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 07-01-2021 , and ending 06-30-2022
Name of foundation
O'BLENESS CHARLES - FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 1558 DEPT EA5W86
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
COLUMBUS, OH43216
A Employer identification number

31-6042978
B Telephone number (see instructions)

(614) 331-9544
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$3,105,110
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 78,749 78,749  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 195,636
b Gross sales price for all assets on line 6a 822,778
7 Capital gain net income (from Part IV, line 2)... 195,636
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 274,385 274,385  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 30,881 15,440   15,440
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... 1,250 0 0 1,250
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... 3,691 79   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... 350 150   200
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 36,172 15,669 0 16,890
25 Contributions, gifts, grants paid....... 272,000 272,000
26 Total expenses and disbursements. Add lines 24 and 25 308,172 15,669 0 288,890
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -33,787
b Net investment income (if negative, enter -0-) 258,716
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.............      
2 Savings and temporary cash investments......... 3,255 35,609 35,609
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 2,912,664 Click to see attachment2,846,087 3,069,501
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)..........     0
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) 2,915,919 2,881,696 3,105,110
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 2,915,919 2,881,696
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 2,915,919 2,881,696
30 Total liabilities and net assets/fund balances (see instructions). 2,915,919 2,881,696
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
2,915,919
2
Enter amount from Part I, line 27a .....................
2
-33,787
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
2,882,132
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
436
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,881,696
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 335. ACTIVISION BLIZZARD INC     2021-11-10
b 300. ADVANCED MICRO DEVICES INC W/1     2022-01-25
c 5. ALPHABET INCORPORATION   2017-01-10 2022-01-25
d 125. AMERICAN EXPRESS COMPANY   2019-07-10 2022-01-25
e 90. ANALOG DEVICES   2018-04-02 2021-07-06
300. APPLIED MATERIALS INC   2021-03-15 2021-11-10
320. BAXTER INTERNATIONAL INC     2021-11-15
30. BLACKROCK INC   2020-04-13 2022-01-25
80. EDWARDS LIFESCIENCES CORP   2018-01-17 2021-07-06
925. FREEPORT MCMORAN COPPER & GOLD   2021-03-15 2021-11-10
2658.87 GOLDMAN SACHS TR     2021-07-06
1400. INVESCO EXCHANGE-TRADED FD TR II   2020-08-14 2021-07-06
2000. INVESCO EXCHANGE-TRADED FD TR II   2020-08-14 2022-05-13
1855. ISHARES GOLD TRUST ETF   2021-01-02 2021-07-31
1855. ISHARES GOLD TRUST ETF   2021-01-02 2021-08-31
1855. ISHARES GOLD TRUST ETF   2021-01-02 2021-09-30
1855. ISHARES GOLD TRUST ETF   2021-01-02 2021-10-31
720. ISHARES GOLD TRUST ETF   2020-08-14 2021-11-10
1135. ISHARES GOLD TRUST ETF   2021-03-23 2021-11-10
550. ISHARES TR   2017-09-08 2021-11-10
785. ISHARES TR   2017-09-08 2022-05-13
2565. ISHARES SILVER TRUST (HOLDS SILVER BARS)   2000-01-01 2021-07-31
2565. ISHARES SILVER TRUST (HOLDS SILVER BARS)   2000-01-01 2021-08-31
2565. ISHARES SILVER TRUST (HOLDS SILVER BARS)   2000-01-01 2021-09-30
2565. ISHARES SILVER TRUST (HOLDS SILVER BARS)   2000-01-01 2021-10-31
1550. ISHARES SILVER TRUST (HOLDS SILVER BARS)   2021-03-23 2021-11-10
1015. ISHARES SILVER TRUST (HOLDS SILVER BARS)   2020-08-14 2021-11-10
90. LAM RESEARCH CORP   2020-07-13 2021-11-10
1598.84 MORGAN STANLEY INSTL FD INC   2020-08-14 2022-05-13
50. NVIDIA CORP   2019-11-21 2021-07-06
125. NVIDIA CORP   2019-11-21 2022-01-25
175. PARKER HANNIFIN CORP     2021-11-10
2122.24 PIMCO FDS     2022-01-25
3298.78 PIMCO FDS     2021-07-06
100. PROLOGIS INC (REIT)   2018-09-17 2021-07-06
50. CHUBB LTD   2016-07-08 2021-07-06
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a 22,316   21,531 785
b 33,693   15,235 18,458
c 12,774   4,138 8,636
d 21,621   15,964 5,657
e 15,132   7,965 7,167
45,267   34,157 11,110
25,299   22,541 2,758
24,050   13,708 10,342
8,473   3,226 5,247
34,734   33,994 740
31,348   27,820 3,528
21,336   20,804 532
24,340   29,720 -5,380
14   14  
13   14 -1
13   13  
13   14 -1
25,243   26,789 -1,546
39,793   37,439 2,354
28,012   24,810 3,202
31,675   35,411 -3,736
26   27 -1
24   26 -2
23   27 -4
23   25 -2
35,138   36,146 -1,008
23,010   24,888 -1,878
54,608   31,234 23,374
33,000   36,501 -3,501
41,394   10,491 30,903
28,090   6,557 21,533
57,078   30,324 26,754
25,000   26,275 -1,275
35,000   36,071 -1,071
12,176   6,769 5,407
8,063   6,474 1,589
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
      24,966
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       785
b       18,458
c       8,636
d       5,657
e       7,167
      11,110
      2,758
      10,342
      5,247
      740
      3,528
      532
      -5,380
       
      -1
       
      -1
      -1,546
      2,354
      3,202
      -3,736
      -1
      -2
      -4
      -2
      -1,008
      -1,878
      23,374
      -3,501
      30,903
      21,533
      26,754
      -1,275
      -1,071
      5,407
      1,589
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 2 195,636
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 3,596
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 3,596
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 4,100
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  
7 Total credits and payments. Add lines 6a through 6d.............. 7 4,100
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  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 504
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet504 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
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)
    bulletOH
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .Click to see attachment
    8b
     
    No
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletHUNTINGTON NATIONAL BANK Telephone no.bullet (614) 480-5453

    Located atbulletPO BOX 1558 DEPT EA5W86COLUMBUSOH ZIP+4bullet43216
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    HUNTINGTON NATIONAL BANK TRUSTEE
    4
    18,881    
    PO BOX 1558 DEPT EA5W86
    COLUMBUS,OH43216
    DAVID VOGT ADVISOR
    1
    6,000    
    754 HUNTLEY AVE
    LOGAN,OH43138
    SUZANNE P WEBER ADVISOR
    1
    6,000    
    6866 SOUTH BLACKBURN ROAD
    ATHENS,OH45701
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    3,658,467
    b
    Average of monthly cash balances.......................
    1b
    60,121
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    3,718,588
    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
    3,718,588
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    55,779
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    3,662,809
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    183,140
    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
    183,140
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    3,596
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    3,596
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    179,544
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    179,544
    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
    179,544
    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 7 179,544
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 0
    b From 2017...... 0
    c From 2018...... 0
    d From 2019...... 12,787
    e From 2020...... 25,725
    f Total of lines 3a through e ........ 38,512
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 288,890
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
    0
    c Treated as distributions out of corpus (Election
    required—see instructions)........
    0
    d Applied to 2021 distributable amount..... 179,544
    e Remaining amount distributed out of corpus 109,346
    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 5 147,858
    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) ...
    0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......
    147,858
    10 Analysis of line 9:
    a Excess from 2017.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 12,787
    d Excess from 2020.... 25,725
    e Excess from 2021.... 109,346
    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
    RED CROSS OF ATHENS COUNTY
    100 S MAY AVE
    ATHENS,OH45701
    NONE PC FOR SERVICES 5,000
    GOOD WORKS INC
    PO BOX 4
    ATHENS,OH45701
    NONE PC FOR STORAGE BUILDING 10,000
    O'BLENESS MEMORIAL HOSP
    55 HOSPITAL DR
    ATHENS,OH45701
    NONE PC SUPPORT OF HOSPITAL 100,000
    AMERICAN RED CROSS
    100 S MAY AVE
    ATHENS,OH45701
    NONE PC GENERAL OPERATING 45,000
    ATHENS PHOTOGRAPHIC PROJECT
    434 W UNITION ST
    ATHENS,OH45701
    NONE PC GENERAL OPERATING 12,000
    ATHENS COUNTY PUBLIC LIBRARY
    30 HOME STREET
    ATHENS,OH45701
    NONE PC GENERAL OPERATING 5,000
    HABITAT FOR HUMANITY OF SE OHIO
    525 W UNION STREET
    ATHENS,OH45701
    NONE PC GENERAL OPERATING 30,000
    STUART'S OPERA HOUSE
    52 PUBLIC SQUARE
    NELSONVILLE,OH45764
    NONE PC GENERAL OPERATING 50,000
    CIRCLE ROUND THE SQUARE
    PO BOX 13
    ATHENS,OH45701
    NONE PC GENERAL SUPPORT 15,000
    Total .................................bullet 3a 272,000
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........
             
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............
        18 195,636  
    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) ..   274,385  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    274,385
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    O'BLENESS CHARLES - FOUNDATION
    EIN:
    31-6042978
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,250     1,250

    TY 2021 ExplnOfNonFilingWithAGStmt
    Name:
    O'BLENESS CHARLES - FOUNDATION
    EIN:
    31-6042978
    Statement:
    The Ohio Attorney General requires that charitable organizations operating or organized within the State submit an annual registration through an online portal that highlights key information from the Form 990-PF for public disclosure purposes. The Trust completes this registration as required in lieu of furnishing a copy of its Form 990-PF to comply with the specific reporting instructions of the State of Ohio.

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    O'BLENESS CHARLES - FOUNDATION
    EIN:
    31-6042978
    Name of Stock End of Year Book Value End of Year Fair Market Value
    654106103 NIKE INC 12,765 15,330
    742718109 PROCTER GAMBLE CO/T 25,990 30,915
    773903109 ROCKWELL AUTOMATION 19,371 23,917
    166764100 CHEVRON CORP NEW 15,007 17,374
    H1467J104 CHUBB LTD 19,421 29,487
    437076102 HOME DEPOT INC 20,793 31,541
    00507V109 ACTIVISION BLIZZARD    
    032654105 ANALOG DEVICES INC 15,009 23,374
    478160104 JOHNSON JOHNSON 24,550 35,502
    67066G104 NVIDIA CORP 14,633 23,496
    713448108 PEPSICO INC 13,067 16,666
    91913Y100 VALERO ENERGY CORP N 24,911 36,135
    071813109 BAXTER INTERNATIONAL    
    09247X101 BLACKROCK INC    
    22822V101 CROWN CASTLE INTL CO 18,024 26,941
    28176E108 EDWARDS LIFESCIENCES 13,992 30,904
    46120E602 INTUITIVE SURGICAL I 24,738 30,107
    55261F104 MT BANK CORP 32,282 33,472
    701094104 PARKER-HANNIFIN CORP    
    74340W103 PROLOGIS INC 22,964 35,295
    882508104 TEXAS INSTRS INC 14,443 19,206
    91324P102 UNITEDHEALTH GROUP I 3,368 38,522
    22160K105 COSTCO WHOLESALE COR 10,813 26,360
    46625H100 JPMORGAN CHASE CO 25,186 28,153
    532457108 ELI LILLY CO 12,538 29,181
    92826C839 VISA INC 34,496 54,145
    025816109 AMERICAN EXPRESS CO    
    037833100 APPLE INC 46,928 97,071
    594918104 MICROSOFT CORP 9,373 93,743
    14040H105 CAPITAL ONE FINL COR 23,474 28,652
    92939U106 WEC ENERGY GROUP INC 22,400 25,160
    G1151C101 ACCENTURE PLC-CL A 24,879 34,706
    02079K305 ALPHABET INCORPORATI 22,366 54,482
    023135106 AMAZON COM INC 40,775 53,105
    337738108 FISERV INC 6,009 18,239
    452308109 ILLINOIS TOOL WKS IN 20,559 23,693
    65339F101 NEXTERA ENERGY INC 9,628 23,238
    31428Q739 FEDERATED TOTAL RETU 255,431 232,226
    38144N841 GOLDMAN SACHS INFLAT    
    40168W483 GUGGENHEIM FDS TR 110,000 104,339
    464287234 ISHARES MSCI EMERGIN    
    169656105 CHIPOTLE MEXICAN GRI 29,684 26,145
    35671D857 FREEPORT-MCMORAN INC    
    444859102 HUMANA INC 26,433 30,425
    592905749 METROPOLITAN WEST FD 50,000 44,370
    649280815 NEW WORLD FD INC NEW 42,679 36,335
    46428Q109 ISHARES SILVER TRUST    
    244199105 DEERE CO 27,865 22,460
    260557103 DOW INC 16,989 13,935
    038222105 APPLIED MATERIALS IN    
    007903107 ADVANCED MICRO DEVIC 7,650 10,323
    512807108 LAM RESEARCH CORP    
    922031737 VANGUARD FIXED INCOM 80,000 70,555
    89155T649 TOUCHSTONE FDS GROUP 35,000 33,509
    543916688 LORD ABBETT INVT TR 227,489 210,153
    88160R101 TESLA INC 28,115 26,937
    72201F490 PIMCO FDS 154,659 135,149
    552982720 MFS SER TR XIII 180,041 167,345
    824348106 SHERWIN WILLIAMS CO 20,030 20,152
    04314H667 ARTISAN PARTNERS FDS 160,341 157,290
    31421N683 FEDERATED HERMES EQU 90,000 64,918
    254687106 DISNEY WALT CO 14,502 9,440
    871829107 SYSCO CORP 24,954 25,413
    72201F623 PIMCO FDS 83,929 60,121
    149123101 CATERPILLAR INC 26,319 20,557
    31420B847 FEDERATED HERMES INS 81,297 70,956
    61756E461 MORGAN STANLEY INSTL 88,499 59,440
    464285204 ISHARES GOLD TRUST E    
    78467Y107 SPDR SP MIDCAP 400 E 63,098 95,103
    46138E511 INVESCO PREFERRED ET    
    053484101 AVALONBAY CMNTYS INC 22,381 19,425
    060505104 BANK AMER CORP 38,395 25,682
    171340102 CHURCH & DWIGHT CO I 24,509 25,018
    235851102 DANAHER CORP 33,336 29,155
    43300A203 HILTON WORLDWIDE HLD 19,784 15,044
    579780206 MCCORMICK INC/MD 36,348 32,468
    7591EP100 REGIONS FINL CORP NE 21,071 18,281
    580135101 MCDONALDS CORP 32,603 32,094
    09857L108 BOOKING HLDGS INC 25,916 17,490
    744320102 PRUDENTIAL FINL INC 21,988 19,136

    TY 2021 OtherDecreasesSchedule
    Name:
    O'BLENESS CHARLES - FOUNDATION
    EIN:
    31-6042978
    Description Amount
    MUTUAL FUND TIMING ADJUSTMENT 44
    ROC ADJ. ON CY SALES 392


    TY 2021 OtherExpensesSchedule
    Name:
    O'BLENESS CHARLES - FOUNDATION
    EIN:
    31-6042978
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    STATE FILING/TAX PAYMENT 200 0   200
    INVESTMENT EXPENSES-INTEREST I 150 150   0


    TY 2021 TaxesSchedule
    Name:
    O'BLENESS CHARLES - FOUNDATION
    EIN:
    31-6042978
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 47 47   0
    FEDERAL ESTIMATES - PRINCIPAL 3,612 0   0
    FOREIGN TAXES ON NONQUALIFIED 32 32   0