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
BEAVER STREET FOUNDATION INC
 
Number and street (or P.O. box number if mail is not delivered to street address)POST OFFICE BOX 41430
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
JACKSONVILLE, FL322031430
A Employer identification number

59-2714980
B Telephone number (see instructions)

(904) 354-8533
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$11,914,665J 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) 500,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 405 405  
4 Dividends and interest from securities... 440,939 440,939  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 526,103
b Gross sales price for all assets on line 6a 2,596,257
7 Capital gain net income (from Part IV, line 2)... 526,103
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,467,447 967,447  
Operating and Administrative Expenses 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).......        
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 16,520 16,520   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 61 0   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 16,581 16,520   0
25 Contributions, gifts, grants paid....... 723,127 723,127
26 Total expenses and disbursements. Add lines 24 and 25 739,708 16,520   723,127
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 727,739
b Net investment income (if negative, enter -0-) 950,927
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 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......... 10,872,703 11,385,321 11,914,665
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment11,700 Click to see attachment226,821 Click to see attachment0
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 10,884,403 11,612,142 11,914,665
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
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........ 0 0
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 10,884,403 11,612,142
29 Total net assets or fund balances (see instructions)..... 10,884,403 11,612,142
30 Total liabilities and net assets/fund balances (see instructions). 10,884,403 11,612,142
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
10,884,403
2
Enter amount from Part I, line 27a .....................
2
727,739
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
11,612,142
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
11,612,142
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 EATON CORPORATION PL C SHS P 2020-08-11 2021-01-15
b EATON CORPORATION PL C SHS P 2020-08-24 2021-01-15
c BRISTOL MYERS SQUIBB CO COM P 2020-06-23 2021-02-04
d BRISTOL MYERS SQUIBB CO COM P 2020-09-23 2021-02-04
e CROWN CASTLE INTL CO RP NEW COM P 2020-09-23 2021-06-29
JP MORGAN CHASE & CO COM P 2020-09-18 2021-03-08
JP MORGAN CHASE & CO COM P 2020-11-23 2021-03-08
ORGANON & CO COM P 2020-08-17 2021-06-09
ORGANON & CO COM P 2020-10-16 2021-06-09
ORGANON & CO COM P 2020-10-21 2021-06-09
ORGANON & CO COM P 2021-04-21 2021-06-09
ORGANON & CO COM P 2021-05-12 2021-06-09
ORION OFFICE REIT IN C COM P 2021-11-17 2021-11-17
ORION OFFICE REIT IN C COM P 2021-11-17 2021-11-17
AT&T INC COM P 2018-05-29 2021-01-15
AT&T INC COM P 2018-05-29 2021-02-04
AT&T INC COM P 2018-05-29 2021-06-07
ABBVIE INC COM P 2018-11-16 2021-04-21
BRITISH AMERN TOB PL C SPONSORED ADR P 2018-08-15 2021-11-05
CANADIAN IMPERIAL BK OF COMMERCE P 2018-05-29 2021-03-30
CANADIAN IMPERIAL BK OF COMMERCE P 2018-05-29 2021-06-07
CANADIAN IMPERIAL BK OF COMMERCE P 2018-05-29 2021-06-29
CANADIAN IMPERIAL BK OF COMMERCE P 2018-05-29 2021-09-29
CANADIAN IMPERIAL BK OF COMMERCE P 2018-08-17 2021-09-29
CANADIAN IMPERIAL BK OF COMMERCE P 2019-08-28 2021-09-29
CANADIAN IMPERIAL BK OF COMMERCE P 2019-08-28 2021-11-05
CANADIAN IMPERIAL BK OF COMMERCE P 2019-09-16 2021-11-05
CANADIAN IMPERIAL BK OF COMMERCE P 2019-09-19 2021-11-05
CHEVRON CORP NEW COM P 2018-05-29 2021-02-24
CISCO SYSTEMS INC P 2019-11-19 2021-02-04
CISCO SYSTEMS INC P 2019-11-19 2021-04-21
CISCO SYSTEMS INC P 2019-12-10 2021-04-21
CISCO SYSTEMS INC P 2019-12-10 2021-05-12
CISCO SYSTEMS INC P 2020-03-16 2021-05-12
CISCO SYSTEMS INC P 2020-03-16 2021-08-11
CISCO SYSTEMS INC P 2020-03-20 2021-08-11
CISCO SYSTEMS INC P 2020-03-20 2021-08-30
CISCO SYSTEMS INC P 2020-03-26 2021-08-30
CISCO SYSTEMS INC P 2020-03-26 2021-11-05
CISCO SYSTEMS INC P 2020-04-21 2021-11-05
COCA COLA COMPANY P 2019-09-20 2021-12-17
COCA COLA COMPANY P 2020-03-16 2021-12-17
DUKE ENERGY CORP NEW COM NEW P 2018-05-29 2021-03-08
DUKE ENERGY CORP NEW COM NEW P 2018-05-29 2021-11-05
HUNTINGTON BANCSHARE S INC P 2018-11-16 2021-03-30
INTERNATIONAL BUSINE SS MACHS CORP COM P 2020-04-27 2021-08-11
INTERNATIONAL BUSINE SS MACHS CORP COM P 2020-04-27 2021-11-11
INTERNATIONAL BUSINE SS MACHS CORP COM P 2020-05-01 2021-11-11
INTERNATIONAL BUSINE SS MACHS CORP COM P 2020-05-05 2021-11-11
INTERNATIONAL BUSINE SS MACHS CORP COM P 2020-05-19 2021-11-11
KYNDRYL HLDGS INC COM P 2020-04-27 2021-11-08
KYNDRYL HLDGS INC COM P 2020-04-27 2021-11-11
KYNDRYL HLDGS INC COM P 2020-05-01 2021-11-11
KYNDRYL HLDGS INC COM P 2020-05-01 2021-11-11
KYNDRYL HLDGS INC COM P 2020-05-05 2021-11-11
KYNDRYL HLDGS INC COM P 2020-05-05 2021-11-11
KYNDRYL HLDGS INC COM P 2020-05-19 2021-11-11
KYNDRYL HLDGS INC COM P 2020-05-19 2021-11-11
MERCK & CO INC NEW C OM P 2020-03-04 2021-10-04
MERCK & CO INC NEW C OM P 2020-03-16 2021-10-04
MERCK & CO INC NEW C OM P 2020-05-13 2021-10-04
NATIONAL GRID PLC SP ON ADR NEW 2017 P 2018-05-29 2021-05-12
ORGANON & CO COM P 2020-03-04 2021-06-07
ORGANON & CO COM P 2020-03-04 2021-06-09
ORGANON & CO COM P 2020-03-16 2021-06-09
ORGANON & CO COM P 2020-05-13 2021-06-09
PNC FINL SVCS GROUP INC COM P 2019-09-16 2021-02-04
PNC FINL SVCS GROUP INC COM P 2019-09-20 2021-02-04
PNC FINL SVCS GROUP INC COM P 2019-09-20 2021-02-24
PNC FINL SVCS GROUP INC COM P 2019-09-20 2021-04-21
PNC FINL SVCS GROUP INC COM P 2019-10-04 2021-04-21
PNC FINL SVCS GROUP INC COM P 2019-10-04 2021-05-12
PNC FINL SVCS GROUP INC COM P 2020-03-16 2021-05-12
PEPSICO INC COM P 2018-12-13 2021-12-15
PEPSICO INC COM P 2019-03-25 2021-12-15
PEPSICO INC COM P 2019-03-25 2021-12-17
PEPSICO INC COM P 2019-09-20 2021-12-17
PFIZER INC COM P 2019-07-15 2021-08-11
PFIZER INC COM P 2019-07-18 2021-08-11
PFIZER INC COM P 2019-07-18 2021-08-20
PFIZER INC COM P 2019-07-24 2021-08-20
PFIZER INC COM P 2019-07-29 2021-08-20
PFIZER INC COM P 2019-09-20 2021-08-20
PFIZER INC COM P 2019-09-20 2021-08-30
PFIZER INC COM P 2019-10-04 2021-08-30
PFIZER INC COM P 2019-10-04 2021-12-15
PHILIP MORRIS INTL I NC COM P 2018-05-29 2021-04-21
PHILIP MORRIS INTL I NC COM P 2018-05-29 2021-06-29
PHILIP MORRIS INTL I NC COM P 2018-05-29 2021-09-29
PHILIP MORRIS INTL I NC COM P 2018-05-29 2021-11-05
REGIONS FINL CORP NE W COM P 2019-04-25 2021-03-08
REGIONS FINL CORP NE W COM P 2019-05-31 2021-03-08
REGIONS FINL CORP NE W COM P 2019-05-31 2021-06-07
REGIONS FINL CORP NE W COM P 2019-09-20 2021-06-07
REGIONS FINL CORP NE W COM P 2019-09-20 2021-11-11
REGIONS FINL CORP NE W COM P 2020-04-27 2021-11-11
TC ENERGY CORPORATIO N REGISTERED SHS P 2019-08-28 2021-02-04
UNILEVER PLC SPON AD R NEW P 2020-01-24 2021-04-21
VERIZON COMMUNICATIO NS INC COM P 2018-05-29 2021-02-04
CAPITAL GAINS DIVIDENDS P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 41,493   34,993 6,500
b 50,578   42,154 8,424
c 79,890   76,603 3,287
d 37,613   36,338 1,275
e 90,277   71,549 18,728
120,225   77,251 42,974
18,838   14,435 4,403
941   1,353 -412
865   1,169 -304
1,831   2,430 -599
1,445   1,942 -497
1,586   2,102 -516
17   17 0
3,948   3,940 8
45,382   50,037 -4,655
44,791   50,102 -5,311
85,056   94,150 -9,094
9,102   7,513 1,589
9,523   9,523 0
26,199   23,302 2,897
9,138   6,633 2,505
88,050   67,724 20,326
36,681   28,626 8,055
28,406   23,620 4,786
3,802   2,614 1,188
30,374   19,531 10,843
37,191   25,704 11,487
25,113   17,676 7,437
13,513   15,793 -2,280
13,890   13,392 498
36,772   32,387 4,385
42,823   36,492 6,331
6,579   5,597 982
34,294   23,324 10,970
23,273   14,657 8,616
28,756   18,470 10,286
28,705   17,464 11,241
6,733   4,518 2,215
32,143   22,312 9,831
60,918   43,652 17,266
31,151   28,966 2,185
17,976   14,301 3,675
11,215   9,499 1,716
9,082   6,818 2,264
12,107   11,294 813
54,349   48,159 6,190
23,130   23,189 -59
41,802   40,501 1,301
11,203   11,038 165
16,745   16,231 514
5   5 0
827   1,011 -184
4   5 -1
1,499   1,771 -272
4   5 -1
399   479 -80
4   5 -1
598   706 -108
43,535   41,064 2,471
58,900   49,079 9,821
13,383   12,014 1,369
9,180   8,288 892
14   16 -2
1,473   2,041 -568
2,008   2,458 -450
1,400   1,846 -446
4,821   4,350 471
4,355   3,974 381
39,622   31,511 8,111
5,042   4,116 926
34,947   28,047 6,900
14,931   10,744 4,187
117,123   57,475 59,648
39,947   27,504 12,443
33,289   23,535 9,754
9,685   6,880 2,805
79,178   63,023 16,155
21,563   18,831 2,732
28,983   25,426 3,557
11,313   9,397 1,916
26,838   22,248 4,590
29,825   24,167 5,658
7,346   5,220 2,126
69,070   51,401 17,669
15,853   11,517 4,336
89,195   52,862 36,333
20,040   16,852 3,188
28,838   23,450 5,388
36,378   29,093 7,285
9,904   8,346 1,558
42,061   30,737 11,324
41,316   26,907 14,409
6,707   4,147 2,560
30,957   22,365 8,592
10,647   7,147 3,500
32,543   13,956 18,587
9,793   11,609 -1,816
10,363   10,363 0
12,738   11,076 1,662
2,299     2,299
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       6,500
b       8,424
c       3,287
d       1,275
e       18,728
      42,974
      4,403
      -412
      -304
      -599
      -497
      -516
      0
      8
      -4,655
      -5,311
      -9,094
      1,589
      0
      2,897
      2,505
      20,326
      8,055
      4,786
      1,188
      10,843
      11,487
      7,437
      -2,280
      498
      4,385
      6,331
      982
      10,970
      8,616
      10,286
      11,241
      2,215
      9,831
      17,266
      2,185
      3,675
      1,716
      2,264
      813
      6,190
      -59
      1,301
      165
      514
      0
      -184
      -1
      -272
      -1
      -80
      -1
      -108
      2,471
      9,821
      1,369
      892
      -2
      -568
      -450
      -446
      471
      381
      8,111
      926
      6,900
      4,187
      59,648
      12,443
      9,754
      2,805
      16,155
      2,732
      3,557
      1,916
      4,590
      5,658
      2,126
      17,669
      4,336
      36,333
      3,188
      5,388
      7,285
      1,558
      11,324
      14,409
      2,560
      8,592
      3,500
      18,587
      -1,816
      0
      1,662
      2,299
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 2 526,103
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 13,218
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 13,218
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 6,357
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 9,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 15,357
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 13
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 2,126
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet2,126 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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletFL
    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 ofbulletLATHUN BRIGMAN Telephone no.bullet (904) 354-8533

    Located atbulletPO BOX 41430JACKSONVILLEFL ZIP+4bullet322031430
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    HANS FRISCH DIRECTOR
    0.00     		0 0 0
    POST OFFICE BOX 41430
    JACKSONVILLE,FL322031430
    BENJAMIN FRISCH DIRECTOR
    0.00     		0 0 0
    POST OFFICE BOX 41430
    JACKSONVILLE,FL322031430
    MARK FRISCH DIRECTOR
    0.00     		0 0 0
    POST OFFICE BOX 41430
    JACKSONVILLE,FL322031430
    ADAM FRISCH DIRECTOR
    0.00     		0 0 0
    POST OFFICE BOX 41430
    JACKSONVILLE,FL322031430
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    0
    b
    Average of monthly cash balances.......................
    1b
    11,413,494
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    11,413,494
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    11,413,494
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    171,202
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    11,242,292
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    562,115
    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
    562,115
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    13,218
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    13,218
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    548,897
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    548,897
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    548,897
    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 7 548,897
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 269,809
    b From 2017...... 112,270
    c From 2018...... 303,549
    d From 2019...... 236,591
    e From 2020...... 44,072
    f Total of lines 3a through e ........ 966,291
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 723,127
    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..... 548,897
    e Remaining amount distributed out of corpus 174,230
    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 1,140,521
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		269,809
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		870,712
    10 Analysis of line 9:
    a Excess from 2017.... 112,270
    b Excess from 2018.... 303,549
    c Excess from 2019.... 236,591
    d Excess from 2020.... 44,072
    e Excess from 2021.... 174,230
    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).)
    HANS FRISCH
    BENJAMIN FRISCH
    MARK FRISCH
    ADAM FRISCH
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    AMERICAN CANCER SOCIETY
    1430 PRUDENTIAL DRIVE
    JACKSONVILLE,FL32207     		    GENERAL CONTRIBUTION 150
    AMERICAN FRIENDS OF MAGEN DAVID ADOM
    3300 PGA BLVD SUITE 970
    PALM BEACH GARDENS,FL33410     		    GENERAL CONTRIBUTION 1,000
    AMERICAN RED CROSS
    751 RIVERSIDE AVENUE
    JACKSONVILLE,FL32204     		    GENERAL CONTRIBUTION 200
    AMERICAN SOCIETY FOR YAD VASHEM INC
    PO BOX 170305
    MILWAUKEE,WI53217     		    GENERAL CONTRIBUTION 300
    ANTI-DEFAMATION LEAGUE (ADL)
    621 NW 53RD STREET 450
    BOCA RATON,FL33487     		    GENERAL CONTRIBUTION 300
    B'NAI B'RITH INTERNATIONAL
    PO BOX 96729
    WASHINGTON,DC20090     		    GENERAL CONTRIBUTION 100
    CHABAD LUBAVITCH
    1760 EAGLE CREST DRIVE
    FLEMING ISLAND,FL32003     		    GENERAL CONTRIBUTION 12,000
    CHILDREN'S VILLAGE OF JERUSALEM
    15 BEEKMAN STREET
    NEW YORK,NY10273     		    GENERAL CONTRIBUTION 100
    CITY YEAR INC
    6 EAST BAY STREET 5TH FLOOR
    JACKSONVILLE,FL32202     		    GENERAL CONTRIBUTION 100,000
    COLEL CHABAD
    806 EASTERN PARKWAY
    BROOKLYN,NY11213     		    GENERAL CONTRIBUTION 100
    CONGREGATION AHAVATH CHESED
    8727 SAN JOSE BOULEVARD
    JACKSONVILLE,FL32217     		    GENERAL CONTRIBUTION 1,700
    CONGREGATION OHAVEI TORAH
    139 CAROL STREET
    LAKEWOOD,NJ08701     		    GENERAL CONTRIBUTION 600
    EIRGUN BARUCH U'MARPEH
    4718 EIGHTEENTH AVENUE SUITE 149
    BROOKLYN,NY11204     		    GENERAL CONTRIBUTION 200
    ETZ CHAIM SYNAGOGUE
    10167 SAN JOSE BOULEVARD
    JACKSONVILLE,FL32257     		    GENERAL CONTRIBUTION 10,000
    FLORIDA SHERIFF'S ASSOCIATION
    PO BOX 12519
    TALLAHASSEE,FL32317     		    GENERAL CONTRIBUTION 100
    GREAT CHARITY CHAYE OLAN OF JERUSALEN INC
    PO BOX 786
    NEW YORK,NY10273     		    GENERAL CONTRIBUTION 200
    HADASSAH
    TRUMP BLDG 40 WALL STREET
    NEW YORK,NY10005     		    GENERAL CONTRIBUTION 3,000
    HILLEL
    PO BOX 92994
    WASHINGTON,DC20001     		    GENERAL CONTRIBUTION 300
    JACKSONVILLE JAGUARS FOUNDATION INC
    ONE EVERBANK FIELD DRIVE
    JACKSONVILLE,FL32202     		    GENERAL CONTRIBUTION 85,000
    JACKSONVILLE JEWISH CENTER
    3662 CROWN POINT ROAD
    JACKSONVILLE,FL32257     		    GENERAL CONTRIBUTION 10,000
    JACKSONVILLE UNIVERSITY
    2800 UNIVERSITY BOULEVARD NORTH
    JACKSONVILLE,FL32211     		    GENERAL CONTRIBUTION 100,000
    JDRF NORTH FLORIDA CHAPTER
    9700 PHILLIPS HIGHWAY SUITE 106
    JACKSONVILLE,FL32256     		    GENERAL CONTRIBUTION 3,000
    JEWISH COMMUNITY ALLIANCE
    8505 SAN JOSE BOULEVARD
    JACKSONVILLE,FL32217     		    GENERAL CONTRIBUTION 110,472
    JEWISH FAMILY & COMMUNITY SERVICES
    6261 DUPONT STATION COURT E
    JACKSONVILLE,FL32217     		    GENERAL CONTRIBUTION 70,000
    JEWISH NATIONAL FUND
    4625 EAST BAY DRIVE 308
    CLEARWATER,FL33764     		    GENERAL CONTRIBUTION 10,000
    JUNIOR ACHIEVEMENT OF FLORIDA'S FIRST COAST INC
    4049 WOODCOCK DRIVE SUITE 200
    JACKSONVILLE,FL32207     		    GENERAL CONTRIBUTION 10,000
    MAYO CLINIC
    4500 SAN PABLO ROAD
    JACKSONVILLE,FL32224     		    GENERAL CONTRIBUTION 30,000
    MESIFTA BETH SHRAGA
    28 SADDLE RIVER ROAD
    MONSEY,NY10952     		    GENERAL CONTRIBUTION 200
    MUSCULAR DYSTROPHY ASSOCIATION
    7077 BONNEVAL ROAD SUITE 460
    JACKSONVILLE,FL32216     		    GENERAL CONTRIBUTION 100
    NATIONAL MULTIPLE SCLEROSIS SOCIETY
    PO BOX 41166
    JACKSONVILLE,FL32203     		    GENERAL CONTRIBUTION 100
    NER ISRAEL RABBINICAL COLLEGE
    400 MT WILSON LANE
    BALTIMORE,MD21208     		    GENERAL CONTRIBUTION 100
    ONEJAX
    1 UNF DRIVE
    JACKSONVILLE,FL32224     		    GENERAL CONTRIBUTION 5,000
    PARALYZED VETERANS OF AMERICA
    PO BOX 758532
    TOPEKA,KS66675     		    GENERAL CONTRIBUTION 100
    PARKINSONS FOUNDATION
    PO BOX 6003
    ALBER LEA,MN56007     		    GENERAL CONTRIBUTION 100
    RIVER GARDEN FOUNDATION
    11401 OLD ST AUGUSTINE RD
    JACKSONVILLE,FL32258     		    GENERAL CONTRIBUTION 30,000
    RODEHEAVER BOYS RANCH INC
    380 BOYS RANCH ROAD
    PALATKA,FL32177     		    GENERAL CONTRIBUTION 200
    SAFE ANIMAL SHELTER
    2913 COUNTY ROAD 220
    MIDDLEBURG,FL32068     		    GENERAL CONTRIBUTION 500
    SENIORS ON A MISSION
    2050 ART MUSEUM DRIVE SUITE 102
    JACKSONVILLE,FL32207     		    GENERAL CONTRIBUTION 1,000
    ST JOSEPH'S INDIAN SCHOOL
    PO BOX 200
    CHAMBERLAIN,SD57326     		    GENERAL CONTRIBUTION 250
    ST VINCENT'S HEALTHCARE FOUNDATION
    PO BOX 41564
    JACKSONVILLE,FL32203     		    GENERAL CONTRIBUTION 25,000
    TELSHE YESHIVA
    28400 EUCLID AVENUE
    WICKLIFFE,OH44092     		    GENERAL CONTRIBUTION 180
    THE ISRAEL YOUTH VILLAGE
    770 EASTERN PARKWAY
    BROOKLYN,NY11213     		    GENERAL CONTRIBUTION 150
    TOM COUGHLIN JAY FUND FOUNDATION
    PO BOX 50798
    JACKSONVILLE BEACH,FL32240     		    GENERAL CONTRIBUTION 7,500
    TORAH ACADEMY OF JACKSONVILLE
    10167 SAN JOSE BOULEVARD
    JACKSONVILLE,FL32257     		    GENERAL CONTRIBUTION 5,000
    UNITED TIBERIAS INSTITUTIONS
    PO BOX 576
    NEW YORK,NY10002     		    GENERAL CONTRIBUTION 200
    WORLD JEWISH CONGRESS
    PO BOX 90400
    WASHINGTON,DC20090     		    GENERAL CONTRIBUTION 500
    BAPTIST HEALTH FOUNDATION
    800 PRUDENTIAL DRIVE
    JACKSONVILLE,FL32207     		    GENERAL CONTRIBUTION 40,000
    FLORIDA COUNSEL ON ECONOMIC EDUCATION
    501 S DAKOTA AVE UNIT 1
    TAMPA,FL33606     		    GENERAL CONTRIBUTION 1,000
    JACKSONVILLE JEWISH FEDERATION
    8505 SAN JOSE BOULEVARD
    JACKSONVILLE,FL32217     		    GENERAL CONTRIBUTION 40,000
    WOLFSON CHILDREN'S HOSPITAL
    1325 SAN MARCO BLVD SUITE 802
    JACKSONVILLE,FL32207     		    GENERAL CONTRIBUTION 2,125
    READ USA
    1001 MAYPORT ROAD 330491
    ATLANTIC BEACH,FL32233     		    GENERAL CONTRIBUTION 5,000
    Total .................................bullet 3a 723,127
    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 ...........     		    14 405  
    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 ............     		    18 526,103  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 967,447 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    967,447
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


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

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

    59-2714980
    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
    BEAVER STREET FOUNDATION INC
          		Employer identification number
    59-2714980
    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
    BEAVER STREET FINANCING INC AND SUBSIDIARIES
     
    1741 WEST BEAVER STREET
     
    JACKSONVILLE, FL32209

    		$ 500,000


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

    		$  


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

    		$  


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

    		$  


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

    		$  


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

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    BEAVER STREET FOUNDATION INC
          		Employer identification number

    59-2714980
    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
    BEAVER STREET FOUNDATION INC
          		Employer identification number

    59-2714980
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 OtherAssetsSchedule
    Name:
    BEAVER STREET FOUNDATION INC
    EIN:
    59-2714980
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    DIVIDENDS IN TRANSIT 11,700 226,821  


    TY 2021 OtherExpensesSchedule
    Name:
    BEAVER STREET FOUNDATION INC
    EIN:
    59-2714980
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CORPORATE FILING FEE 61 0   0


    TY 2021 TaxesSchedule
    Name:
    BEAVER STREET FOUNDATION INC
    EIN:
    59-2714980
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 9,520 9,520   0
    FEDERAL TAXES 7,000 7,000   0