TY 2021 Form 990PF

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	116,296
3	Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
	If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 ...................	3

1a	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2	Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	2	0
3	Add lines 1 and 2...........................	3	1,619
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	1,619
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	0
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	1,620
d	Backup withholding erroneously withheld ...........	6d	0

7	Total credits and payments. Add lines 6a through 6d..............	7	1,620
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.	8	5
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......	9	4
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...	10
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax	Refunded	11

(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
DAVID D DORTCH	PRESIDENT 2.00	0	0	0
2900 TYNE BLVD NASHVILLE,TN37215
BETH FRANKLIN	SECRETARY 2.00	0	0	0
2900 TYNE BLVD NASHVILLE,TN37215

3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient	If recipient is an individual, show any relationship to any foundation manager or substantial contributor	Foundation status of recipient	Purpose of grant or contribution	Amount
Name and address (home or business)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
A THOUSAND HILLS 7113 CHARLOTTE PIKE NASHVILLE,TN37209			TO FURTHER CHARITABLE PURPOSE	100
AFB 1401 SOUTH CLARK STREET SUITE 730 ARLINGTON,VA22202			TO FURTHER CHARITABLE PURPOSE	100
AID FOR STAGGERING CHILDDREN PO BOX 2156 WINDSOR,CA95492			TO FURTHER CHARITABLE PURPOSE	100
AID TO THE CHURCH FOR NEED 725 LEONARD STREET PO BOX 220384 BROOKLYN,NY11222			TO FURTHER CHARITABLE PURPOSE	100
ALZHEIMERS ASSN 225 N MICHIGAN AVE FL 17 CHICAGO,IL60601			TO FURTHER CHARITABLE PURPOSE	100
AMERICA NEEDS FATHERS PO BOX 341 HANOVER,PA17331			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN AUTISM FUND 1800 JOHNSON STREET BALTIMORE,MD21230			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN CANCER SOCIETY 3380 CHASTAIN MEADOWS PKWY NW SUITE 200 KENNESAW,GA30144			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN DIABETES ASSOCIATION 2451 CRYSTAL DRIVE SUITE 900 ARLINGTON,VA22202			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN FOUNDATION FOR THE BLIND 1800 JOHNSON STREET BALTIMORE,MD21230			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS,TX75231			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN KIDNEY FUND 11921 ROCKVILLE PIKE SUITE 300 ROCKVILLE,ND20852			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN LEPROSY MISSIONS ONE ALM WAY GREENVILLE,SC29601			TO FURTHER CHARITABLE PURPOSE	200
AMERICAN PARKINSON DISEASE 55 W WACKER DRIVE SUITE 1150 CHICAGO,IL60601			TO FURTHER CHARITABLE PURPOSE	100
AMERICAN LUNG 55 W WACKER DRIVE SUITE 1150 CHICAGO,IL60601			TO FURTHER CHARITABLE PURPOSE	100
ANNFOR 120 WALL STREET 13TH FLOOR NEW YORK,NY10005			TO FURTHER CHARITABLE PURPOSE	100
APPALACHIA SERVICE PROJECT 4523 BRISTOL HIGHWAY JOHNSON CITY,TN37601			TO FURTHER CHARITABLE PURPOSE	100
ARSELK FRASER PO BOX 2571 ROUND ROCK,TX78680			TO FURTHER CHARITABLE PURPOSE	500
ARTHRITIS FOUNDATION 1355 PEACHTREE ST NE SUITE 600 ATLANTA,GA30309			TO FURTHER CHARITABLE PURPOSE	100
ASSN OF MARIAN HELPERS EDEN HILL STOCKBRIDGE,MA01263			TO FURTHER CHARITABLE PURPOSE	100
AUTISM SPEAKS 1060 STATE ROAD 2ND FLOOR PRINCETON,NJ08540			TO FURTHER CHARITABLE PURPOSE	100
B MISSION HOUSE 1123 ROAD I SCHUYLER,NE68661			TO FURTHER CHARITABLE PURPOSE	100
BENEDICTION MONDO 736 OLD HICKORY BLVD NASHVILLE,TN37209			TO FURTHER CHARITABLE PURPOSE	100
BETHANY CHRISTIAN SERVICES 230 GREAT CIRCLE 229 NASHVILLE,TN37228			TO FURTHER CHARITABLE PURPOSE	100
BLINDED VETERANS ASSN PO BOX 90770 WASHINGTON,DC20090			TO FURTHER CHARITABLE PURPOSE	100
BOYS AND GIRLS CLUB 1275 PEACHTREE STREET NE ATLANTA,GA30309			TO FURTHER CHARITABLE PURPOSE	100
BOYS RANCH 14100 CRAWFORD ST BOYS TOWN,NE68010			TO FURTHER CHARITABLE PURPOSE	100
BOY'S TOWN 14100 CRAWFORD ST BOYS TOWN,NE68010			TO FURTHER CHARITABLE PURPOSE	100
BREAD AND WATER FOR AFRICA 8301 RICHMOND HIGHWAY SUITE 300 ALEXANDRIA,VA22309			TO FURTHER CHARITABLE PURPOSE	100
BREAD FOR THE WORLD 425 3RD STREET SW SUITE 1200 WASHINGTON,DC20024			TO FURTHER CHARITABLE PURPOSE	100
BUCKMAN INTL PO BOX 390966 MOUNTAIN VIEW,CA94039			TO FURTHER CHARITABLE PURPOSE	100
CRS 228 W LEXINGTON ST BALTIMORE,MD21201			TO FURTHER CHARITABLE PURPOSE	100
CAMM 5284 CROSS CREEK COURT ACWORTH,GA30102			TO FURTHER CHARITABLE PURPOSE	100
CAPACHINO FRANCISCAN FRIARS 1345 CORTEZ AVE BURLINGAME,CA94010			TO FURTHER CHARITABLE PURPOSE	100
CARMEL OF JMJ 327 WATER STREET FAIRFIELD,PA17320			TO FURTHER CHARITABLE PURPOSE	100
CATHOLIC BISHOP OF NORTH ALASKA 1316 PEGER ROAD FAIRBANKS,AK99709			TO FURTHER CHARITABLE PURPOSE	100
CHECK PAID 2806 MCGAVOCK PK NASHVILLE,TN37214			TO FURTHER CHARITABLE PURPOSE	300
CHILDRENS CANCER RESEARCH 7301 OHMS LANE SUITE 355 MINNEAPOLIS,MN55439			TO FURTHER CHARITABLE PURPOSE	100
CONSUMER REPORTS 101 TRUMAN AVE YONKERS,NY10703			TO FURTHER CHARITABLE PURPOSE	100
CORE 100 LAKE HART DRIVE ORLANDO,FL32832			TO FURTHER CHARITABLE PURPOSE	100
CUMBERLAND HEIGHTS 8283 RIVER ROAD PIKE NASHVILLE,TN37209			TO FURTHER CHARITABLE PURPOSE	100
DHONORS 6301 19TH AVE NW MINOT,ND58702			TO FURTHER CHARITABLE PURPOSE	100
DAYSPRING INTERNATIONAL PO BOX 3309 VIRGINIA BEACH,VA23454			TO FURTHER CHARITABLE PURPOSE	100
DOCTORS WITHOUT BORDERS 40 RECTOR STREET 16TH FLOOR NEW YORK,NY10006			TO FURTHER CHARITABLE PURPOSE	100
DOMINICAN FOUNDATION 141 EAST 65TH STREET NEW YORK,NY10065			TO FURTHER CHARITABLE PURPOSE	100
DOMINICAN SISTERS OF HOPE 299 N HIGHLAND AVE OSSINING,NY10562			TO FURTHER CHARITABLE PURPOSE	100
DOMINICAN SISTERS OF MARY 4597 WARREN ROAD ANN ARBOR,MI48105			TO FURTHER CHARITABLE PURPOSE	100
DOMINICAN SISTERS OF SPARKILL 175 NY-340 SPARKILL,NY10976			TO FURTHER CHARITABLE PURPOSE	100
DOMINICAN SISTERS OF ST CECILIA 500 WILSON PIKE CIRCLE SUITE 228 BRENTWOOD,TN37207			TO FURTHER CHARITABLE PURPOSE	100
EWTN 5817 OLD LEEDS ROAD IRONDALE,AL35210			TO FURTHER CHARITABLE PURPOSE	200
ECELSIDE FRIENDS FOR VOCATIONS 3540 CAIN HIGHWAY SUITE 675 BOWIE,MD20716			TO FURTHER CHARITABLE PURPOSE	100
EDMUNDITE MISSIONS 1428 BROAD STREET SELMA,AL36701			TO FURTHER CHARITABLE PURPOSE	100
EPILEPSY FOUNDATION PO BOX 2323 SANTA CRUZ,CA95063			TO FURTHER CHARITABLE PURPOSE	100
ESCTERADO 530 E IRELAND ROAD SOUTH BEND,IN46614			TO FURTHER CHARITABLE PURPOSE	100
EWTN 530 E IRELAND ROAD SOUTH BEND,IN46614			TO FURTHER CHARITABLE PURPOSE	100
FSDB 530 E IRELAND ROAD SOUTH BEND,IN46614			TO FURTHER CHARITABLE PURPOSE	100
FEED THE CHILDREN 310 TECH PARK DR LA VERGNE,TN37086			TO FURTHER CHARITABLE PURPOSE	100
FEED THE HUNGRY 530 E IRELAND ROAD SOUTH BEND,IN46614			TO FURTHER CHARITABLE PURPOSE	100
FLA SHERRIFS YOUTH RANCHERO PO BOX 17408 DENVER,CO80217			TO FURTHER CHARITABLE PURPOSE	100
FOOD FOR THE POOR 6401 LYONS ROAD COCONUT CREEK,FL33073			TO FURTHER CHARITABLE PURPOSE	100
FORMATION FOUNDATION 6925 OAKLAND MILLS ROAD 701 COLUMBIA,MD21045			TO FURTHER CHARITABLE PURPOSE	100
FRANCISCAN MISSIONS 1400 QUINCY ST NE WASHINGTON,DC20017			TO FURTHER CHARITABLE PURPOSE	100
FRANCISCAN MONASTERY 1400 QUINCY ST NE WASHINGTON,DC20017			TO FURTHER CHARITABLE PURPOSE	100
FREDI AMERICA 104 CHANNING AVENUE MALVERN,PA19355			TO FURTHER CHARITABLE PURPOSE	100
FT MYERS RESCUE MISSION 6900 MISSION LN FORT MEYERS,FL33916			TO FURTHER CHARITABLE PURPOSE	100
GLA FOUNDATION 4119 GLENMARY TRACE FAIRFIELD,OH45014			TO FURTHER CHARITABLE PURPOSE	100
GRACE PLACE 4316 CENTRAL PIKE HERMITAGE,TN37076			TO FURTHER CHARITABLE PURPOSE	100
GUADALUPE CENTER 509 HOPE CIRCLE IMMOKALEE,FL34142			TO FURTHER CHARITABLE PURPOSE	100
GUEST HOUSE 1601 JOSLYN ROAD LAKE ORION,MI48360			TO FURTHER CHARITABLE PURPOSE	100
HABITAT FOR HUMANITY 414 HARDING PLACE SUITE 100 NASHVILLE NASHVILLE,TN37211			TO FURTHER CHARITABLE PURPOSE	100
HEARTBEAT INTERNATINOAL 8405 PULSAR PLACE COLUMBUS,OH43240			TO FURTHER CHARITABLE PURPOSE	100
HEIFEN INTERNATIONAL 267 KENTLANDS BLVD UNIT 600 GAITHERSBURG,MD20878			TO FURTHER CHARITABLE PURPOSE	100
HIAS 937 BLACKFORD STREET CHATTANOOGA,TN37403			TO FURTHER CHARITABLE PURPOSE	100
HOLY TRINITY MEETING 1800 ORLEANS STEET BALTIMORE,MD21287			TO FURTHER CHARITABLE PURPOSE	100
HOME FOR THE BOYS 6 MAIN STREET TAUNTON,MA02780			TO FURTHER CHARITABLE PURPOSE	100
HONOR OF ST MARY OF THE LASE 4 QUENTIN ROAD KENDELL PARK,NJ08824			TO FURTHER CHARITABLE PURPOSE	100
HUGS FOR BRADY 4 QUENTIN ROAD KENDELL PARK,NJ08824			TO FURTHER CHARITABLE PURPOSE	100
ICF 2505 N AVENUE NATIONAL CITY,CA91950			TO FURTHER CHARITABLE PURPOSE	100
IEF INTL PO BOX 6068 ALBERT LEA,MN56007			TO FURTHER CHARITABLE PURPOSE	100
JDRF 200 VESEY STREET 28TH FLOOR NEW YORK,NY10281			TO FURTHER CHARITABLE PURPOSE	100
JOHN HOPKINS ALL CHILDRENDS FOUNDATION 501 6TH AVENUE SOUTH ST PETERSBURG,FL33701			TO FURTHER CHARITABLE PURPOSE	100
LEGUMMO OF CHRIST 30 MANSELL COURT SUITE 103 ROSWELL,GA30076			TO FURTHER CHARITABLE PURPOSE	100
MA DEP RESEARCH 375 KINGS HIGHWAY NORTH CHERRY HILL,NJ08034			TO FURTHER CHARITABLE PURPOSE	100
MAJINE TREJO FOR IODT 4700 GLYNCO PARKWAY BRUNSWICK,GA31525			TO FURTHER CHARITABLE PURPOSE	100
MARCH OF DIMES PO BOX 18819 ATLANTA,GA31126			TO FURTHER CHARITABLE PURPOSE	100
MARRIONET MISSION MOUNT SAINT JOHN PO BOX 340998 DAYTON,OH45434			TO FURTHER CHARITABLE PURPOSE	100
MARY QUEEN OF ANGELS 34 WHITE BRIDGE ROAD NASHVILLE,TN37205			TO FURTHER CHARITABLE PURPOSE	9,400
MARY QUEEN OF THE THIRD MILLENIUM PO BOX 832347 MIAMI,FL33283			TO FURTHER CHARITABLE PURPOSE	100
MARYKNOLL FATHERS & BROTHERS PO BOX 306 MARYKNOLL,NY10545			TO FURTHER CHARITABLE PURPOSE	100
MARYKNOLL SISTERS PO BOX 306 MARYKNOLL,NY10545			TO FURTHER CHARITABLE PURPOSE	100
MAYO MISSION 200 FIRST ST SW ROCHESTER,MN55905			TO FURTHER CHARITABLE PURPOSE	100
MD ANDERSON CANCER CENTER 1515 HOLCOMBE BLVD HOUSTON,TX77030			TO FURTHER CHARITABLE PURPOSE	100
MDA 1515 HOLCOMBE BLVD HOUSTON,TX77030			TO FURTHER CHARITABLE PURPOSE	100
MEMORIAL SLOAN KETTERING 633 PENNSYLVANIA AVE NW WASHINGTON,DC20004			TO FURTHER CHARITABLE PURPOSE	100
MERCY CORP PO BOX 37800 BOONE,IA50037			TO FURTHER CHARITABLE PURPOSE	100
MERCY HOME FOR BOYS & GIRLS 11140 W JACKSON BLVD CHICAGO,IL60607			TO FURTHER CHARITABLE PURPOSE	100
MERCY SHIPS PO BOX 2020 GARDEN VALLEY,TX75771			TO FURTHER CHARITABLE PURPOSE	100
MIC 11140 W JACKSON BLVD CHICAGO,IL60607			TO FURTHER CHARITABLE PURPOSE	100
MINISTRIES OF THE SACRED HEART PO BOX 280 2000 W GALENA BLVD SUITE 205 AURORA,IL60507			TO FURTHER CHARITABLE PURPOSE	100
MISSION FIRST 4651 25TH STREET NORTH ARLINGTON,VA22207			TO FURTHER CHARITABLE PURPOSE	100
MISSION TRIPS FOR TOTS PO BOX 967 ELMER,NJ08318			TO FURTHER CHARITABLE PURPOSE	100
MISSIONARY SISTERS OF MARY IMMACULATE PO BOX 967 ELMER,NJ08318			TO FURTHER CHARITABLE PURPOSE	100
MONROE HARDING 1 VANTAGE WAY SUITE C-165 NASHVILLE,TN37228			TO FURTHER CHARITABLE PURPOSE	100
MSAA 375 KINGS HIGHWAY NORTH CHERRY HILL,NJ08034			TO FURTHER CHARITABLE PURPOSE	100
NAMI 4031 WILSON BLVD SUITE 300 ARLINGTON,VA22203			TO FURTHER CHARITABLE PURPOSE	100
NAVA PO BOX 55071 58049 BOSTON,MA02205			TO FURTHER CHARITABLE PURPOSE	100
NBCRC 4080 EAST PLEASANT VALLEY BOULEVARD ALTOONA,PA16601			TO FURTHER CHARITABLE PURPOSE	100
NCCS 500 NORTH BROADWAY SUITE 1850 ST LOUIS,MO63102			TO FURTHER CHARITABLE PURPOSE	100
NCH CENTER 3040 W SALT CREEK LANE ARLINGTON HEIGHTS,IL60005			TO FURTHER CHARITABLE PURPOSE	100
NCMFC 333 JOHN CARLYLE STREET SUITE 125 ALEXANDRIA,VA22314			TO FURTHER CHARITABLE PURPOSE	100
NDF 1429 S RAMPART STREET NEW ORLEANS,LA70113			TO FURTHER CHARITABLE PURPOSE	100
NOF 1429 S RAMPART STREET NEW ORLEANS,LA70113			TO FURTHER CHARITABLE PURPOSE	100
NATIONAL FEDERATION OF THE BLIND 200 EAST WELLS STREETAT JERNIGAN PLACE BALTIMORE,MD21230			TO FURTHER CHARITABLE PURPOSE	100
NATIONAL POLICE ASSOCIATION 205 W MONROE ST CHICAGO,IL60606			TO FURTHER CHARITABLE PURPOSE	100
NATIONAL SHRINE 400 MICHIGAN AVENUE NORTHEAST WASHINGTON,DC20017			TO FURTHER CHARITABLE PURPOSE	100
NATIVE AMERICAN CHILDRENS FUND PO BOX 25 SAPULPA,OK74067			TO FURTHER CHARITABLE PURPOSE	100
NATL FEDERATION OF THE BLIND 200 EAST WELLS STREETAT JERNIGAN PLACE BALTIMORE,MD21230			TO FURTHER CHARITABLE PURPOSE	100
NATL SHRINE ST JUDE 205 W MONROE ST CHICAGO,IL60606			TO FURTHER CHARITABLE PURPOSE	100
NEIGHBORHOOD HEALTH CLINIC 88 12TH STREET NORTH SUITE 100 NAPLES,FL34102			TO FURTHER CHARITABLE PURPOSE	100
NEW OF MELIADEK PO BOX 5053 PINE RIDGE,SD57770			TO FURTHER CHARITABLE PURPOSE	100
NO KID HUNGRY 1030 15TH STREET NW SUITE 1100W WASHINGTON,DC20005			TO FURTHER CHARITABLE PURPOSE	200
OLV CHARITIES 810 NEEB RD CINCINNATI,OH45233			TO FURTHER CHARITABLE PURPOSE	100
OPUS BONO SACERDATION PO BOX 251 DRYDEN,MI48428			TO FURTHER CHARITABLE PURPOSE	100
ORBIS 520 8TH AVENUE 12TH FLOOR NEW YORK,NY10018			TO FURTHER CHARITABLE PURPOSE	100
ORDER OF FRIAR SORRENTO OF MARY 1439 HARLEM AVE BERWYN,IL60402			TO FURTHER CHARITABLE PURPOSE	100
OUR LADY OF LOURDES 4210 HARDING PIKE NASHVILLE,TN37205			TO FURTHER CHARITABLE PURPOSE	1,000
OZARK SISTERS OF ST FRANIS DE SELLA 4210 HARDING PIKE NASHVILLE,TN37205			TO FURTHER CHARITABLE PURPOSE	200
PWNA PO BOX 447 BELLEVUE,OH44811			TO FURTHER CHARITABLE PURPOSE	100
PA FOUNDATION 463 MAIN STREET CROMWELL,CT06416			TO FURTHER CHARITABLE PURPOSE	100
PARKINSON'S FOUNDATION 1359 BROADWAY STE 1509 NEW YORK,NY10018			TO FURTHER CHARITABLE PURPOSE	100
PARTNERS IN HEALTH 800 BOYLSTON STREET SUITE 300 BOSTON,MA02199			TO FURTHER CHARITABLE PURPOSE	100
PATH EARLY EDUCATION 415 COLORADO AVENUE IMMOKALEE,FL34142			TO FURTHER CHARITABLE PURPOSE	100
PERKINS SCHOOL FOR THE BLIND 175 NORTH BEACON STREET WATERTOWN,MA02472			TO FURTHER CHARITABLE PURPOSE	100
PONTIFICIAL NATIVE AMERICAN COLLEGE 3211 4TH STREET NE WASHINGTON,DC20017			TO FURTHER CHARITABLE PURPOSE	100
POOR CLAUS 4200 NORTH MARKET AVENUE CANTON,OH44714			TO FURTHER CHARITABLE PURPOSE	100
PRIESTS OF THE SACRED HEART PO BOX 900 HALES CORNERS,WA53130			TO FURTHER CHARITABLE PURPOSE	100
PRIORITY FRATERNITY OF ST PETER 450 VENARD ROAD SOUTH ABINGTON TOWNSHI,PA18411			TO FURTHER CHARITABLE PURPOSE	100
PRIORY FELLOWSHIP PO BOX 1550 MERRIFIELD,VA22116			TO FURTHER CHARITABLE PURPOSE	100
PROJECT HOPE 1220 19TH STREET NW ST 800 WASHINGTON,DC20036			TO FURTHER CHARITABLE PURPOSE	100
PROVENT BLIND 225 WEST WACKER DRIVE SUITE 400 CHICAGO,IL60606			TO FURTHER CHARITABLE PURPOSE	100
PROVIDENCE HOUSE 1250 FOURTH STREET SANTA MONICA,CA90401			TO FURTHER CHARITABLE PURPOSE	100
PROVINCE OF ST MARY 30 GEDNEY PARK DRIVE WHITE PLAINS,NY10605			TO FURTHER CHARITABLE PURPOSE	100
RMHC 110 NORTH CARPENTER STREET CHICAGO,IL60607			TO FURTHER CHARITABLE PURPOSE	100
RED CLOUD INDIAN SCHOOL 100 MISSION DRIVE PINE RIDGE,SD57770			TO FURTHER CHARITABLE PURPOSE	100
S MISSIONS 2 LEFEVRE LANE NEW ROCHELLE,NY10801			TO FURTHER CHARITABLE PURPOSE	100
SDVP PO BOX 9130 PITTSBURG,PA15224			TO FURTHER CHARITABLE PURPOSE	100
SMHC 331 GREAT CIRCLE ROAD NASHVILLE,TN37228			TO FURTHER CHARITABLE PURPOSE	100
SOS CHILDRENS VILLAGES 1735 N HI MOUNT BLVD MILWAUKEE,WI53208			TO FURTHER CHARITABLE PURPOSE	100
SWRA 1735 N HI MOUNT BLVD MILWAUKEE,WI53208			TO FURTHER CHARITABLE PURPOSE	100
SACRED HEART SOUTHERN MESSINI 6050 HWY 161 WALLS,MS38680			TO FURTHER CHARITABLE PURPOSE	100
SALVATORIANO 1735 N HI MOUNT BLVD MILWAUKEE,WI53208			TO FURTHER CHARITABLE PURPOSE	100
SAMARITAN'S PURSE PO BOX 3000 BOONE,NC28607			TO FURTHER CHARITABLE PURPOSE	100
SECOND HARVEST FOOD BANK 331 GREAT CIRCLE ROAD NASHVILLE,TN37228			TO FURTHER CHARITABLE PURPOSE	100
SERAPHIC MASS ASSN PO BOX 9130 PITTSBURG,PA15224			TO FURTHER CHARITABLE PURPOSE	100
SERVANTS OF MARY 6601 IRELAND ROAD WINDSOR,OH44099			TO FURTHER CHARITABLE PURPOSE	100
SHRINE OF ST PIO 2900 ROCKY POINT DRIVE TAMPA,FL33607			TO FURTHER CHARITABLE PURPOSE	100
SISTERS OF CHARITY 54 W MAIN ST BALTIC,CT06330			TO FURTHER CHARITABLE PURPOSE	100
SISTERS OF NOTRE DAME DE NAMAR 3912 SUNFOREST COURT SUITE B TOLEDO,OH43623			TO FURTHER CHARITABLE PURPOSE	100
SISTERS OF ST JOSEPH 802 E 10TH ST FERDINAND,IN47532			TO FURTHER CHARITABLE PURPOSE	100
SISTERS OF ST FRANCIS OF ASSISI 3221 S LAKE DRIVE SAINT FRANCIS,WI53235			TO FURTHER CHARITABLE PURPOSE	100
SISTERS SHRINE 3430 ROCKY RIVER DRIVE CLEVELAND,OH44111			TO FURTHER CHARITABLE PURPOSE	100
SLOAN KETTERING 1275 YORK AVENUE NEW YORK,NY10065			TO FURTHER CHARITABLE PURPOSE	100
SMILE TRAIN 633 THIRD AVENUE 9TH FLOOR NEW YORK,NY10017			TO FURTHER CHARITABLE PURPOSE	100
SOARING EAGLE PO DRAWER 879 BILLINGS,MT59103			TO FURTHER CHARITABLE PURPOSE	100
SOLES AND SMILES 319 MARTINGALE DRIVE OLD HICKORY,TN37138			TO FURTHER CHARITABLE PURPOSE	100
SPIRITS OF THE LATTE FLOWER 1313 N FRONTAGE ROAD DARIEN,IL60561			TO FURTHER CHARITABLE PURPOSE	100
ST LAWRENCE DENNING 301 CHURCH STREET MT CALVARY,WI53057			TO FURTHER CHARITABLE PURPOSE	100
ST LUKE 8380 COLESVILLE RD STE 300 SILVER SPRING,MD20910			TO FURTHER CHARITABLE PURPOSE	100
ST ANN'S 104 ACADEMY STREET MANLIUS,NY13104			TO FURTHER CHARITABLE PURPOSE	1,700
ST BONAVENTURE INDIAN MISSION 25 NAVARRE BLVD W THOREAU,NM87323			TO FURTHER CHARITABLE PURPOSE	100
ST JOHN OF GOD 44 TEMPLE STREET WORCHESTER,MA01604			TO FURTHER CHARITABLE PURPOSE	100
ST JOHN'S ANNEP 10955 SE 25TH AVE MILWAUKIE,OR97222			TO FURTHER CHARITABLE PURPOSE	100
ST JOSEPH 1301 NORTH MAIN STREET CHAMBERLAIN,SD57325			TO FURTHER CHARITABLE PURPOSE	100
ST JOSEPH'S INDIAN SCHOOL 1301 NORTH MAIN STREET CHAMBERLAIN,SD57325			TO FURTHER CHARITABLE PURPOSE	100
ST JUDE SHRINE 205 W MONROE ST CHICAGO,IL60606			TO FURTHER CHARITABLE PURPOSE	100
ST JUDE'S CHILDRENS HOSPITAL 262 DANNY THOMAS PLACE MEMPHIS,TN38105			TO FURTHER CHARITABLE PURPOSE	100
ST LABRE INDIAN SCHOOL ST LABRE INDIAN SCHOOL ASHLAND,MT59004			TO FURTHER CHARITABLE PURPOSE	100
ST MARYS FOUNDATION FOR CHILDREN 25437 NARBONNE AVE STE A LOMITA,CA90717			TO FURTHER CHARITABLE PURPOSE	100
ST MARY'S MISSIONO 15272 ST MARYS MISSION ROAD RED LAKE,MN56671			TO FURTHER CHARITABLE PURPOSE	200
ST MATTHEW'S HOUSE 2001 AIRPORT ROAD S NAPLES,FL34112			TO FURTHER CHARITABLE PURPOSE	100
ST VINCENT DE PAUL 13400 LORAIN AVENUE CLEVELAND,OH44111			TO FURTHER CHARITABLE PURPOSE	1,500
ST WILLIAMS 620 ROUND ROCK W DRIVE ROUND ROCK,TX78681			TO FURTHER CHARITABLE PURPOSE	1,400
SUSAN G KOMEN 13770 NOEL ROAD SUITE 801889 DALLAS,TX75380			TO FURTHER CHARITABLE PURPOSE	100
THE AMERICAN LEGION 1740 EASTCHESTER ROAD BRONX,NY10461			TO FURTHER CHARITABLE PURPOSE	100
THE CCETNER 453 JOHN LEWIS FREEDOM PARKWAY NE ATLANTA,GA30307			TO FURTHER CHARITABLE PURPOSE	100
THE JOSEPHITES PO BOX 65010 BALTIMORE,MD21209			TO FURTHER CHARITABLE PURPOSE	100
THE MARIST BROTHERS PO BOX 6000 COLORADO SPRINGS,CO80934			TO FURTHER CHARITABLE PURPOSE	100
THE PASSIONISTS 86-45 EDGERTON BLVD JAMAICA,NY11432			TO FURTHER CHARITABLE PURPOSE	100
THE SERVING EYE PO BOX 375 MORRISTOWN,NJ07963			TO FURTHER CHARITABLE PURPOSE	100
VOYA 5300 ANGELES VISTA BOULEVARD LOS ANGELES,CA90043			TO FURTHER CHARITABLE PURPOSE	100
WAYFAIR FAMILY SERVICES 5300 ANGELES VISTA BOULEVARD LOS ANGELES,CA90043			TO FURTHER CHARITABLE PURPOSE	100
WORLD VILLAGES FOR CHILDREN 4200 PARLIAMENT PLACE SUITE 230 LANHAM,MD20706			TO FURTHER CHARITABLE PURPOSE	100
WOUNDED WARRIOR PROJECT 1725 EYE STREET NW SUITE 510 WASHINGTON,DC20006			TO FURTHER CHARITABLE PURPOSE	100
XAVIER SECURITY FOR THE BLIND 248 WEST 35TH STREET SUITE 1502 NEW YORK,NY10001			TO FURTHER CHARITABLE PURPOSE	200
Total ................................. 3a				35,100

	Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)	(a) Revenue and expenses per books		(b) Net investment income	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)	166,522
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...	193		193
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		-813
b	Gross sales price for all assets on line 6a 165,710
7	Capital gain net income (from Part IV, line 2)...			116,296
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........	165,902		116,489
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)....		1,500	0	1,500
17	Interest...............
18	Taxes (attach schedule) (see instructions)...
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		25	0	25
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	1,525		0	1,525
25	Contributions, gifts, grants paid.......	35,100			35,100
26	Total expenses and disbursements. Add lines 24 and 25	36,625		0	36,625
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	129,277
b	Net investment income (if negative, enter -0-)			116,489
c	Adjusted net income (if negative, enter -0-)...

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	24,104	153,381	153,381
	2	Savings and temporary cash investments.........
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....	333	333	333
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	90,240	90,240	90,240
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	114,677	243,954	243,954
	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 )
	23	Total liabilities (add lines 17 through 22).........	0	0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	1,000	1,000
	27	Paid-in or capital surplus, or land, bldg., and equipment fund	465,881	465,881
	28	Retained earnings, accumulated income, endowment, or other funds	-352,204	-222,927
	29	Total net assets or fund balances (see instructions).....	114,677	243,954
	30	Total liabilities and net assets/fund balances (see instructions).	114,677	243,954

(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	AMERICAN WATER WORKS/COMPANY, INC.	D	2013-11-14	2021-03-26
b
c
d
e

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	165,710	49,414	116,296
b
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			116,296
b
c
d
e


(a) Name and address of each employee paid more than $50,000	(b) Title, and average hours per week devoted to position	(c) Compensation	(d) Contributions to employee benefit plans and deferred compensation	(e) Expense account, other allowances
NONE









Total number of other employees paid over $50,000...................				0

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

		(a) Corpus	(b) Years prior to 2020	(c) 2020	(d) 2021
1 Distributable amount for 2021 from Part X, line 7					9,569
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......	96,623
b From 2017......	82,759
c From 2018......	109,961
d From 2019......	96,520
e From 2020......	91,583
f Total of lines 3a through e ........		477,446
4Qualifying distributions for 2021 from Part
XI, line 4: $ 36,625
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.....					9,569
e Remaining amount distributed out of corpus		27,056
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		504,502
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) ...		96,623
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......		407,879
10 Analysis of line 9:
a Excess from 2017....	82,759
b Excess from 2018....	109,961
c Excess from 2019....	96,520
d Excess from 2020....	91,583
e Excess from 2021....	27,056

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2021	(b) 2020	(c) 2019	(d) 2018	(e) Total

b 85% (0.85) of line 2a .........
c Qualifying distributions from Part XI, line 4 for each year listed .....
d Amounts included in line 2c not used directly for active conduct of exempt activities ..........
e Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c ....
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part IX, line 6 for each year listed ..
c “Support" alternative test—enter:
(1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

bApproved for future payment

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

Enter gross amounts unless otherwise indicated.	Unrelated business income		Excluded by section 512, 513, or 514		(e) Related or exempt function income (See instructions.)
1Program service revenue:	(a) Business code	(b) Amount	(c) Exclusion code	(d) Amount	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments ....
3 Interest on savings and temporary cash investments ...........
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	-813
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		-620	0

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

Name of organization B & R CHARITABLE FOUNDATION INC

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	DAVID D DORTCH 4021 GULF SHORE BLVD N APT 603 NAPLES, FL34103	$ 166,522	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Name of organization B & R CHARITABLE FOUNDATION INC		Employer identification number 62-1664477

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
1	1150 SHARES OF AMERICAN WATER WORKS COMPANY, INC.	$ 166,522	2021-03-26
(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)


Name of organization B & R CHARITABLE FOUNDATION INC			Employer identification number 62-1664477
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.) $ Use duplicate copies of Part III if additional space is needed.

Software ID:
Software Version: