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
THE BLUM FAMILY FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)909 BOWRING PARK
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NASHVILLE, TN372152456
A Employer identification number

62-1871174
B Telephone number (see instructions)

(615) 383-4965
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$2,889,254J 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) 4,936
2 Check bullet.............
3 Interest on savings and temporary cash investments 8 8 8
4 Dividends and interest from securities... 21,353 21,353 21,353
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 120,342
b Gross sales price for all assets on line 6a 120,342
7 Capital gain net income (from Part IV, line 2)... 120,342
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........ 146,639 141,703 21,361
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 33,707 33,707 28,771 0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 2,000 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 35,707 33,707 28,771 0
25 Contributions, gifts, grants paid....... 277,233 277,233
26 Total expenses and disbursements. Add lines 24 and 25 312,940 33,707 28,771 277,233
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -166,301
b Net investment income (if negative, enter -0-) 107,996
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 160,506 141,754 141,754
2 Savings and temporary cash investments......... 4,858 4,859 4,859
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).......... 579,675 Click to see attachment367,525 2,742,641
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 745,039 514,138 2,889,254
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........ 745,039 514,138
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 0 0
29 Total net assets or fund balances (see instructions)..... 745,039 514,138
30 Total liabilities and net assets/fund balances (see instructions). 745,039 514,138
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
745,039
2
Enter amount from Part I, line 27a .....................
2
-166,301
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
578,738
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
64,600
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
514,138
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 BELLE MEADE ASSOC. NT LP - LONG TERM P   2021-12-31
b CAPITAL GAINS DIVIDENDS P    
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 120,316     120,316
b 26     26
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       120,316
b       26
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 120,342
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3 0
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 1,501
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 1,501
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 2,667
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 2,667
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 1,166
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet1,166 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)
    bulletTN
    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 ofbulletJOAN B SHAYNE Telephone no.bullet (615) 383-4965

    Located atbullet909 BOWRING PARKNASHVILLETN ZIP+4bullet372152456
    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
    JOAN B SHAYNE TRUSTEE
    0.00     		0 0 0
    909 BOWRING PARK
    NASHVILLE,TN37215
    JENNIFER L BLUM TRUSTEE
    0.00     		0 0 0
    1018 MAPLE STREET
    SANTA MONICA,CA90405
    LAUREN BLUM TRUSTEE
    0.00     		0 0 0
    35 EAST 85TH STREET
    NEW YORK,NY10028
    EMILY BLUM HASLETT TRUSTEE
    0.00     		0 0 0
    26 BAKER BRIDGE ROAD
    LINCOLN,MA01773
    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
    160,985
    c
    Fair market value of all other assets (see instructions)................
    1c
    2,742,641
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,903,626
    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
    2,903,626
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    43,554
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    2,860,072
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    143,004
    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
    143,004
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    1,501
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,501
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    141,503
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    141,503
    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
    141,503
    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 7 141,503
    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...... 200,640
    b From 2017...... 77,754
    c From 2018...... 118,143
    d From 2019...... 304,885
    e From 2020...... 122,410
    f Total of lines 3a through e ........ 823,832
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 277,233
    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..... 141,503
    e Remaining amount distributed out of corpus 135,730
    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 5 959,562
    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) ...     		200,640
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		758,922
    10 Analysis of line 9:
    a Excess from 2017.... 77,754
    b Excess from 2018.... 118,143
    c Excess from 2019.... 304,885
    d Excess from 2020.... 122,410
    e Excess from 2021.... 135,730
    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).)
    JOAN B SHAYNE
    LAUREN BLUM
    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
    350ORG
    PO BOX 843004
    BOSTON,MA02284     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 10,000
    92ND STREET Y
    1395 LEXINGTON AVENUE
    NEW YORK,NY10128     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    ABE'S GARDEN
    115 WOODMONT BLVD
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    ABRAHAM INITIATIVES
    1460 BROADWAY
    NEW YORK,NY10036     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    AGE WELL MIDDLE TENNESSEE
    PO BOX 158309
    NASHVILLE,TN37215     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,250
    ALIVE HOSPICE
    1718 PATTERSON ST
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    AMERICAN CANCER SOCIETY
    2008 CHARLOTTE AVE
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 150
    AMERICAN CIVIL LIBERTIES UNION
    125 BROAD STREET 18TH FLOOR
    NEW YORK,NY10004     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    AMERICAN CIVIL LIBERTIES UNION FOUNDATION
    PO BOX 120160
    NASHVILLE,TN37212     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,000
    AMERICAN JEWISH JOINT DISTRIBUTION COMMITTEE
    PO BOX 4124
    NEW YORK,NY10163     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,000
    AMERICAN MUSEUM OF NATURAL HISTORY
    200 CENTRAL PARK W
    NEW YORK,NY10024     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,000
    AMERICAN PARDES FOUNDATION
    54 W 40TH ST
    NEW YORK,NY10018     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    AWJS
    45 W 36TH ST
    NEW YORK,NY10018     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 400
    BELCOURT THEATRE
    2102 BELCOURT AVE
    NASHVILLE,TN37212     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    BOSTON FOOD FOREST COALITION
    76 WELD HILL STREET
    JAMAICA PLAIN,MA02130     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 6,000
    BRENNAN CENTER FOR JUSTICE
    120 BROADWAY STE 1750
    NEW YORK,NY10271     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    BROOME STREET ACADEMY
    121 AVENUE OF THE AMERICAS
    NEW YORK,NY10013     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 3,500
    CASA INC
    340 21ST AVE N
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    CENTENNIAL PARK CONSERVANCY
    2565 PARK PLAZA
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    CENTER FOR SCHOLARS AND STORYTELLERS
    FRANZ HALL 1285
    LOS ANGELES,CA90024     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    CENTRAL PARK CONSERVANCY
    14 E 60TH ST
    NEW YORK,NY10022     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    CENTRAL SYNAGOGUE
    123 E 55TH ST
    MANHATTAN,NY10022     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    CHOOSING JUSTICE INITIATIVE
    1623 HAYNES MEADE CIR
    NASHVILLE,TN37207     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 50,000
    CITY HARVEST
    6 EAST 32ND ST 5TH FLOOR
    NEW YORK,NY10016     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    CITY SPROUTS
    1035 CAMBRIDGE STREET
    CAMBRIDGE,MA02141     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,800
    CITY YEAR
    287 COLUMBUS AVENUE
    BOSTON,MA02116     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 6,500
    CLIFTON K MEADOR EDUCATION FUND AT THE MEHARRY - VANDERBILT ALLIANCE
    PO BOX 290369
    NASHVILLE,TN37229     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    CONEXION AMERICAS
    2195 NOLENSVILLE PIKE
    NASHVILLE,TN37211     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    CROSSROADS CAMPUS
    707 MONROE ST
    NASHVILLE,TN37208     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    DALTON SCHOOL
    108 E 89TH ST
    NEW YORK,NY10128     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,250
    DARTMOUTH ALUMNI FUND
    6066 DEVELOPMENT OFFICE
    HANOVER,NH03755     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 3,500
    DOCTORS WITHOUT BORDERS
    40 RECTOR ST 16TH FLOOR
    NEW YORK,NY10006     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 10,000
    ECHO HORIZON SCHOOL
    3430 MCMANUS AVE
    CULVER CITY,CA90232     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    ELEM YOUTH IN DISTRESS IN ISRAEL
    121 WEST 36TH STREET SUITE 329
    NEW YORK,NY10018     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 400
    EQUAL JUSTICE UNDER LAW
    400 7TH ST NW STE 602
    WASHINGTON,DC20004     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    FAITH AND CULTURE CENTER
    320 MALLORY STATION ROAD
    FRANKLIN,TN37067     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    FAMILY AND CHILDREN'S SERVICE
    2400 CLIFTON AVE
    NASHVILLE,TN37209     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    FIFTY FORWARD
    174 RAINS AVE
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,750
    FISK UNIVERSITY
    1000 17TH AVENUE N
    NASHVILLE,TN37208     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    FOOD PROJECT
    5904 CALIFORNIA AVE
    NASHVILLE,TN37209     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    FRIENDS OF ALTA
    10201 E HWY 210
    ALTA,UT84092     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    FRIENDS OF RADNOR LAKE
    1160 OTTER CREEK RD
    NASHVILLE,TN37220     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    FRIENDS OF WARNER PARK
    50 VAUGHN RD
    NASHVILLE,TN37221     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    FRIST ART MUSEUM
    919 BROADWAY
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    GILDA CLUB MIDDLE TENNESSEE
    1707 DIVISION ST
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    GORDON JEWISH COMMUNITY CENTER
    801 PERCY WARNER BLVD
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 3,950
    HARVARD UNIVERSITY
    PO BOX 419209
    BOSTON,MA02241     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    HARVARD-RADCLIFFE COLLEGIUM MUSICUM FOUNDATION
    PO BOX 381987
    CAMBRIDGE,MA02238     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    HILLEL THE FOUNDATION FOR JEWISH CAMPUS LIFE
    800 EIGHTH STREET NW
    WASHINGTON,DC20001     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    HISTORIC TRAVELLER'S REST
    636 FARRELL PKWY
    NASHVILLE,TN37220     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    HOMEWORK HOTLINE
    4805 PARK AVE
    NASHVILLE,TN37209     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    HUMAN RIGHTS WATCH
    350 FIFTH AVENUE 34TH FLOOR
    NEW YORK,NY10118     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    HUMANITIES TENNESSEE
    807 MAIN ST STE B
    NASHVILLE,TN37206     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 400
    JEWISH FAMILY SERVICES
    801 PERCY WARNER BLVD STE 103
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    JEWISH FEDERATION OF NASHVILLE AND MIDDLE TENNESSEE
    801 PERCY WARNER BLVD STE 102
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 8,000
    JMS
    3600 WEST END AVE
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 4,250
    JUST CITY MEMPHIS
    PO BOX 41852
    MEMPHIS,TN38174     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    LA LGBT CENTER
    8745 SANTA MONICA BOULEVARD
    WEST HOLLYWOOD,CA90069     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    LAND TRUST OF TENNESSEE
    4000 FRANKLIN PIKE
    NASHVILLE,TN37204     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 275
    LEAGUE OF CONSERVATION VOTERS
    740 15TH STREET NW 7TH FLOOR
    WASHINGTON,DC20005     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    LEGAL AID SOCIETY OF MID-TENNESSEE
    1321 MURFREESBORO PIKE STE 400
    NASHVILLE,TN37217     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    LOS ANGELES REGIONAL FOOD BANK
    1734 E 41ST ST
    LOS ANGELES,CA90058     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    MAINE ORGANIC FARMERS AND GROWERS ASSOCIATION
    PO BOX 170
    UNITY,ME04988     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    MAINE SEACOAST MISSION
    6 OLD FIREHOUSE LANE PO BOX 600
    NORTHEAST HARBOR,ME04662     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,000
    MASSACHUSETTS INSTITUTE OF TECHNOLOGY
    77 MASSACHUSETTS AVENUE
    CAMBRIDGE,MA02139     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    MOUNTAIN VALLEY TREATMENT CENTER
    703 RIVER ROAD
    PLAINFIELD,NH03781     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    NAMI TENNESSEE
    1101 KERMIT DR STE 605
    NASHVILLE,TN37217     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    NASHVILLE FOOD PROJECT
    5904 CALIFORNIA AVE
    NASHVILLE,TN37209     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    NASHVILLE OPERA GUILD
    3622 REDMON ST
    NASHVILLE,TN37209     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 600
    NASHVILLE PUBLIC EDUCATION FOUNDATION
    1207 18TH AVE STE 202
    NASHVILLE,TN37212     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    NASHVILLE PUBLIC LIBRARY FOUNDATION
    615 CHURCH ST
    NASHVILLE,TN37219     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    NASHVILLE PUBLIC RADIO
    630 MAINSTREAM DRIVE
    NASHVILLE,TN37228     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    NASHVILLE REPERTORY THEATRE
    161 RAINS AVE
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,100
    NASHVILLE SYMPHONY
    1 SYMPHONY PL
    NASHVILLE,TN37201     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 300
    NCJW NASHVILLE SECTION
    801 PERCY WARNER BLVD
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    NEW ISRAEL FUND
    PO BOX 70358
    PHILADELPHIA,PA19176     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    NEW YORK COMMON PANTRY
    8 E 109TH ST
    NEW YORK,NY10029     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    NEW YORK PUBLIC LIBRARY
    476 5TH AVE
    NEW YORK,NY10018     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    NOAH
    7500 N DREAMY DRAW DRIVE SUITE 145
    PHOENIX,AZ85020     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    OPEN TABLE NASHVILLE
    PO BOX 110266
    NASHVILLE,TN37222     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    PARDES INSTITUTE OF JEWISH STUDIES
    228 PARK AVE S SUITE 35858
    NEW YORK,NY10003     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 10,000
    PARK CENTER
    186 N 1ST ST
    NASHVILLE,TN37213     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    PLANNED PARENTHOOD
    412 DR DB TODD JR BLVD
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,200
    PLANNED PARENTHOOD FEDERATION OF AMERICA FOUNDATION
    PO BOX 97166
    WASHINGTON,DC20090     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,200
    PROJECT RETURN
    109 LAFAYETTE ST
    NASHVILLE,TN37210     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    PROPUBLICA
    155 AVENUE OF THE AMERICAS 13TH
    FLOOR
    NEW YORK,NY10013     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    REIMAGINE
    2616 S RIDGELEY DR
    LOS ANGELES,CA90016     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    RENEWAL HOUSE
    3410 CLARKSVILLE PIKE
    NASHVILLE,TN37218     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    SAFE HAVEN FAMILY SHELTER
    1234 3RD AVE S
    NASHVILLE,TN37210     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    SECOND HARVEST FOOD BANK
    331 GREAT CIRCLE RD
    NASHVILLE,TN37228     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,000
    SEEDS OF PEACE
    370 LEXINGTON AVENUE SUITE 1201
    NEW YORK,NY10017     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    SEXUAL ASSAULT CENTER
    101 FRENCH LANDING DR
    NASHVILLE,TN37228     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 400
    SILOAM HEALTH
    PO BOX 2751
    TEMECULA,CA92593     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    SOUTHERN POVERTY LAW CENTER
    400 WASHINGTON AVE
    MONTGOMERY,AL36104     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    SOUTHERN WORD
    1704 CHARLOTTE AVE STE 200
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    SPECIAL OLYMPICS TENNESSEE
    461 CRAIGHEAD ST
    NASHVILLE,TN37204     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 200
    STUDIO IN A SCHOOL
    410 W 59TH ST
    NEW YORK,NY10019     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    SUMMER SCIENCE PROGRAM
    11010 LAKE GROVE BLVD 100-418
    MORRISVILLE,NC27560     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,000
    SWAN BALL 2021
    1200 FORREST PARK DR
    NASHVILLE,TN37205     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 275
    TECHNOSERVE
    1800 STREET NW SOUTH TOWER STE M
    WASHINGTON,DC20036     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,000
    TENNESSEE INNOCENCE PROJECT
    700 CRAIGHEAD ST STE 300
    NASHVILLE,TN37204     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    TENNESSEE JUSTICE CENTER
    211 7TH AVE N STE 100
    NASHVILLE,TN37219     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,750
    THE CLEMENTE COURSE IN THE HUMANITIES
    PO BOX 532
    ROSENDALE,NY12472     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    THE CONTRIBUTOR
    154 8TH AVE N
    NASHVILLE,TN37219     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,000
    THE DOE FUND
    345 E 102ND ST STE 305
    NEW YORK,NY10029     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 3,500
    THE FIELD CENTER
    61 WILLIAMS ROAD
    BELLOWS FALLS,VT05101     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    THE LEGION FUND
    PO BOX 737
    BOWLING GREEN,KY42102     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    THE MARSHALL PROJECT
    156 W 56TH ST SUITE 701
    NEW YORK,NY10019     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    THE NATURE CONSERVANCY
    2021 21ST AVE S
    NASHVILLE,TN37212     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    THE OASIS CENTER
    1704 CHARLOTTE AVE STE 200
    NASHVILLE,TN37203     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    THE PEOPLE CONCERN
    503 OLYMPIC BLVD
    SANTA MONICA,CA90401     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    THE SCHOOLHOUSE
    106 VERNON VALLEY RD
    EAST NORTHPORT,NY11731     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    THE TEMPLE
    1589 PEACHTREE ST NE
    ATLANTA,GA30309     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    THE WOMEN'S FUND OF THE COMMUNITY FOUNDATION OF MIDDLE TN
    3833 CLEGHORN AVE
    NASHVILLE,TN37215     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    THERE WITH CARE
    1616 PORTER RD STE 100
    NASHVILLE,TN37206     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    TIRCC
    3310 EZELL ROAD
    NASHVILLE,TN37211     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    T'RUAH
    266 WEST 37TH STREET SUITE 803
    NEW YORK,NY10018     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 250
    TULANE UNIVERSITY
    6823 ST CHARLES AVENUE
    NEW ORLEANS,LA70118     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 8,333
    UCLA FOUNDATION
    PO BOX 7145
    PASADENA,CA91109     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    UNICEF USA
    125 MAIDEN LANE
    NEW YORK,NY10038     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,000
    VANDERBILT UNIVERSITY
    2301 VANDERBILT PLACE
    NASHVILLE,TN37235     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,500
    VENICE FAMILY CLINIC
    604 ROSE AVE
    VENICE,CA90291     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    VERA INSTITUTE OF JUSTICE
    34 35TH STREET SUITE 4-2A
    BROOKLYN,NY11232     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    VERMONT WORKS FOR WOMEN
    32 MALLETTS BAY AVE STE A
    WINOOSKI,VT05404     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    WALL STREET SYNAGOGUE
    47 BEEKMAN ST
    NEW YORK,NY10038     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 200
    WELLESLEY CENTERS FOR WOMEN
    106 CENTRAL ST
    WELLESLEY,MA02481     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    WELLESLEY COLLEGE
    106 CENTRAL STREET
    WELLESLEY,MA02481     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    WELLESLEY STUDENTS' AID SOCIETY
    106 CENTRAL STREET
    WELLESLEY,MA02481     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    WESTCHESTER COMMUNITY COLLEGE FOUNDATION
    75 GRASSLANDS ROAD
    VALHALLA,NY10595     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    WESTPORT WARM-UP FUND
    110 MYRTLE AVE
    WESTPORT,CT06880     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 150
    WESTWOOD BAPTIST CHURCH CENTER
    2510 ALBION ST
    NASHVILLE,TN37208     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    WINDWARD SCHOOL
    11350 PALMS BOULEVARD
    LOS ANGELES,CA90066     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    WOMEN FOR HEALTHY RURAL LIVING
    PO BOX 463
    MILBRIDGE,ME04658     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 5,000
    WORLD CONNECT
    632 BROADWAY SUITE 901
    NEW YORK,NY10012     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 1,000
    WORLD WILDLIFE FUND
    1250 24TH STREET NW PO BOX 97180
    WASHINGTON,DC20090     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 150
    YALE UNIVERSITY
    PO BOX 208234
    NEW HAVEN,CT06520     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 2,500
    YES MAGAZINE
    284 MADRONA WAY NE STE 116
    BAINBRIDGE ISLAND,WA98110     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 500
    YWCA OF NASHVILLE AND MIDDLE TENNESSEE
    1608 WOODMONT BLVD
    NASHVILLE,TN37215     		  PC FOR ONE OR MORE EXEMPT PURPOSES DESCRIBED IN IRC SECTION 501(C)(3) 750
    Total .................................bullet 3a 277,233
    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 8  
    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 ............     		    18 120,316 26
    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) .. 0 120,324 21,379
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    141,703
    (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.)
    13 N/A
    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

    TY 2021 AccountingFeesSchedule
    Name:
    THE BLUM FAMILY FOUNDATION
    EIN:
    62-1871174
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 4,936 4,936 0 0
    INVESTMENT EXPENSES FROM BELLE MEADE ASSOCIATES NT, LP K-1 28,771 28,771 28,771 0

    TY 2021 InvestmentsOtherSchedule2
    Name:
    THE BLUM FAMILY FOUNDATION
    EIN:
    62-1871174
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    BELLE MEADE ASSOCIATES NT, LP AT COST 367,525 2,742,641

    TY 2021 OtherDecreasesSchedule
    Name:
    THE BLUM FAMILY FOUNDATION
    EIN:
    62-1871174
    Description Amount
    DECREASE IN FUND BALANCE 64,600


    TY 2021 TaxesSchedule
    Name:
    THE BLUM FAMILY FOUNDATION
    EIN:
    62-1871174
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    2021 ESTIMATED PAYMENTS 2,000 0 0 0