TY 2021 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
bullet

Go 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 ADJUVANT FOUNDATION

Number and street (or P.O. box number if mail is not delivered to street address)191 N WACKER DRIVE SUITE 1500
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL606061899

A Employer identification number

36-3866528

B Telephone number (see instructions)

(312) 621-0590

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$28,923,138J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check .............
3	Interest on savings and temporary cash investments	54		54
4	Dividends and interest from securities...	642,349		642,349
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		1,137,756
b	Gross sales price for all assets on line 6a 2,299,828
7	Capital gain net income (from Part IV, line 2)...			1,134,562
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).......		517,271	494,949
12	Total. Add lines 1 through 11........	2,297,430		2,271,914
13	Compensation of officers, directors, trustees, etc.	0		0	0
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......		11,257	5,629	5,628
c	Other professional fees (attach schedule)....		148,889	148,889	0
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		5,651	5,636	15
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		210,058	188,285	278
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	375,855		348,439	5,921
25	Contributions, gifts, grants paid.......	1,134,000			1,034,000
26	Total expenses and disbursements. Add lines 24 and 25	1,509,855		348,439	1,039,921
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	787,575
b	Net investment income (if negative, enter -0-)			1,923,475
c	Adjusted net income (if negative, enter -0-)...

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2021)

Form 990-PF (2021)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............
	2	Savings and temporary cash investments.........	1,738,119	1,217,649	1,217,649
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	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)
		Less: allowance for doubtful accounts
	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).......	14,354,700	15,709,554	19,413,410
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	10,669,392	10,661,601	8,292,079
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	26,762,211	27,588,804	28,923,138
	17	Accounts payable and accrued expenses..........	47,511	37,733
	18	Grants payable.................		100,000
	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 )	42,094	31,175
	23	Total liabilities (add lines 17 through 22).........	89,605	168,908
		Foundations that follow FASB ASC 958, check here
		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
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	0	0
	27	Paid-in or capital surplus, or land, bldg., and equipment fund	10,000	10,000
	28	Retained earnings, accumulated income, endowment, or other funds	26,662,606	27,409,896
	29	Total net assets or fund balances (see instructions).....	26,672,606	27,419,896
	30	Total liabilities and net assets/fund balances (see instructions).	26,762,211	27,588,804

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

26,672,606

Enter amount from Part I, line 27a .....................

787,575

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

27,460,181

Decreases not included in line 2 (itemize) bullet

40,285

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

27,419,896

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	SIH DEBT OPPORTUNITIES FUND II, L.P.	P	2021-01-01	2021-12-31
b	WHI FIXED INCOME FUND II, LLC	P	2021-01-01	2021-12-31
c	WHI FIXED INCOME FUND III, L.P.	P	2021-01-01	2021-12-31
d	WHI MORULA FUND II, L.P.	P	2021-01-01	2021-12-31
e	WHI NFP FUND, LLC	P	2021-01-01	2021-12-31
	WHI PRIVATE EQUITY MANAGERS FUND II, L.P.	P	2021-01-01	2021-12-31
	WHI PRIVATE EQUITY MANAGERS FUND III, L.P.	P	2021-01-01	2021-12-31
	WHI PRIVATE EQUITY MANAGERS FUND IV, L.P.	P	2021-01-01	2021-12-31
	WHI PRIVATE EQUITY MANAGERS FUND, LLC	P	2021-01-01	2021-12-31
	WHI REAL ESTATE PARTNERS IV-PF, L.P.	P	2021-01-01	2021-12-31
	WHI REAL ESTATE PARTNERS V-TE, L.P.	P	2021-01-01	2021-12-31
	WHI REALTY FUND II, L.P.	P	2021-01-01	2021-12-31
	WHI REALTY FUND, LLC	P	2021-01-01	2021-12-31
	WHIREP IV MANAGEMENT PARTNERS LLC	P	2021-01-01	2021-12-31
	GAIN ON DISPOSITION - WHI FIXED INCOME FUND II	P	2021-01-01	2021-12-31
	LOSS ON DISPOSITION - WHI REALTY FUND	P	2021-01-01	2021-12-31
	LOSS ON DISPOSITION - WHI REALTY FUND II	P	2021-01-01	2021-12-31
	PUBLICLY TRADED SECURITIES

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a			3,151
b			-3,028
c			-88,779
d			-96,477
e			160,667
			12,595
			-2,077
			54,772
			114
			17,349
			114
			-3,205
			461
			6,148
			17,891
			-127
			-5,636
	2,299,828	1,239,199	1,060,629

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			3,151
b			-3,028
c			-88,779
d			-96,477
e			160,667
			12,595
			-2,077
			54,772
			114
			17,349
			114
			-3,205
			461
			6,148
			17,891
			-127
			-5,636
			1,060,629

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	1,134,562
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 ...................		3

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 and enter “N/A" on line 1.
	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	26,736
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	26,736
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	27,990
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	25,000
d	Backup withholding erroneously withheld ...........	6d	0

7	Total credits and payments. Add lines 6a through 6d..............		7	52,990
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.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	26,254
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax26,254	Refunded	11	0

Part VI-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

$ 0

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?.........

Yes

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Yes

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2021)

Page 5

Part VI-A

Statements Regarding Activities (continued)

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

WILLIAM HARRIS INVESTORS INC Telephone no. bullet

(312) 621-0590

Located at bullet

191 NORTH WACKER DRIVE SUITE 1500CHICAGOIL ZIP+4 bullet

606061899

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

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

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)

Yes

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? ..............................

1a(2)

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........

1a(3)

Yes

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............

1a(4)

Yes

(5) Transfer any income or assets to a disqualified person (or make any of either available

for the benefit or use of a disqualified person)? ......................

1a(5)

(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)

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 ..........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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? .............

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)):

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?....................

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year? ..............................

Yes

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.) .....................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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? ..

Form 990-PF (2021)

Page 6

Part VI-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........

5a(1)

(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)

(3) Provide a grant to an individual for travel, study, or other similar purposes? .............

5a(3)

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions ........................

5a(4)

(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)

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 ........

Organizations relying on a current notice regarding disaster assistance check here ......... bullet

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? .................

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? .............................

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....

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? .........................

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
JACK R POLSKY DECEASED 7621	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
CHARLES V POLSKY	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
GEORGE POLSKY	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
JAMES HARRIS POLSKY	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
JEAN POLSKY	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
RICHARD M POLSKY	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	VICE PRESIDENT/DIRECTOR 1.00	0	0	0
VIRGINIA POLSKY	PRESIDENT/SECRETARY/DIRECT 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	PRESIDENT/SECRETARY/DIRECT 1.00	0	0	0
LAUREN K MACDONALD	TREASURER 1.00	0	0	0
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL606061899	TREASURER 1.00	0	0	0

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...................				0

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
WILLIAM HARRIS INVESTORS INC	ACCOUNTING & INVESTMENT SERVICES	111,156
191 N WACKER DRIVE SUITE 1500 CHICAGO,IL60606	ACCOUNTING & INVESTMENT SERVICES	111,156

Total number of others receiving over $50,000 for professional services............. bullet

Part VIII-A

Summary of Direct Charitable Activities

List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.	Expenses
1


2


3


4

Part VIII-B

Summary of Program-Related Investments (see instructions)

Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.	Amount
1


2


All other program-related investments. See instructions.
3

Total. Add lines 1 through 3......................... bullet

Form 990-PF (2021)

Page 8

Part IX

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

19,050,829

Average of monthly cash balances.......................

1,212,943

Fair market value of all other assets (see instructions)................

8,210,349

Total (add lines 1a, b, and c).........................

28,474,121

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

28,474,121

Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see

instructions) .............................

427,112

Net value of noncharitable-use assets. Subtract line 4 from line 3. .......

28,047,009

Minimum investment return. Enter 5% (0.05) of line 5................

1,402,350

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.)

Minimum investment return from Part IX, line 6..................

1,402,350

Tax on investment income for 2021 from Part V, line 5.......

26,736

Income tax for 2021. (This does not include the tax from Part V.) ...

3,712

Add lines 2a and 2b............................

30,448

Distributable amount before adjustments. Subtract line 2c from line 1............

1,371,902

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

1,371,902

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...

1,371,902

Part XI

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

Program-related investments—total from Part VIII-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.

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				1,371,902
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......			637,239
b Total for prior years:20, 20, 20		0
3 Excess distributions carryover, if any, to 2021:
a From 2016......
b From 2017......
c From 2018......
d From 2019......
e From 2020......
f Total of lines 3a through e ........	0
4Qualifying distributions for 2021 from Part
XI, line 4: $ 1,039,921
a Applied to 2020, but not more than line 2a			637,239
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.....				402,682
e Remaining amount distributed out of corpus	0
5 Excess distributions carryover applied to 2021.	0			0
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5	0
b Prior years’ undistributed income. Subtract line 4b from line 2b ..........		0
c Enter the amount of prior years’ undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed......		0
d Subtract line 6c from line 6b. Taxable amount —see instructions ...........		0
e Undistributed income for 2019. Subtract line 4a from line 2a. Taxable amount—see instructions .............			0
f Undistributed income for 2021. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2022 ..........				969,220
7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (Election may be required - see instructions) .......	0
8 Excess distributions carryover from 2016 not applied on line 5 or line 7 (see instructions) ...	0
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......	0
10 Analysis of line 9:
a Excess from 2017....
b Excess from 2018....
c Excess from 2019....
d Excess from 2020....
e Excess from 2021....

Form 990-PF (2021)

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 4942(j)(3) or4942(j)(5)

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	(e) Total

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).)

RICHARD M POLSKY

VIRGINIA POLSKY

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

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions

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)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
DIEU DONNE PAPER MILL INC 63 FLUSHING AVE UNIT 112 BROOKLYN,NY112051069	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	20,000
DIEU DONNE PAPER MILL INC 63 FLUSHING AVE UNIT 112 BROOKLYN,NY112051069	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	100,000
ETHICAL CULTURE FIELDSTON SCHOOL 33 CENTRAL PARK W NEW YORK,NY100236001	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	15,000
HAVERFORD COLLEGE CORPORATION OF HAVERFORD COLLEGE 370 LANCASTER AVE HAVERFORD,PA190411336	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	1,000
HAYWARD LIBRARY FOUNDATION PO BOX 1303 HAYWARD,WI548431303	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	1,000
JAZZ GENERATION INC 145 HUDSON ST APT 13B NEW YORK,NY100132122	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	100,000
MASSACHUSETTS GENERAL HOSPITAL 399 REVOLUTION DR STE 645 SOMERVILLE,MA021451465	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	100,000
MASSACHUSETTS GENERAL HOSPITAL 399 REVOLUTION DR STE 645 SOMERVILLE,MA021451465	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	450,000
MASSACHUSETTS GENERAL HOSPITAL 399 REVOLUTION DR STE 645 SOMERVILLE,MA021451465	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	20,000
NEW YORK PUBLIC LIBRARY 6021 STATE FARM RD GUILDERLAND,NY120849503	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	1,000
PLANNED PARENTHOOD FEDERATION OF AMERICA INC 123 WILLIAM ST 10TH FLOOR NEW YORK,NY100383844	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	5,000
SAINT ANN'S SCHOOL 129 PIERREPONT ST BROOKLYN,NY112012705	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	5,000
STREETSQUASH INC 40 W 116 STREET NEW YORK,NY100262864	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	200,000
THIRTEENWNET 825 EIGHTH AVE 14TH FLOOR NEW YORK,NY100197416	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	500
UNIVERSITY OF CHICAGO - LABORATORY SCHOOLS 6054 S DREXEL AVE CHICAGO,IL606372612	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	5,000
WILD SALMON CENTER 721 NW 9TH AVE STE 300 PORTLAND,OR972093446	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	10,000
WQXR NEW YORK PUBLIC RADIO 160 VARICK STREET NEW YORK,NY100131220	N/A	PC	GENERAL OPERATING SUPPORT/ANNUAL GIFT	500
Total ................................. 3a				1,034,000

bApproved for future payment

Total ................................. 3b				0

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	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments ....
3 Interest on savings and temporary cash investments ...........			14	54
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 ............	901101	3,834	18	1,133,922
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) ..		24,475		2,272,955	0

13Total. Add line 12, columns (b), (d), and (e)..................

2,297,430

(See worksheet in line 13 instructions to verify calculations.)

Part XV-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	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)

Page 13

Part XVI

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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? ...........Yes No

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.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name				Firm's EIN
	Firm's address				Phone no.

Form 990-PF (2021)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2021 AccountingFeesSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
TAX ACCOUNTING FEES	11,257	5,629		5,628

- TIN:

TY 2021 InvestmentsCorpStockSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Name of Stock	End of Year Book Value	End of Year Fair Market Value
ISHARES CORE S&P 500 ETF	866,055	1,640,369
SEVERN TRENT ADR	3,592	3,641
SANDERSON FARMS, INC	31,264	50,827
REINSURANCE GROU	13,546	14,124
PENNON GROUP PLC UNSPONSORD ADR	3,511	3,472
NORTHERN TRUST CORP	32,757	49,519
MUELLER WTR PRODS INC COM SER A	11,856	14,645
MONMOUTH REAL ESTATE INVESTMENT CORP	7,197	7,900
METLIFE, INC	1,726	3,499
INTERSECT ENT INC	3,627	3,605
SJW GROUP ORD SHS	37,843	44,066
INDEPENDENT BANK CORP.	3,296	3,669
ICU MEDICAL ORD SHS	18,408	21,598
HENKEL AG&CO SPON ADS EA REP .25 ORD SHS	13,576	12,621
HEALTHCARE REALTY TRUST REIT ORD SHS	32,547	34,646
HARTFORD FINANCIAL SVCS	13,593	13,877
GCP APPLIED TECHNOLOGIES ORD SHS	20,187	21,529
EVEREST RE GROUP	38,592	49,306
EQUITY COMMONWEALTH REIT	87,315	71,303
DENTSPLY SIRONA INC COM	10,233	13,445
COUSINS PPTYS INC	13,851	14,863
SMITH & NEPHEW ADR EACH REP 2 ORD SHS	70,926	64,532
TRAVELERS COMPANIES, INC	56,487	78,371
TOWNEBANK ORD SHS	3,036	4,707
METLIFE INC DP PFD F 4.75000%	6,461	6,883
BECTON DICKINSON &CO DP CONV PFD B	49,438	50,587
BEIERSDORF A G UNSPONSORED GERMANY ADR	77,131	70,768
NORTHROP GRUMMAN	14,260	18,192
MISSION PRODUCE ORD SHS	3,802	4,490
KIMBERLY CLARK	57,539	61,170
IDACORP INC.	2,946	3,853
ESSENTIAL UTILITIES ORD SHS	6,039	7,517
ESSENTIAL UTILITIES 6.0 TANGIBLE ETY UNTS	27,832	31,617
METLIFE INC 5.625 NCUM PFD E 5.62500%	1,392	1,346
ZIMMER HOLDINGS INC	58,938	51,451
WR BERKLEY CORP	16,150	19,114
WERNER ENTERPRISES, INC	5,200	5,958
VALLEY NATL BANCORP	5,932	10,450
UNIVERSAL HEALTH SRVCS, INC CL B	45,408	43,566
UNITED UTILITIES GROUP ADR	43,184	49,232
UMB FINANCIAL ORD SHS	6,027	11,248
CLOROX COMPANY	13,787	14,646
US BANCORP DEL DEP SHS PFD F 6.50000%	5,687	5,350
CHUBB LTD.	14,770	28,223
CALIFORNIA WATER SRVC GRP HLDG CO	7,934	12,288
ISHARES CORE US AGGREGATE BOND FUND	807,297	793,997
DOUBLELINE TOTAL RETURN BOND FUND CL 1	1,471,384	1,415,826
EATON VANCE SHORT DURATION HIGH INC I	430,852	429,603
DOUBLELINE FLEXIBLE INCOME CL I	527,677	520,233
CS FLOATING RATE HIGH INC INSTL SHS	294,394	287,388
VIRTUS KAR INTL SMALL-CAP FUND CL I	240,862	306,000
UBS INTL SUSTAINABLE EQUITY FUND	372,814	439,800
THORNBURG INTERNATIONAL EQUITY FUND	439,900	488,481
PEAR TREE POLARIS FGN VAL SM CAP INSTL	306,574	419,660
MORGAN STANLEY INST FUND INTL ADVT PORT	224,145	312,408
JOHN HANCOCK EMERGING MRKTS EQ I	109,336	91,975
ISHARES TR BARCLAYS 7 10 YR	362,625	346,150
HARTFORD SCHRODERS EMG MKTS EQUITY FD CL I	101,082	90,749
BROWN CAPITAL MGMT INTL SM CO CL INST	237,942	329,654
ARIEL INTERNATIONAL INST CLASS	397,740	432,238
VIRTUS KAR LONG/SHORT EQUITY FUND CL I	75,897	83,078
JOHN HANCOCK SEAPORT FUND CL I	510,413	523,984
WASATCH SMALL CAP VALUE FUND CL INST	554,307	764,197
VIRTUS NFJ MID CAP VALUE INSTL	1,394,282	1,636,273
VIRTUS KAR SMALL CAP GROWTH FUND I	610,981	941,953
MORGAN STANLEY INSTL FND CAP GRWH PTF CL I	553,268	791,134
MFS CORE EQUITY FUND CLASS I	1,148,167	1,760,608
GMO QUALITY FUND INSTL	1,187,896	1,769,263
COLUMBIA CONTRARIAN CORE FD CL R5	474,748	615,511
COLUMBIA ACORN INTERNATIONAL FUND	260,528	319,596
MFS GLOBAL ALTERNATIVE STRAT I	252,226	260,822
VIVALDI MERGER ARBITRAGE FUND CL I	271,317	262,904
US BANCORP DEL DEPOSITARY SHS 3.53900% PFD	23,316	24,671
CALAVO GROWERS, INC	15,309	10,897
CAL MAINE FOODS ORD SHS	43,953	39,283
BOSTON PPTYS, INC	2,433	3,686
BIOVENTUS INC COM CL A	3,672	2,985
BAXTER INT'L, INC	63,521	67,556
AVISTA ORD SHS	24,647	26,131
APTARGROUP, INC	3,562	3,307
AMPHENOL CORP CL A	11,085	18,891
ALLEGHANY CORP	22,972	22,698
AEROJET ROCKETDYNE HLDGS INC COM	11,552	11,737

- TIN:

TY 2021 InvestmentsOtherSchedule2

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
WHIREP IV MGMT PARTNERS LLC	AT COST	13,162	13,162
WHI REAL ESTATE PARTNERS V-TE, L.P.	AT COST	99,452	111,545
WHI REAL ESTATE PARTNERS IV, LP PF	AT COST	169,816	217,632
WHI PRIVATE EQUITY MNGRS FUND IV	AT COST	105,128	164,008
WHI PRIVATE EQUITY MNGRS FUND III	AT COST	21,090	11,684
WHI PRIVATE EQUITY MNGRS FUND II	AT COST	55,500	92,577
WHI PRIVATE EQUITY MNGRS FUND	AT COST	0	8,976
WHI NFP FUND, LLC	AT COST	5,964,434	6,949,481
WHI MORULA FUND II, LP	AT COST	119,742	41,871
WHI FIXED INCOME FUND III, LLC	AT COST	165,441	23,327
HARRIS FAMILY REP - PF	AT COST	565,733	516,454
SIH DEBT OPPORTUNITIES FUND	AT COST	154,869	141,362
PEF CORPORATION	AT COST	3,227,234	0

- TIN:

TY 2021 OtherDecreasesSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Description	Amount
OTHER DECREASES	40,285

- TIN:

TY 2021 OtherExpensesSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Description	Revenue and Expenses per Books	Net Investment Income	Disbursements for Charitable Purposes
OTHER EXPENSES FROM PASSTHROUGHS	178,946	178,946	0
FILING FEES	278	0	278
NON - DEDUCTIBLE EXPENSES	21,495	0	0
BANK FEES	9,339	9,339	0

- TIN:

TY 2021 OtherIncomeSchedule2

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
NONTAXABLE INCOME	1,681	0	1,681
OTHER INCOME FROM PASSTHROUGH	456,130	435,489	456,130
FEDERAL TAX REFUNDS	59,460	59,460	59,460

- TIN:

TY 2021 OtherLiabilitiesSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Description	Beginning of Year - Book Value	End of Year - Book Value
OTHER INVESTMENTS	42,094	31,175

- TIN:

TY 2021 OtherProfessionalFeesSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
FINANCIAL SERVICE FEE	70,750	70,750		0
INVESTMENT ADVISORY FEES	78,139	78,139		0

- TIN:

TY 2021 TaxesSchedule

Name:

THE ADJUVANT FOUNDATION

EIN:

36-3866528

Category	Amount	Net Investment Income	Disbursements for Charitable Purposes
FOREIGN TAXES	5,453	5,453	0
STATE TAX PAYMENTS	15	0	15
OTHER TAXES	183	183	0