Form990-PF
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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
DAVID & FATEN BLACK FOUNDATION INC
 
% Donald Wilkens
Number and street (or P.O. box number if mail is not delivered to street address)9 Huntley Road
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Eastchester, NY10709
A Employer identification number

46-1350510
B Telephone number (see instructions)

(914) 337-0649
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$1,567,593J 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)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 1,313 1,313  
4 Dividends and interest from securities... 18,352 18,352  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 132,791
b Gross sales price for all assets on line 6a 1,198,565
7 Capital gain net income (from Part IV, line 2)... 132,791
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........ 152,456 152,456  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 57,469 28,236    
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment 598      
b Accounting fees (attach schedule)....... Click to see attachment 4,199      
c Other professional fees (attach schedule).... Click to see attachment 10,923 10,923    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 6,169 6,169    
19 Depreciation (attach schedule) and depletion... Click to see attachment 1,415 1,415  
20 Occupancy..............        
21 Travel, conferences, and meetings....... 808 808    
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 7,437 7,437    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 89,018 54,988   0
25 Contributions, gifts, grants paid....... 179,028 179,028
26 Total expenses and disbursements. Add lines 24 and 25 268,046 54,988   179,028
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -115,590
b Net investment income (if negative, enter -0-) 97,468
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 29,944 54,841 54,841
2 Savings and temporary cash investments......... 264,462    
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)....... 1,056,120 Click to see attachment965,540 1,085,118
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet11,452
Less: accumulated depreciation (attach schedule) bullet6,644 4,130 Click to see attachment4,808 4,808
15 Other assets (describe bullet) Click to see attachment230,078 Click to see attachment422,826 Click to see attachment422,826
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,584,734 1,448,015 1,567,593
Liabilities 17 Accounts payable and accrued expenses.......... 13,400 54,226
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)......... 13,400 54,226
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........... 1,571,334 1,393,789
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 1,571,334 1,393,789
30 Total liabilities and net assets/fund balances (see instructions). 1,584,734 1,448,015
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
1,571,334
2
Enter amount from Part I, line 27a .....................
2
-115,590
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
1,455,744
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
61,955
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
1,393,789
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 AB MUNICIPAL BOND P 2021-06-11 2021-12-20
b ALGER SMALL CAP P 2019-12-18 2021-12-20
c ALGER SMALL CAP P 2019-08-06 2021-12-20
d ALGER SMALL CAP P 2019-07-10 2021-05-11
e ALGER SMALL CAP P 2019-07-10 2021-10-06
ALGER SMALL CAP P 2019-08-06 2021-10-06
ALGER SMALL CAP P 2021-12-15 2021-12-20
ALGER SMALL CAP P 2019-12-18 2021-12-20
DELAWARE EMERGING P 2020-12-18 2021-11-02
DELAWARE EMERGING P 2020-12-18 2021-11-02
DELAWARE EMERGING P 2019-12-19 2021-11-02
DELAWARE EMERGING P 2019-11-05 2021-11-02
DELAWARE EMERGING P 2018-12-21 2021-11-02
DELAWARE EMERGING P 2018-09-28 2021-11-02
DELAWARE IVY MID CAP P 2021-06-10 2021-07-29
DELAWARE IVY MID CAP P 2021-05-18 2021-07-29
DELAWARE IVY MID CAP P 2021-04-07 2021-07-29
DESTRA FLAHERTY P 2017-04-11 2021-04-07
DESTRA FLAHERTY P 2017-03-31 2021-04-07
DESTRA FLAHERTY P 2017-04-11 2021-06-11
EATON VANCE SHORT P    
EATON VANCE SHORT P    
EATON VANCE SHORT P 2020-12-16 2021-09-10
EATON VANCE SHORT P    
EATON VANCE SHORT P    
EATON VANCE SHORT P    
EATON VANCE SHORT P 2020-08-06  
EATON VANCE SHORT P 2020-10-30 2021-09-10
EATON VANCE SHORT P 2020-12-16 2021-10-06
EATON VANCE SHORT P 2020-12-31 2021-10-06
EATON VANCE SHORT P 2021-02-26 2021-10-06
EATON VANCE SHORT P 2021-03-31 2021-10-06
EATON VANCE SHORT P 2021-01-29 2021-10-06
EATON VANCE SHORT P 2021-05-28 2021-10-06
EATON VANCE SHORT P 2021-06-30 2021-10-06
EATON VANCE SHORT P 2021-07-30 2021-10-06
EATON VANCE SHORT P 2021-08-31 2021-10-06
EATON VANCE SHORT P 2021-09-30 2021-10-06
EATON VANCE SHORT P 2021-04-30 2021-10-06
EATON VANCE SHT DURATION P 2021-06-11 2021-12-06
IINVESCO QQQ TRUST ETF P 2020-02-27 2021-03-17
IINVESCO QQQ TRUST ETF P 2020-03-10 2021-03-17
IINVESCO QQQ TRUST ETF P 2020-10-02 2021-03-17
ISHARES SP 500 VALUE P 2021-05-18 2021-06-24
PIMCO INCOME FUND P 2019-06-04 2021-01-22
PIMCO INCOME FUND P 2020-07-31 2021-06-15
PIMCO INCOME FUND P 2020-06-30 2021-06-15
PIMCO INCOME FUND P 2020-05-29 2021-06-15
PIMCO INCOME FUND P 2020-04-30 2021-06-15
PIMCO INCOME FUND P 2019-12-31 2021-06-15
PIMCO INCOME FUND P 2020-01-31 2021-06-15
PIMCO INCOME FUND P 2019-06-04 2021-06-15
PIMCO INCOME FUND P 2019-06-28 2021-06-15
PIMCO INCOME FUND P 2019-10-31 2021-06-15
PIMCO INCOME FUND P 2019-07-31 2021-06-15
PIMCO INCOME FUND P 2019-08-30 2021-06-15
PIMCO INCOME FUND P 2019-09-30 2021-06-15
PIMCO INCOME FUND P 2019-11-29 2021-06-15
PIMCO INCOME FUND P 2019-12-26 2021-06-15
PIMCO INCOME FUND P 2020-08-30 2021-06-15
PIMCO INCOME FUND P 2021-04-30 2021-06-15
PIMCO INCOME FUND P 2020-10-30 2021-06-15
PIMCO INCOME FUND P 2021-05-28 2021-06-15
PIMCO INCOME FUND P 2020-09-30 2021-06-15
PIMCO INCOME FUND P 2020-02-28 2021-06-15
PIMCO INCOME FUND P 2021-03-31 2021-06-15
PIMCO INCOME FUND P 2020-03-31 2021-06-15
PIMCO INCOME FUND P 2021-01-29 2021-06-15
PIMCO INCOME FUND P 2020-12-31 2021-06-15
PIMCO INCOME FUND P 2020-11-30 2021-06-15
PIMCO INCOME FUND P 2021-02-26 2021-06-15
VIRTUS KAR MID-CAP P 2020-03-10 2021-05-11
VIRTUS KAR MID-CAP P 2020-01-28 2021-05-11
VIRTUS KAR MID-CAP P 2020-11-06 2021-05-11
VIRTUS KAR MID-CAP P 2020-11-06 2021-05-25
VIRTUS KAR MID-CAP P 2020-12-22 2021-06-03
VIRTUS KAR MID-CAP P 2020-11-06 2021-06-03
VIRTUS KAR SMALL-CAP P 2018-07-12 2021-05-18
VIRTUS KAR SMALL-CAP P 2018-07-25 2021-05-18
VIRTUS KAR SMALL-CAP P 2018-07-25 2021-10-06
VIRTUS KAR SMALL-CAP P 2018-08-15 2021-10-06
VIRTUS KAR SMALL MID CAP P 2021-05-18 2021-10-06
(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 70,000   69,050 950
b 847   709 138
c 29,242   25,356 3,886
d 25,184   19,182 6,002
e 4,043   2,918 1,125
7,215   5,030 2,185
2,111   2,163 -52
718   600 118
147   149 -2
42   43 -1
206   171 35
13,160   10,401 2,759
824   540 284
11,737   8,700 3,037
266   265 1
57,236   56,853 383
38,005   36,576 1,429
23,336   22,590 746
25,275   24,306 969
37,139   35,404 1,735
10,000   10,024 -24
43,086   43,234 -148
44,423   44,833 -410
156   157 -1
159   160 -1
123   125 -2
54,976   55,689 -713
164   166 -2
91,551   92,382 -831
252   255 -3
326   329 -3
350   353 -3
363   367 -4
288   290 -2
271   272 -1
281   281  
282   281 1
193   193  
294   297 -3
50,242   50,000 242
11,085   7,300 3,785
54,790   34,792 19,998
60,808   52,976 7,832
40,087   40,740 -653
30,000   29,417 583
740   696 44
755   702 53
762   697 65
772   692 80
699   677 22
702   682 20
98,200   95,201 2,999
1,010   985 25
809   779 30
986   960 26
933   894 39
808   776 32
718   691 27
433   420 13
465   443 22
366   365 1
469   447 22
366   367 -1
468   445 23
711   685 26
368   363 5
780   686 94
433   430 3
456   451 5
460   449 11
367   365 2
39,520   25,252 14,268
57,831   39,695 18,136
9,196   9,164 32
7,472   7,399 73
144   156 -12
39,077   38,978 99
38,656   25,721 12,935
16,024   10,699 5,325
6,474   4,000 2,474
13,814   8,382 5,432
63   61 2
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       950
b       138
c       3,886
d       6,002
e       1,125
      2,185
      -52
      118
      -2
      -1
      35
      2,759
      284
      3,037
      1
      383
      1,429
      746
      969
      1,735
      -24
      -148
      -410
      -1
      -1
      -2
      -713
      -2
      -831
      -3
      -3
      -3
      -4
      -2
      -1
       
      1
       
      -3
      242
      3,785
      19,998
      7,832
      -653
      583
      44
      53
      65
      80
      22
      20
      2,999
      25
      30
      26
      39
      32
      27
      13
      22
      1
      22
      -1
      23
      26
      5
      94
      3
      5
      11
      2
      14,268
      18,136
      32
      73
      -12
      99
      12,935
      5,325
      2,474
      5,432
      2
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 2 132,791
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 11,755
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 1,355
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,355
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a  
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7  
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 1,355
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
Yes
 
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletFL, NY
    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 O N E
    14
    The books are in care ofbulletSAIDAH DOMENECH Telephone no.bullet (813) 389-2513

    Located atbullet644 Bayshore DriveTarpon SpringsFL ZIP+4bullet34689
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
    Yes
     
    If "Yes," list the years bullet2020, 2019, 2018, 2017
    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
    RUTH GLENN HIRSHFELD President
    006.00     		33,219    
    2639 SILVERMOSS DR
    WESLEY CHAPEL,FL33544
    SAIDAH DOMENECH Chairperson /Treasurer
    000.50     		0    
    644 Bayshore Drive
    TARPON SPRINGS,FL34689
    DONALD F WILKENS CFO
    004.00     		24,250    
    9 HUNTLEY ROAD
    EASTCHESTER,NY10709
    MITCHELL C RAY Secretary
    000.50     		0    
    5125 Palm Springs Blvd Unit 2101
    TAMPA,FL33647
    SILVIA DIEHL Director
    000.25     		0    
    9624 Birnam Wood St
    Riverview,FL33569
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 Funding provided to WETA for production/acquisition of content about social & emotional learning (SEL) to serve the needs of autistic children. Focus was to bolster autism-related content on both ReadingRockets.org, which supports elementary age students, as well as AdLit.org, which serves middle and high school students 30,000
    2 Support to USF Foundation for programming & related resources for the 2021 Autism Summer Institute, purchase of a server as well as MiFi devices for field work/remote back up for virtual work. Also supported TLAs development of a college prep course to increase likelihood of student success w/applications & coursework 28,000
    3 WNET supported the needs of parents and families in the NYC Metro area thru the production of Parenting Minutes segments (including supporting materials for distribution) that highlight challenges faced & practical solutions for use by all families but with a specific focus on issues affecting autistic children/their caregivers. 25,000
    4 Addressing the issue of employee talent shortages & highlighting an undervalued segment of the population, WEDU created public awareness messaging that highlighted the benefits of hiring autistic employees & identified local supports available to businesses that assist with creating neuro-diverse employment programs. 25,000
    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 The Foundation loaned $ 250,000 to DFB&T, Inc., dba Hukama, a 501(c)(3) non profit for start up expenses. Hukama was formed to assist dental and medical practices to understand and welcome autistic children through the development and sale of a comprehensive training manual with supporting toolkit. 250,000
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet250,000
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,170,000
    b
    Average of monthly cash balances.......................
    1b
    102,000
    c
    Fair market value of all other assets (see instructions)................
    1c
    300,000
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,572,000
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    1,572,000
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    23,580
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    1,548,420
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    77,421
    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
    77,421
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    1,355
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,355
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    76,066
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    76,066
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    76,066
    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 76,066
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 167,444
    b Total for prior years:2017, 2018, 2019 231,465
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 121,159
    b From 2017...... 65,641
    c From 2018...... 93,402
    d From 2019...... 72,422
    e From 2020...... 167,444
    f Total of lines 3a through e ........ 520,068
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 429,028
    a Applied to 2020, but not more than line 2a 167,444
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount.....  
    e Remaining amount distributed out of corpus 261,584
    5 Excess distributions carryover applied to 2021. 76,066 76,066
    (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 5 705,586
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		231,465
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		231,465
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    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) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		45,093
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		660,493
    10 Analysis of line 9:
    a Excess from 2017.... 65,641
    b Excess from 2018.... 93,402
    c Excess from 2019.... 72,422
    d Excess from 2020.... 167,444
    e Excess from 2021.... 261,584
    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).)
    NA
    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.
    NA
    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
    WETA - Noel Gunther VP Learning & Media
    2775 South Quincy Street
    Arlington,VA22206     		None PC Produce on-line SEL content for educators and families to support autistic children. 30,000
    South Florida PBS - D Sukhdeo President
    3401 S Congress Blvd
    Boynton Beach,FL33426     		None PC Support autism awareness campaign highlighting the lifelong positive impact of music sports 25,000
    WEDU PBS - Joyce Cotton Dir Marketing
    1300 North Blvd - Berkman Ctr
    Tampa,FL33607     		None PC Create public awareness re benefits of hiring autistic people supports for local businesses 25,000
    WGCU Public Media - A Shumaker Assoc Dir
    10501 FGCU Blvd
    Fort Myer,FL33965     		None PC Reduce social isolation/teach soft skills via the creation of a book-club podcasting tutorials 10,000
    Donorschooseorg - G Hill CFO
    134 West 37 Street 11th Floor
    New York,NY10018     		None PC Support 38 classrooms throughout the US serving autistic students from low-income households 9,028
    Jacob's Touch Foundation - K Cimino Fine Pres
    10339 Green Links Drive
    Tampa,FL33626     		None PC Funding for Camp Move to support brain development / cognition thru movement 2,000
    Arts4All Florida Inc - K Aguayo Unv S Florida
    4202 E Fowler Avenue EDU105
    Tampa,FL33620     		None PC Train staff working w/autistic students to better understand communication differences/needs 2,000
    Infinity Tomorrow - E Seltzer President
    8-14 Saddle River Road 2nd Floor
    Fair Lawn,NJ07410     		None PC Facilitate breaking down social isolation, open social opportunities improve health/well-being. 4,000
    WJCU - Pat Grossman LCSW
    845 N Broadway
    White Plains,NY10603     		None PC Develop programs to assist autistic clients with social supports, empowerment and transition skills. 10,000
    WNET- S Sheppard Dir Kids Media & Education
    825 8th Ave The WNET Group
    New York,NY10019     		None PC Address diverse familial needs for NY Metro viewers thru production of Parenting Minutes segments 25,000
    FSU CARD C Zenko Director
    2312 Killearn Center Blvd Bldg A
    Tallahassee,FL32309     		None PC Assist autistic clients find opportunities to improve quality of life, independence mental health 5,000
    USF Foundation (TLA) Beth Boone Director
    13301 Bruce B Downs Blvd
    Tampa,FL33612     		None PC Support TLAs development of a college prep course to increase likelihood of student successes 19,000
    USF Foundation (CARD) Beth Boone Director
    13301 Bruce B Downs Blvd
    Tampa,FL33612     		None PC Purchase teacher resources, a server, MiFi devices for field work/remote back-up for virtual work 9,000
    UMNSU CARD A Alessandri Director
    5665 Ponce de Leon Boulevard
    Coral Gables,FL33124     		None PC Guide local businesses supporting autism awareness in Broward, Miami-Dade Monroe counties 4,000
    Total .................................bullet 3a 179,028
    bApproved for future payment
    Total .................................bullet 3b  
    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 ...........     		        1,313
    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 ............     		        132,791
    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) ..     152,456
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    152,456
    (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.)
    3 Assumption that Exempt Organizations generate income from program activities DOES NOT APPLY to the David
    3 Faten Black Foundation since it was funded entirely by the Faten T. Black Estate. Money received was invested
    3 at UBS Financial to maximize returns ROI such as dividend interest income in addition to capital gains
    4 in order to provide gifts/grant contributions to benefit both Public Television as well as to fund programs
    4 and services for people with Autism, Aspergers and PDD-NOS.
    8 Represents realized gains/losses on sale of securities held to generate income to fund grants made to public television
    8 and non profit organizations dedicated to providing assistance / education to the autistic community.
    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: 21013562
    Software Version: 21.0.3.0


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Payroll service 661      
    CPA firm to provide assistance on loan creation 2,400      
    CPA firm to provide assistance on IRS inquiry 1,138      

    TY 2021 AppliedToPriorYearElection
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Election:
    The David Faten Black Foundation, Inc. hereby attaches the following STATEMENT following Regulation sect 53.4942a-3c2 To Elect and to apply excess distributions from prior years to satisfy distribution rquirements as set forth in section 170b1F and 4942g3, it

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2021 DepreciationSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    FURNI EQUIP / iPads / Computers 2016-01-01 11,452 5,229 SL 0000000007.000000000000 1,415 1,415    

    TY 2021 GeneralExplanationAttachment
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Identifier Return Reference Explanation
      As the David Faten Black Foundation, Inc. EIN 46-1350510 Chief Financial Officer I hereby ELECTS to As the David Faten Black Foundation, Inc. EIN 46-1350510 Chief Financial Officer I hereby ELECTS to apply Prior Year Excess Distributions to satify its current year distribution requirements. This Election is made in leiu of locating any form to do so at the IRS website. If this creates a problem please notify me ASAP. Donald F. Wilkens

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
    786 shares of VIRTUS KAR SMALL CAP GRWTH PXSGX 33,139 38,369
    594 shares of SPDR DOW JONES INDL AVER DIA 162,353 215,812
    1477 shares of MORGAN STANLEY INTL ADVANTAGE 30,405 44,742
    6586 shares of USB US QUALITY GROWTH QGRPX 73,131 94,387
    296 shares of ISHARES CORE SP 500 ETF 131,483 141,189
    1750 shares of SMEAD VALUE FUND CLASS 113,311 121,183
    3023 shares of USB US DIVIDEND RULER 39,427 41,384
    2901 shares of AB MUNICIPAL BOND INFLATION 31,637 32,384
    15160 shares of PIMCO REAL RETURN FUND 185,262 186,771
    4850 shares of EV SHT DUR MUNI OPP 50,303 50,013
    5941 shares of EV SHT DUR INFL PROTECTED 62,548 62,261
    2853 shares of VIRTUS KAR SM-MID CAP CORE 52,541 56,623

    TY 2021 InvestmentsOtherSchedule2
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value

    TY 2021 LandEtcSchedule2
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Furniture / iPads / Computers 11,452 6,644 4,808 4,808


    TY 2021 LegalFeesSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL EXPENSE 598      


    TY 2021 OtherAssetsSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Unrealized Gain Loss On Investments 178,134 119,578 119,578
    Note Receivable from DBFT Inc. dba Hukuma 501c3 Non Profit 51,944 303,248 303,248


    TY 2021 OtherDecreasesSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Description Amount
    Unrealized Securites Gain / Mark to Market 61,955


    TY 2021 OtherExpensesSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TELEPHONE 4,032 4,032    
    INSURANCE 664 664    
    EQUIPMENT MAINTENANCE SUPPLIES 1,108 1,108    
    OFFICE EXPENSE 926 926    
    POSTAGE AND DELIVERY 363 363    
    OTHER MISCELLANEOUS COSTS 344 344    


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    U. B. S INVTMT MGMT FEES / BANK CHGR 10,923 10,923    


    TY 2021 TaxesSchedule
    Name:
    DAVID & FATEN BLACK FOUNDATION INC
    EIN:
    46-1350510
    Software ID:
    21013562
    Software Version:
    21.0.3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PAYROLL TAXES 6,169 6,169