRITS
    PO BOX 1222
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 1,000
    PENINSULA HUMANE SOCIETY
    1450 ROLLINS RD
    BURLINGAME,CA94010     		N/A PC GENERAL SUPPORT 500
    SHARED RADIANCE PERFORMING ARTS COMPANY
    609 NC HWY 62 EAST
    PLEASANT GARDEN,NC27313     		N/A PC GENERAL SUPPORT 1,000
    SPARKLE CAT RESCUE INC
    2966 S CHURCH ST STE 164
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 1,000
    SPARKLE CAT RESCUE INC
    2966 S CHURCH ST STE 164
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 1,000
    SPRINGFIELD FOUNDATION
    333 N LIMESTONE ST STE 201
    SPRINGFIELD,OH45503     		N/A PC GENERAL SUPPORT 1,000
    SUNCOAST ASIAN CULTURAL ASSOCIATION
    15914 MYSTIC WAY
    TAMPA,FL33624     		N/A PC GENERAL SUPPORT 500
    UNITY HEALTH CARE INC
    1220 12TH ST SE SUITE 120
    WASHINGTON,DC20003     		N/A PC GENERAL SUPPORT 5,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    ODYSSEY FOUNDATION
    120 WALL STREET
    NEW YORK,NY10005     		N/A PC GENERAL SUPPORT 2,500
    FUNDACION HISPANIA DE AMPARO AL NECESITADO
    1013 TALBOTTON RD
    COLUMBUS,GA31904     		N/A PC GENERAL SUPPORT 15,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    OPERATION HOMEFRONT
    PO BOX 158010
    NASHVILLE,TN37215     		N/A PC GENERAL SUPPORT 5,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    DONORSCHOOSE
    PO BOX 7247
    PHILADELPHIA,PA19170     		N/A PC GENERAL SUPPORT 100,000
    AMERICAN HEART ASSOCIATION
    4217 PARK PLACE CT
    GLEN ALLEN,VA23060     		N/A PC GENERAL SUPPORT 5,000
    VIRGINIA SUPPORTIVE HOUSING
    8002 DISCOVERY DRIVE SUITE 201
    RICHMOND,VA23229     		N/A PC GENERAL SUPPORT 2,500
    CHURCH WORLD SERVICE
    28606 PHILLIPS ST
    ELKHART,IN46515     		N/A PC GENERAL SUPPORT 500
    RONALD MCDONALD HOUSE CHARITIES
    535 ALABAMA AVE
    MEMPHIS,TN38105     		N/A PC GENERAL SUPPORT 2,500
    UNITED WAY OF ALAMANCE COUNTY
    220 EAST FRONT ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 15,000
    NATIONAL URBAN LEAGUE INC
    80 PINE ST 9TH FLOOR
    NEW YORK,NY10005     		N/A PC GENERAL SUPPORT 25,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    ALEXANDER WILSON ELEMENTARY SCHOOL
    2518 SOUTH NC HWY 54
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 2,500
    YMCA OF THE TRIANGLE
    801 CORPORATE CENTER DR SUITE 200
    RALEIGH,NC27607     		N/A PC GENERAL SUPPORT 10,000
    RADIANT HEALTH CENTERS
    17982 SKY PARK CIRCLE SUITE J
    IRVINE,CA92614     		N/A PC GENERAL SUPPORT 10,000
    SARSEF - SOUTHERN ARIZONA RESEARCH SCIENCE AND ENGINEERING FOUNDATION
    4574 E BROADWAY BLVD
    TUCSON,AZ85711     		N/A PC GENERAL SUPPORT 5,000
    HELP OF SOUTHERN NEVADA
    1640 E FLAMINGO RD STE 100
    LAS VEGAS,NV89119     		N/A PC GENERAL SUPPORT 10,000
    BARREN RIVER AREA CHILD ADVOCACY CENTER
    103 E 12TH AVE
    BOWLING GREEN,KY42101     		N/A PC GENERAL SUPPORT 535
    CENTER FOR SCIENCE TECHNOLOGY AND LEADERSHIP DEVEOPMENT
    PO BOX 165
    BETHEL,NC27812     		N/A PC GENERAL SUPPORT 25,000
    HEALTHY AMERICAS FOUNDATION
    4001 MORRISON ST NW
    WASHINGTON,DC20036     		N/A PC GENERAL SUPPORT 100,000
    ALAMANCE REGIONAL CHARITABLE FOUNDATION
    PO BOX 202
    BURLINGTON,NC27216     		N/A PC GENERAL SUPPORT 250
    AMERICAN INTERNATIONAL COLLEGE
    1000 STATE ST
    SPRINGFIELD,MA01109     		N/A PC GENERAL SUPPORT 75
    BIKE TO THE BEACH
    1990 K ST NW 2ND FLOOR
    WASHINGTON,DC20006     		N/A PC GENERAL SUPPORT 107
    BISHOP O'DOWD HIGH SCHOOL
    9500 STEARNS AVE
    OAKLAND,CA94605     		N/A PC GENERAL SUPPORT 900
    BURLINGTON CHRISTIAN ACADEMY
    621 E SIXTH ST
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 1,000
    CAL POLY POMONA PHILANTHROPIC FOUNDATION
    PO BOX 3121
    POMONA,CA91769     		N/A PC GENERAL SUPPORT 2,500
    CARLETON COLLEGE
    ONE NORTH COLLEGE ST
    NORTHFIELD,MN55057     		N/A PC GENERAL SUPPORT 250
    COLLEGE OF THE HOLY CROSS
    1 COLLEGE ST
    WORCESTER,MA01610     		N/A PC GENERAL SUPPORT 350
    DUKE CHILDREN'S HOSPITAL
    DUKE CHILDRENS HOSPTIAL BOX 90581
    DURHAM,NC27708     		N/A PC GENERAL SUPPORT 250
    DURHAM ACADEMY
    3601 RIDGE RD
    DURHAM,NC27705     		N/A PC GENERAL SUPPORT 3,251
    EAST CAROLINA UNIVERSITY FOUNDATION
    2200 S CHARLES BLVD
    GREENVILLE,NC27858     		N/A PC GENERAL SUPPORT 5,000
    ELON UNIVERSITY
    ELON UNIVERSITY 2600 CAMPUS BOX
    ELON,NC27244     		N/A PC GENERAL SUPPORT 5,000
    FRANKLIN COLLEGE
    101 BRANIGIN BLVD
    FRANKLIN,IN46131     		N/A PC GENERAL SUPPORT 250
    HOLYOKE COMMUNITY COLLEGE FOUNDATION
    303 HOMESTEAD AVE
    HOLYOKE,MA01040     		N/A PC GENERAL SUPPORT 100
    JUDSON COLLEGE
    302 BIBB ST
    MARION,AL36756     		N/A PC GENERAL SUPPORT 5,000
    LEUKEMIA & LYMPHOMA SOCIETY
    3505 EAST FRONTAGE RD STE 145
    TAMPA,FL33607     		N/A PC GENERAL SUPPORT 500
    LSU FOUNDATION
    3796 NICHOLSON DR
    BATON ROUGE,LA70802     		N/A PC GENERAL SUPPORT 5,000
    MORAVIAN COLLEGE
    1200 MAIN ST
    BETHLEHEM,PA18018     		N/A PC GENERAL SUPPORT 500
    NAZARETH COLLEGE OF ROCHESTER
    4245 EAST AVE
    ROCHESTER,NY14618     		N/A PC GENERAL SUPPORT 2,528
    NORTH CAROLINA CENTRAL UNIVERSITY FOUNDATION
    PO BOX 19363
    DURHAM,NC27707     		N/A PC GENERAL SUPPORT 250
    RANDOLPH COLLEGE
    PO BOX 3215
    LYNCHBURG,VA24503     		N/A PC GENERAL SUPPORT 1,000
    RIPON COLLEGE
    300 W SEWARD ST
    RIPON,WI54971     		N/A PC GENERAL SUPPORT 300
    RUTGERS UNIVERSITY FOUNDATION
    335 GEORGE ST LIBERTY PLAZA - STE
    400
    NEW BRUNSWICK,NJ08901     		N/A PC GENERAL SUPPORT 50
    SAINT ANSELM COLLEGE
    100 SAINT ANSELM DR
    MANCHESTER,NH03102     		N/A PC GENERAL SUPPORT 75
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		N/A PC GENERAL SUPPORT 100
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    502 ST JUDE PLACE
    MEMPHIS,TN38105     		N/A PC GENERAL SUPPORT 150
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    503 ST JUDE PLACE
    MEMPHIS,TN38105     		N/A PC GENERAL SUPPORT 250
    STIFTUNG DEUTSCHE KREBSHILFE
    BUSCHSTR 32
      BONN53113
    GM     		N/A PC GENERAL SUPPORT 119
    TENNESSEE TECHNOLOGICAL UNIVERSITY FOUNDATION
    1 WILLIAM L JONES DR
    COOKEVILLE,TN38506     		N/A PC GENERAL SUPPORT 50
    THE NORTH CAROLINA PUBLIC TELEVISION FOUNDATION
    PO BOX 12231
    RTP,NC27709     		N/A PC GENERAL SUPPORT 50
    UNC AT CHAPEL HILL
    PO BOX 309
    CHAPEL HILL,NC27514     		N/A PC GENERAL SUPPORT 50
    UNC-GREENSBORO
    1100 W MARKET ST STE 105C
    GREENSBORO,NC27410     		N/A PC GENERAL SUPPORT 5,000
    UNIVERSITY OF LYNCHBURG
    1501 LAKESIDE DR
    LYNCHBURG,VA24501     		N/A PC GENERAL SUPPORT 250
    UNIVERSITY OF MASSACHUSETTS
    134 HICKS WAY MEMORIAL HALL
    AMHERST,MA01003     		N/A PC GENERAL SUPPORT 500
    UNIVERSITY OF VIRGINIA DARDEN SCHOOL FOUNDATION
    PO BOX 400331
    CHARLOTTESVILLE,VA22904     		N/A PC GENERAL SUPPORT 100
    WEST VIRGINIA UNIVERSITY FOUNDATION
    PO BOX 1650
    MORGANTOWN,WV26507     		N/A PC GENERAL SUPPORT 1,000
    WORCESTER STATE FOUNDATION INC
    486 CHANDLER ST
    WORCESTER,MA01602     		N/A PC GENERAL SUPPORT 30
    SPECIAL OLYMPICS NORTH CAROLINA
    2200 GATEWAY CENTRE BLVD STE 201
    MORRISVILLE,NC27560     		N/A PC GENERAL SUPPORT 2,500
    HVAF OF INDIANA
    964 N PENNSYLVANIA ST
    INDIANAPOLIS,IN46204     		N/A PC GENERAL SUPPORT 5,000
    METHODIST RICHARDSON MEDICAL CENTER FOUNDATION
    401 W CAMPBELL RD
    RICHARDSON,TX75080     		N/A PC GENERAL SUPPORT 20,000
    PROVIDENCE HEALTH CARE FOUNDATION EASTERN WASHINGTON
    101 WEST 8TH AVE
    SPOKANE,WA99204     		N/A PC GENERAL SUPPORT 10,000
    CENTER FOR EXCELLENCE IN EDUCATION
    8201 GREENSBORO DR SUITE 215
    MCLEAN,VA22102     		N/A PC GENERAL SUPPORT 10,000
    PROJECT HOME
    1515 FAIRMOUNT AVE
    PHILADELPHIA,PA19130     		N/A PC GENERAL SUPPORT 10,000
    RMH CHARITIES OF GREATER LAS VEGAS
    2323 POTOSI ST
    LAS VEGAS,NV89146     		N/A PC GENERAL SUPPORT 5,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    UNC HEALTH FOUNDATION
    PO BOX 1050
    CHAPEL HILL,NC27514     		N/A PC GENERAL SUPPORT 5,000
    AMERICAN DIABETES ASSOCIATION
    237 HANBURY RD EAST SUITE 17 108
    CHESAPEAKE,VA23322     		N/A PC GENERAL SUPPORT 25,000
    AMERICAN HEART ASSOCIATION
    5001 MIAMI BLVD SUITE 300
    DURHAM,NC27703     		N/A PC GENERAL SUPPORT 25,000
    AMERICAN RED CROSS
    PO BOX 14710
    GREENSBORO,NC27415     		N/A PC GENERAL SUPPORT 25,000
    UNITED WAY WORLDWIDE
    701 NORTH FAIRFAX ST
    ALEXANDRIA,VA22314     		N/A PC GENERAL SUPPORT 25,000
    NATIONAL URBAN LEAGUE INC
    80 PINE ST 9TH FLOOR
    NEW YORK,NY10005     		N/A PC GENERAL SUPPORT 25,000
    AMERICAN CANCER SOCIETY
    PO BOX 11796
    CHARLOTTE,NC28220     		N/A PC GENERAL SUPPORT 25,000
    AMERICAN RED CROSS
    PO BOX 14710
    GREENSBORO,NC27415     		N/A PC GENERAL SUPPORT 250,000
    NATIVE AMERICAN CONNECTIONS
    4520 N CENTRAL AVE STE 600
    PHOENIX,AZ85012     		N/A PC GENERAL SUPPORT 25,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    ZERO - THE END OF PROSTATE CANCER
    515 KING ST SUITE 420
    ALEXANDRIA,VA22314     		N/A PC GENERAL SUPPORT 15,000
    GUILFORD EDUCATION ALLIANCE
    311 POMONA DR SUITE E
    GREENSBORO,NC27407     		N/A PC GENERAL SUPPORT 5,000
    IMD GUEST HOUSE FOUNDATION
    1933 WEST POLK ST SSR 214
    CHICAGO,IL60612     		N/A PC GENERAL SUPPORT 5,000
    NATIONAL HISPANIC HEALTH FOUNDATION
    1920 L ST NW SUITE 725
    WASHINGTON,DC20036     		N/A PC GENERAL SUPPORT 5,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    NOTE IN THE POCKET
    9650 STRICKLAND RD STE 103-168
    RALEIGH,NC27615     		N/A PC GENERAL SUPPORT 10,000
    LEVINE JEWISH COMMUNITY CENTER
    5007 PROVIDENCE RD
    CHARLOTTE,NC28226     		N/A PC GENERAL SUPPORT 5,000
    SALVATION ARMY
    PO BOX 1238
    BURLINGTON,NC27216     		N/A PC GENERAL SUPPORT 10,000
    LEUKEMIA & LYMPHOMA SOCIETY
    3 INTERNATIONAL DR SUITE 200
    RYE BROOK,NY10573     		N/A PC GENERAL SUPPORT 5,000
    AMERICAN CANCER SOCIETY
    320 BILMAR DR
    PITTSBURGH,PA15205     		N/A PC GENERAL SUPPORT 500
    MARION MILITARY INSTITUTE
    1101 WASHINGTON ST
    MARION,AL36756     		N/A PC GENERAL SUPPORT 5,000
    NORFOLK STATE UNIVERSITY FOUNDATION
    700 PARK AVE 410 WILSON HALL
    NORFOLK,VA23504     		N/A PC GENERAL SUPPORT 1,000
    ALAMANCE REGIONAL CHARITABLE FOUNDATION
    PO BOX 202
    BURLINGTON,NC27216     		N/A PC GENERAL SUPPORT 50
    ALAMANCE COMMUNITY COLLEGE FOUNDATION
    PO BOX 8000
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 1,000
    CHILDREN'S HOSPITAL OF PHILADELPHIA FOUNDATION
    PO BOX 781352
    PHILADELPHIA,PA19178     		N/A PC GENERAL SUPPORT 250
    MIDDLEBURY COLLEGE
    700 EXCHANGE ST
    MIDDLEBURY,VT05753     		N/A PC GENERAL SUPPORT 100
    ALZHEIMER'S ASSOCIATION
    225 N MICHIGAN AVE FLR 17
    CHICAGO,IL60601     		N/A PC GENERAL SUPPORT 100
    ALAMANCE COMMUNITY COLLEGE FOUNDATION
    PO BOX 8000
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 250
    THE COLLEGE OF WOOSTER
    1012 BEALL AVE
    WOOSTER,OH44691     		N/A PC GENERAL SUPPORT 2,500
    AMERICAN HEART ASSOCIATION
    2850 DAIRY DR STE 130
    MADISON,WI53718     		N/A PC GENERAL SUPPORT 250
    WAKE FOREST UNIVERSITY - WFDD
    1834 WAKE FOREST RD
    WINSTONSALEM,NC27109     		N/A PC GENERAL SUPPORT 3,500
    NATIONAL MULTIPLE SCLEROSIS SOCIETY
    214 OUTLOOK CIR SUITE 153
    BRENTWOOD,TN37027     		N/A PC GENERAL SUPPORT 500
    PENNSYLVANIA STATE UNIVERSITY PHILANTHROPIC FUND
    2583 GATEWAY DR SUITE 130
    STATE COLLEGE,PA16801     		N/A PC GENERAL SUPPORT 100
    AUSTIN PEACE ACADEMY
    5110 MANOR RD
    AUSTIN,TX78723     		N/A PC GENERAL SUPPORT 5,000
    AUBURN UNIVERSITY FOUNDATION
    317 S COLLEGE ST
    AUBURN UNIVERSITY,AL36849     		N/A PC GENERAL SUPPORT 25
    ALAMANCE COMMUNITY COLLEGE FOUNDATION
    PO BOX 8000
    GRAHAM,NC27253     		N/A PC GENERAL SUPPORT 500
    UNIVERSITY OF VIRGINIA - WISE FOUNDATION
    1 COLLEGE AVE
    WISE,VA24293     		N/A PC GENERAL SUPPORT 1,000
    VIRGINIA TECH FOUNDATION
    902 PRICES FORK RD 336
    BLACKBURG,VA24061     		N/A PC GENERAL SUPPORT 500
    RUTGERS UNIVERSITY FOUNDATION
    335 GEORGE ST LIBERTY PLAZA - STE
    400
    NEW BRUNSWICK,NJ08901     		N/A PC GENERAL SUPPORT 50
    MASSACHUSETTS INSTITUTE OF TECHNOLOGY
    600 MEMORIAL DR W98-308
    CAMBRIDGE,MA02139     		N/A PC GENERAL SUPPORT 168
    BLESSED SACRAMENT SCHOOL
    515 HILLCREST AVE
    BURLINGTON,NC27215     		N/A PC GENERAL SUPPORT 500
    BALDWIN WALLACE UNIVERSITY
    275 EASTLAND RD
    BEREA,OH44017     		N/A PC GENERAL SUPPORT 1,000
    FRANKLIN COLLEGE
    101 BRANIGIN BLVD
    FRANKLIN,IN46131     		N/A PC GENERAL SUPPORT 250
    NC CENTRAL UNIVERSITY FOUNDATION
    PO BOX 19363
    DURHAM,NC27707     		N/A PC GENERAL SUPPORT 250
    MACALESTER COLLEGE
    1600 GRAND AVE
    ST PAUL,MN55105     		N/A PC GENERAL SUPPORT 750
    FRANKLIN COLLEGE
    101 BRANIGIN BLVD
    FRANKLIN,IN46131     		N/A PC GENERAL SUPPORT 750
    UNIVERSITY OF VIRGINIA DARDEN SCHOOL FOUNDATION
    PO BOX 37963
    BOONE,IA50036     		N/A PC GENERAL SUPPORT 250
    UNIVERSITY OF VIRGINIA DARDEN SCHOOL FOUNDATION
    PO BOX 37963
    BOONE,IA50036     		N/A PC GENERAL SUPPORT 100
    NORTH CAROLINA STATE UNIVERSITY
    CAMPUS BOX 7474
    RALEIGH,NC27695     		N/A PC GENERAL SUPPORT 50
    HEARTLAND RABBIT RESCUE
    PO BOX 224
    BLANCHARD,OK73010     		N/A PC GENERAL SUPPORT 1,000
    EAST CAROLINA UNIVERSITY FOUNDATION
    2200 S CHARLES BLVD
    GREENVILLE,NC27858     		N/A PC GENERAL SUPPORT 1,000
    AMERICAN RED CROSS
    PO BOX 14710
    GREENSBORO,NC27415     		N/A PC GENERAL SUPPORT 1,000
    CENTROMED
    3750 COMMERCIAL AVE
    SAN ANTONIO,TX78221     		N/A PC GENERAL SUPPORT 8,000
    SWLA
    2000 OPELOUSAS ST
    LAKE CHARLES,LA70601     		N/A PC GENERAL SUPPORT 5,000
    ACCESS HEALTH
    400 AUSTIN ST
    RICHMOND,TX77469     		N/A PC GENERAL SUPPORT 6,700
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 8,750
    LEGACY COMMUNITY HEALTH
    1415 CALIFORNIA ST
    HOUSTON,TX77006     		N/A PC GENERAL SUPPORT 15,000
    Total .................................bullet 3a 1,497,088
    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 ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 4,204 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    4,204
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

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

    81-0587320
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    THE LABCORP CHARITABLE FOUNDATION
          		Employer identification number
    81-0587320
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    LABORATORY CORP OF AMERICA
     
    231 MAPLE AVE
     
    BURLINGTON, NC27215

    		$ 10,000,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    THE LABCORP CHARITABLE FOUNDATION
          		Employer identification number

    81-0587320
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    THE LABCORP CHARITABLE FOUNDATION
          		Employer identification number

    81-0587320
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 OtherExpensesSchedule
    Name:
    THE LABCORP CHARITABLE FOUNDATION
    EIN:
    81-0587320
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANKING FEES 297 59 0 238