TY 2021 Form 990

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)

(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) MICHAEL F SHELTON......................................................................
WORSHIPFUL MAST

2.00
.................
0.00

(2) ERIC GOETSCH......................................................................
Secretary

2.00
.................
0.00

(3) ROBERT PUCKETT......................................................................
Treasurer

2.00
.................
0.00

(4) MICHAEL W SHELTON......................................................................
JR WARDEN

2.00
.................
0.00

(5) AGRACIADO IRIZARRY......................................................................
SR WARDEN

2.00
.................
0.00

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)

(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)

(F)
Estimated amount of other compensation from the organization and related organizations

(A)
Name and business address

(B)
Description of services

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet

	(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

(a) Description	(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........	434,497

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......	1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................	2e
3	Subtract line 2e from line 1..................	3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................	4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......	5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........	1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................	2e
3	Subtract line 2e from line 1...................	3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................	4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......	5

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

OCCIDENTAL LODGE NO 40 AF & AM

Employer identification number

36-0732752

Return Reference	Explanation
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	OCCIDENTAL LODGE #40'S BY-LAWS MAKE PROVISION FOR PARTICIPATION BY MEMBERS IN CERTAIN AFFAIRS OF THE ORGANIZATION. MEMBERS ARE ENTITLED TO VOTE ON ALL MATTERS SUBMITTED TO A VOTE OF THE MEMBERSHIP INCLUDING COMPOSITION OF THE BOARD OF DIRECTORS AND AS OTHERWISE PROVIDED IN AND ALLOWED UNDER THE BY-LAWS.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	OCCIDENTAL LODGE #40'S BY-LAWS MAKE PROVISION FOR PARTICIPATION BY MEMBERS IN CERTAIN AFFAIRS OF THE ORGANIZATION. MEMBERS ARE ENTITLED TO VOTE ON ALL MATTERS SUBMITTED TO A VOTE OF THE MEMBERSHIP INCLUDING COMPOSITION OF THE BOARD OF DIRECTORS AND AS OTHERWISE PROVIDED IN AND ALLOWED UNDER THE BY-LAWS.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	OCCIDENTAL LODGE #40'S BY-LAWS MAKE PROVISION FOR PARTICIPATION BY MEMBERS IN CERTAIN AFFAIRS OF THE ORGANIZATION. MEMBERS ARE ENTITLED TO VOTE ON ALL MATTERS SUBMITTED TO A VOTE OF THE MEMBERSHIP INCLUDING COMPOSITION OF THE BOARD OF DIRECTORS AND AS OTHERWISE PROVIDED IN AND ALLOWED UNDER THE BY-LAWS.
Form 990, Part VI, Line 11b: Form 990 Review Process	FORM 990 IS REVIEWED AT THE MEETING FOLLOWING THE COMPLETION OF THE FORM.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Each Occidental Lodge #40 Director, Officer or Member of a Committee with Board-Delegated powers, who has a direct or indirect financial interest in Occidental Lodge #40-related matters is: subject to the procedures and protocols identified in the "Occidental Lodge #40 Board of Directors Policy - Conflict of Interest" ("the Conflict of Interest Policy"); and required to execute annually a document styled "Occidental Lodge #40 Board of Directors Annual Statement - Conflict of Interest" acknowledging and affirming that he/she:(1) Has received a copy of the Conflict of Interest Policy; (2) Has read and understands the Conflict of Interest Policy; (3) Agrees to comply with the Conflict of Interest Policy; and (4) Understands that the Occidental Lodge #40 is a not-for-profit organization and, in order to maintain its federal tax exemption, must engage primarily in activities which accomplish one or more of its tax-exempted purposes.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	The organization makes its governing documents, conflict of interest policy, and financial statements available to the general public upon demand in its business office on premises.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

1	Briefly describe the organization’s mission or most significant activities: FREEMASONRY IS A CHARITABLE, BENEVOLENT, EDUCATIONAL AND RELIGIOUS SOCIETY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	132
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	132
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,823	3,326
9	Program service revenue (Part VIII, line 2g) .........	7,563	5,697
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	61,445	65,471
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,080	2,285
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	72,911	76,779
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,150	3,603
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)		0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	32,105	39,448
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	34,255	43,051
19	Revenue less expenses. Subtract line 18 from line 12.......	38,656	33,728
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	724,811	758,539
21	Total liabilities (Part X, line 26).............		0
22	Net assets or fund balances. Subtract line 21 from line 20.....	724,811	758,539

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 20,562 including grants of $ 3,603 ) (Revenue $ )
	FREEMASONRY IS A CHARITABLE, BENEVOLENT, EDUCATIONAL AND RELIGIOUS SOCIETY.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses20,562

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	3,326

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		3,326

		Business Code
2a	Membership Dues & Assessments		5,697	5,697
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		5,697

3 Investment income (including dividends, interest, and othersimilar amounts) ......			22,586	22,586
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		1,625	6a
b	Less: rental expenses			6b
c	Rental income or (loss)		1,625	6c
d	Net rental income or (loss).......			1,625	1,625
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		109,604	7a
b	Less: cost or other basis and sales expenses		66,719	7b
c	Gain or (loss)		42,885	7c
d	Net gain or (loss).........			42,885	42,885
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS		900099	660	660
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			660
12	Total revenue. See instructions.....			76,779	73,453

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	3,603	3,603
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	0
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	880		880
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	5,090		5,090
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	0
12	Advertising and promotion ....	0
13	Office expenses .......	1,166	1,166
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	20,586	10,293	10,293
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	1,414	707	707
23	Insurance ...	5,519		5,519
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	SUPPLIES	3,114	3,114
b	DUES & SUBSCRIPTIONS	1,679	1,679
c
d
e	All other expenses	0
25	Total functional expenses. Add lines 1 through 24e	43,051	20,562	22,489	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			14,683	1	11,953
2	Savings and temporary cash investments .........				2	0
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............				4	0
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6	0
7	Notes and loans receivable, net ...........				7	0
8	Inventories for sale or use ............				8	0
9	Prepaid expenses and deferred charges ......				9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	318,988
b	Less: accumulated depreciation	10b	6,899	254,058	10c	312,089
11	Investments—publicly traded securities .				11	0
12	Investments—other securities. See Part IV, line 11 .....				12	0
13	Investments—program-related. See Part IV, line 11 ..				13	0
14	Intangible assets ...............				14	0
15	Other assets. See Part IV, line 11 ...........			456,070	15	434,497
16	Total assets. Add lines 1 through 15 (must equal line 33)...			724,811	16	758,539

17	Accounts payable and accrued expenses .....		17
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	0	26	0

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	724,811	27	758,539
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	724,811	32	758,539
33	Total liabilities and net assets/fund balances ........	724,811	33	758,539

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

1a	Land .....	211,864		211,864
b	Buildings ....	107,124	6,899	100,225
c	Leasehold improvements
d	Equipment ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				312,089

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)