Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
Jaxson William Augustus Swank Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)3900 Edison Lakes Parkway Suite 201
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Mishawaka, IN46545
A Employer identification number

30-6072980
B Telephone number (see instructions)

(574) 247-3248
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$3,453,637
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) 1,153,291
2 Check bullet.............
3 Interest on savings and temporary cash investments 91 91  
4 Dividends and interest from securities... 21,373 21,373  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 435,353
b Gross sales price for all assets on line 6a 3,019,377
7 Capital gain net income (from Part IV, line 2)... 435,353
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances 0
b Less: Cost of goods sold.... 0
c Gross profit or (loss) (attach schedule)..... 0  
11 Other income (attach schedule)....... 65,666 6 0
12 Total. Add lines 1 through 11........ 1,675,774 456,823 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 133,898     133,898
14 Other employee salaries and wages...... 5,886     5,886
15 Pension plans, employee benefits....... 11,349      
16a Legal fees (attach schedule)......... 2,851 0 0 0
b Accounting fees (attach schedule)....... 38,000 5,000 0 17,500
c Other professional fees (attach schedule).... 0 0 0 0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 1,418 0 0 0
19 Depreciation (attach schedule) and depletion... 0 0 0
20 Occupancy..............        
21 Travel, conferences, and meetings....... 36,012      
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 178,469 0 0 28,104
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 407,883 5,000 0 185,388
25 Contributions, gifts, grants paid....... 203,140 203,140
26 Total expenses and disbursements. Add lines 24 and 25 611,023 5,000 0 388,528
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 1,064,751
b Net investment income (if negative, enter -0-) 451,823
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......... 733,453 2,216,757 2,216,757
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet   0 0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet   0 0 0
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)..... 0 0 0
7 Other notes and loans receivable (attach schedule) bullet0
Less: allowance for doubtful accounts bullet0 0 0 0
8 Inventories for sale or use.............. 12,180 12,180 12,180
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 0 0 0
b Investments—corporate stock (attach schedule)....... 1,568,411 Click to see attachment1,160,036 1,270,745
c Investments—corporate bonds (attach schedule)....... 0   0
11 Investments—land, buildings, and equipment: basis bullet0
Less: accumulated depreciation (attach schedule) bullet0 0   0
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 0 0 0
14 Land, buildings, and equipment: basis bullet0
Less: accumulated depreciation (attach schedule) bullet0 0   0
15 Other assets (describe bullet) Click to see attachment-35,867 Click to see attachment-46,045 Click to see attachment-46,045
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,278,177 3,342,928 3,453,637
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons 0 0
21 Mortgages and other notes payable (attach schedule)...... 0 0
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 2,278,177 3,342,928
29 Total net assets or fund balances (see instructions)..... 2,278,177 3,342,928
30 Total liabilities and net assets/fund balances (see instructions). 2,278,177 3,342,928
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
2,278,177
2
Enter amount from Part I, line 27a .....................
2
1,064,751
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
3,342,928
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
3,342,928
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a PUBLICLY TRADED SECURITIES P    
b CAPITAL GAIN DISTRIBUTIONS P    
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a 3,107,812   2,674,024 433,788
b 1,565     1,565
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a     0 433,788
b     0 1,565
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 435,353
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 0
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 6,280
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 6,280
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 1,215
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,215
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 5,065
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11 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
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
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)
    bulletIN
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletKristin Swank Telephone no.bullet (574) 247-3248

    Located atbullet3900 Edison Lakes Parkway Suite 201MishawakaIN ZIP+4bullet46545
    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)
    Yes
     
    (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
     
    No
    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
    Larry A Swank TRUSTEE
    10.000
    0 0 0
    3900 Edison Lakes Parkway
    Mishawaka,IN46545
    Sherry LT Swank TRUSTEE
    10.000
    0 0 0
    3900 Edison Lakes Parkway
    Mishawaka,IN46545
    Jeanie Shuck Executive Director
    40.000
    133,898 0 0
    3900 Edison Lakes Parkway
    Mishawaka,IN46545
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet 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
     
    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 The Foundation currently supports 20 Jaxson Scholars, which includes funding their education from primary through secondary school and an annual programming customized towards character and leadership development. The Foundation provides experiences to cultivate self-confidence and encourages all Jaxson Scholars and their families to give back through service and become forces of good in the community. Some of the activities a Jaxson Scholar participates in throughout the year are Leadership Day Camps, Service Days, Self-Defense Classes and Etiquette Dinners, among others. 388,528
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,865,032
    b
    Average of monthly cash balances.......................
    1b
    924,926
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,789,958
    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
     
    3
    Subtract line 2 from line 1d.........................
    3
    2,789,958
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    41,849
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    2,748,109
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    137,405
    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
    137,405
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    6,280
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    6,280
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    131,125
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    131,125
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    131,125
    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 7 131,125
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:2019, 2018, 2017 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 102,429
    b From 2017...... 148,440
    c From 2018...... 68,336
    d From 2019...... 82,147
    e From 2020...... 298,506
    f Total of lines 3a through e ........ 699,858
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 388,528
    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..... 131,125
    e Remaining amount distributed out of corpus 257,403
    5 Excess distributions carryover applied to 2021.   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 5 957,261
    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......
     
    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) ...
    102,429
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......
    854,832
    10 Analysis of line 9:
    a Excess from 2017.... 148,440
    b Excess from 2018.... 68,336
    c Excess from 2019.... 82,147
    d Excess from 2020.... 298,506
    e Excess from 2021.... 257,403
    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 e-mail address of the person to whom applications should be addressed:
    Jeanie Shuck
    3900 Edison Lakes Pkwy Ste 201
    Mishawaka,IN46545
    (574) 229-6484
    jshuck@jwasfoundation.org
    bThe form in which applications should be submitted and information and materials they should include:
    Completed and signed application should be mailed in, faxed applications will not be accepted. Required materials include copies of child/family agreements, birth certificate, pay stubs and verification of any financial assistance.
    cAny submission deadlines:
    February 6
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Children between the ages of 2.5 and 5 years old are eligible to apply for the 2020-2021 school year. Child must show readiness to be in a primary environment (ability to follow direction, accept a gentle no, be potty trained.) Families must qualify within the foundation's income guidelines of federal poverty level and 240% of the poverty level.
    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
    Freedom Jones
    116 S Walnut St
    South Bend,IN46601
    none I Scholarships 26,894
    Marilynn Springer
    10600 Muckshaw Rd
    Plymouth,IN46563
    none I Scholarships 26,635
    Jolie Springer
    10600 Muckshaw Rd
    Plymouth,IN46563
    none I scholarships 26,515
    Finleigh Hoffer
    512 North Hill Street
    South Bend,IN46617
    none I scholarships 18,480
    Savino Rivera III
    1022 South Oakland St
    South Bend,IN46615
    none I scholarships 11,625
    Rihanna Castillo
    721 Birchwood Ave
    South Bend,IN46619
    none I scholarships 11,620
    Santiago Recalde
    1718 W Indiana Ave
    South Bend,IN46613
    none I scholarship 10,604
    Kiara Nikol Nunez
    17358 Starlite Dr
    South Bend,IN46614
    none I scholarships 10,521
    Freddy Rodriguez
    1020 West 8th Street
    Mishawaka,IN46544
    none I scholarships 10,498
    Autumn Healey
    65225 State Road 23
    North Liberty,IN46554
    none I scholarships 9,435
    Branton Givens Jr
    613 Eckman Street
    South Bend,IN46614
    none I scholarships 8,280
    Layla Rodriguez
    1020 West 8th Street
    Mishawaka,IN46544
    none I scholarships 8,258
    Savannah Castillo
    721 Birchwood Ave
    South Bend,IN46619
    none I scholarships 8,235
    Ember Healey
    65225 State Road 23
    North Liberty,IN46554
    none I scholarships 4,985
    Josiah Frazier
    116 S Walnut St
    South Bend,IN46601
    none I scholarships 4,217
    Aline Jimenez
    251 Concord Ave
    South Bend,IN46619
    none I scholarships 4,149
    Alani Jimenez
    251 Concord Ave
    South Bend,IN46619
    none I scholarships 1,704
    Masai Teague
    4834 Belleville Circle Bldg Apt 8
    South Bend,IN46619
    none I scholarships 485
    Total .................................bullet 3a 203,140
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........
        14 91  
    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 ............
        18 435,353  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aBill payment return
        18 1,675  
    bSterling Columbia Apartments LLC     18 -293  
    cFundraising Revenue     18 64,284  
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 522,488 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    522,488
    (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: 21014044
    Software Version: 2021v4.2


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

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number

    30-6072980
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    1
    Daniel Luck
     
    1132 Napoleon St
     
    South Bend, IN466171458

    $ 68,148


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    2
    Richard Levine
     
    520 Harbour Gate Cir
     
    Alpharetta, GA300223306

    $ 55,075


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    3
    Vice Versa Wine
     
    1461 Railroad Avenue Ste 100
     
    St Helena, CA94574

    $ 55,253


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    4
    Mike Parin
     
    8708 Elm Valley Rd
     
    Union Pier, MI491299313

    $ 47,910


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    5
    Pete Hodo
     
    242 Inverness Center Drive
     
    Birmingham, AL35242

    $ 37,545


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    6
    Lance Swank
     
    1201 E Northshore Dr
     
    Syracuse, IN465678474

    $ 37,200


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    7
    Sherry Swank
     
    1155 Dunrobbin Ln
     
    South Bend, IN466142149

    $ 24,901


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    8
    John Garr II
     
    3705 N 1350-34
     
    Converse, IN46919

    $ 32,400


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    9
    Chris Shepherd
     
    51720 Bluffside Ct
     
    Granger, IN465307054

    $ 30,100


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    10
    Doug Rassi
     
    6226 E Trusdell Ave
     
    Syracuse, IN465679419

    $ 31,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    11
    Todd Browne
     
    5155 Plantation Dr
     
    Indianapolis, IN462501640

    $ 26,350


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    12
    Susan Moore Hall
     
    3308 Tartan Cir
     
    Birmingham, AL352423940

    $ 25,250


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    13
    James Schwartz
     
    50885 Waldon Park Ln
     
    Granger, IN465307703

    $ 20,830


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    14
    Fred Hoppe
     
    1600 Stonyhill Rd
     
    Lincoln, NE685201173

    $ 18,333


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    15
    Robert Nielsen
     
    380 Linden St
     
    Reno, NV895024309

    $ 8,333


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    16
    Suzie Weirick
     
    23268 Shorelane
     
    Elkhart, IN465144560

    $ 15,630


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    17
    Kevin Baxter
     
    51231 Pine Croft Ct
     
    South Bend, IN466376047

    $ 15,100


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    18
    Shetal Patel
     
    14208 Avery Pt
     
    Granger, IN46530

    $ 16,685


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    19
    Larry Swank II
     
    1327 Honan Dr
     
    South Bend, IN466142175

    $ 15,135


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    20
    Christine McJunkin
     
    Highland Commercial Mortgage 242 In
    verness Center Dr
    Birmingham, AL352424834

    $ 14,950


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    21
    Allora Vineyards
     
    3244 Ehlers Ln
     
    St Helena, CA945749657

    $ 13,603


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    22
    JT Schwartz
     
    16094 Cobblestone Square Dr
     
    Granger, IN46530

    $ 12,700


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    23
    Chris Murphy
     
    1237 E Jefferson Blvd
     
    South Bend, IN466173315

    $ 12,700


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    24
    Jeremy Borak
     
    TBM Insurance 5871 Glenridge Dr Ste
    400
    Atlanta, GA303285343

    $ 12,750


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    25
    Ryan Morris
     
    888 Vinewood Ave
     
    Birmingham, MI480091314

    $ 12,750


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    26
    Sterling Group
     
    3900 Edison Lakes Pkwy Suite 201
     
    Mishawaka, IN46545

    $ 12,519


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    27
    Jennifer Schwartz
     
    50885 Waldon Park Ln
     
    Granger, IN465307703

    $ 10,950


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    28
    Albert Cho and Ken Lewton
     
    51230 Pine Croft Ct
     
    South Bend, IN466376047

    $ 9,500


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    29
    Cohnreznick Foundation Inc
     
    4 Becker Farm Road
     
    Roseland, NJ07068

    $ 8,500


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    30
    Highland Commercial Mortgage
     
    242 Inverness Center Drive
     
    Birmingham, AL35242

    $ 10,000


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    31
    Richard Armstrong
     
    3377 Bridgetown Rd
     
    Bristol, IN465078765

    $ 10,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    32
    Mardot LP
     
    50885 Waldon Park Lane
     
    Granger, IN46530

    $ 8,500


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    33
    Christine Barrett
     
    1229 Ridgedale Rd
     
    South Bend, IN466142107

    $ 10,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    34
    John Gilbert
     
    1430 Greenleaf Blvd
     
    Elkhart, IN465143723

    $ 9,100


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    35
    Andrea Vinstra
     
    22040 Wagon Wheel Ln
     
    Edwardsburg, MI491129767

    $ 8,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    36
    Wendy Noble
     
    1208 Honan Dr
     
    South Bend, IN466142172

    $ 8,273


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    37
    Jeff Shuck
     
    3542 Pottawattomie Trl
     
    Michigan City, IN463601044

    $ 7,802


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    38
    Woodcox Building Contractors Inc
     
    51175 Presco Avenue
     
    South Bend, IN46637

    $ 7,500


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    39
    Joseph Scimia
     
    124 Chatham Hills Blvd
     
    Westfield, IN46074

    $ 5,720


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    40
    Nicholas Borden
     
    71058 Reserve Pkwy
     
    Niles, MI491207828

    $ 7,135


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    41
    Chris Kintzele
     
    30324 Blackhawk Dr
     
    Granger, IN465306567

    $ 7,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    42
    Matthew Harris
     
    1119 W Overlook Rd
     
    Marion, IN469521328

    $ 7,000


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    43
    Charles Schultz
     
    16162 Cobblestone Square Dr
     
    Granger, IN465301350

    $ 6,645


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    44
    Paraclete Professionals
     
    71438 Forest Eagle Ln
     
    Niles, MI491207826

    $ 6,135


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    45
    Jimmy Adams
     
    3038 Salisbury Rd
     
    Birmingham, AL352133512

    $ 6,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    46
    John VanMeeter
     
    14765 Heatherton Dr
     
    Granger, IN465304221

    $ 5,500


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    47
    Michiana Eye Center
     
    230 East Day Road Suite 100
     
    Mishawaka, IN46545

    $ 6,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    48
    Crowe LLP
     
    330 E Jefferson Blvd
     
    South Bend, IN46601

    $ 6,000


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    49
    Gibson Insurance
     
    202 S Michigan St 1400
     
    South Bend, IN46601

    $ 6,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    50
    Rick Rolph
     
    3241 Country Club Pkwy
     
    Castle Rock, CO801088300

    $ 6,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    51
    Joann Callahan
     
    111 W Elmwood Ter
     
    Elmhurst, IL601263334

    $ 5,123


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    52
    Josh Miller
     
    51680 Bluffside Ct
     
    Granger, IN465307055

    $ 5,500


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    53
    Mike Garatoni
     
    1610 Riverview Blvd
     
    Osceola, IN465613529

    $ 5,353


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    54
    Mark McCool
     
    31 Mystic View Ln
     
    Doylestown, PA189012040

    $ 5,250


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    55
    Chris Katris
     
    380 N Saint Clair Ct
     
    Warsaw, IN465828222

    $ 5,250


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    56
    David DenHerder
     
    1316 Bishop Ln
     
    Alexandria, VA223023401

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    57
    Scott Welch
     
    1020 Herman St
     
    Elkhart, IN465169028

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    58
    Cyndee Herald
     
    1300 S Harkless Dr 7
     
    Syracuse, IN465671965

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    59
    Heather Williams
     
    1210 Country Club Dr
     
    Warsaw, IN465805004

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    60
    Cho Lewton 2017 Trust
     
    51230 Pine Croft Ct
     
    South Bend, IN46637

    $ 5,000


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number
    30-6072980
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    61
    Jane Synnestvedt Interior Design INC
     
    551 S Bates St
     
    Birmingham, MI480091422

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    62
    Sarah Butus
     
    2 Sundance Dr
     
    Buchanan, MI491078120

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    63
    Geo Mijilem & Company Inc
     
    466 Sunrise Avenue
     
    Lake Bluff, IL60044

    $ 5,000


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    64
    George Klenovich
     
    106 Longmeadow Rd
     
    Winnetka, IL600933500

    $ 5,000


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

    $  


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

    $  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number

    30-6072980
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    Jaxson William Augustus Swank Foundation
     
    Employer identification number

    30-6072980
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID: 21014044
    Software Version: 2021v4.2

    TY 2021 AccountingFeesSchedule
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting Fees 38,000 5,000   17,500

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Name of Stock End of Year Book Value End of Year Fair Market Value
    Marketable Securities 1,160,036 1,270,745

    TY 2021 LegalFeesSchedule
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 2,851      


    TY 2021 OtherAssetsSchedule
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Investment in Sterling Columbia Apartments LLC -35,867 -46,045 -46,045


    TY 2021 OtherExpensesSchedule
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Fundraising Expenses 124,211      
    Office Expense 163     163
    Marketing Expense 26,877     13,438
    Meals and Entertainment Expense 13,642     6,633
    Software Expenses 4,540     4,540
    Miscellaneous 1,815      
    Insurance 3,891      
    Program Expense Reimbursements 3,330     3,330


    TY 2021 OtherIncomeSchedule2
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Sterling Columbia Apartments LLC -293 6  
    Bill payment return 1,675    
    Fundraising Revenue 64,284    


    TY 2021 TaxesSchedule
    Name:
    Jaxson William Augustus Swank Foundation
    EIN:
    30-6072980
    Software ID:
    21014044
    Software Version:
    2021v4.2
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Excise Tax 1,418