TY 2021 Form 990PF

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	258,679	425,058	425,058
	2	Savings and temporary cash investments.........	27,302	86,725	86,725
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....		0
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts		0
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)		0
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	1,596,796	1,610,129	2,212,664
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)		0
	15	Other assets (describe )	167,232	-813	-813
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	2,050,009	2,121,099	2,723,634
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons		0
	21	Mortgages and other notes payable (attach schedule)......		0
	22	Other liabilities (describe )	0	0
	23	Total liabilities (add lines 17 through 22).........		0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........
	27	Paid-in or capital surplus, or land, bldg., and equipment fund
	28	Retained earnings, accumulated income, endowment, or other funds	2,050,009	2,121,099
	29	Total net assets or fund balances (see instructions).....	2,050,009	2,121,099
	30	Total liabilities and net assets/fund balances (see instructions).	2,050,009	2,121,099

(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	42 Artisan Intl SM/Mid-Inst	P	2020-11-25	2021-05-27
b	706 Champlain Mid Cap Fund-Ins	P	2020-08-19	2021-05-27
c	1,374 Dodge & Cox Income Fund	P	2020-11-25	2021-05-27
d	11 Harbor Fund International Growth Fund	P	2020-08-19	2021-05-27
e	7 IShares Core MSCI Emerging	P	2020-11-25	2021-05-27
	291 IShares Core MSCI Emerging	P	2020-11-25	2021-11-16
	57 Vanguard Dev Mkt Indx-Adm	P	2020-11-25	2021-05-27
	1,148 Vanguard Dev Mkt Indx-Adm	P	2020-11-25	2021-11-17
	57 Vanguard Extended Market Index Adm	P	2020-11-25	2021-05-27
	13 Vanguard Extended Market Index Adm	P	2020-11-25	2021-11-17
	23 Vanguard FTSE AW SC X US-Adm	P	2020-11-25	2021-05-27
	140 Vulcan Value Part SM CAP-INS	P	2020-11-25	2021-11-16
	814 Artisan Developing World-Ins	P	2020-02-20	2021-11-16
	157 Champlain Mid Cap Fund-Ins	P	2020-08-19	2021-11-16
	3,451.52 Dodge & Cox Income Fund	P	2020-11-25	2021-05-27
	28 JPM Opport Eq Lng/Shrt-R6	P	2020-08-19	2021-11-16
	315.629 Vanguard Equity Income-Adm	P	2015-07-06	2021-05-27
	72.947 Vanguard Equity Income-Adm	P	2015-07-06	2021-11-17
	291 Vanguard High Dvd Yield ETF	P	2015-07-06	2021-05-27
	63 Vanguard High Dvd Yield ETF	P	2013-11-14	2021-11-16

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	893	788	105
b	19,570	15,836	3,734
c	19,634	20,381	-747
d	255	207	48
e	464	416	48
	18,520	17,311	1,209
	958	836	122
	19,286	16,841	2,445
	7,899	6,678	1,221
	1,942	1,523	419
	776	659	117
	3,900	2,404	1,496
	23,077	13,602	9,475
	5,087	3,522	1,565
	49,322	46,177	3,145
	708	586	122
	29,085	20,361	8,724
	6,966	4,706	2,260
	31,030	17,302	13,728
	6,987	3,873	3,114

Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69				(l) Gains (Col. (h) gain minus col. (k), but not less than -0-) or Losses (from col.(h))
(i) F.M.V. as of 12/31/69		(j) Adjusted basis as of 12/31/69	(k) Excess of col. (i) over col. (j), if any
a	0	0	0	105
b	0	0	0	3,734
c	0	0	0	-747
d	0	0	0	48
e	0	0	0	48
	0	0	0	1,209
	0	0	0	122
	0	0	0	2,445
	0	0	0	1,221
	0	0	0	419
	0	0	0	117
	0	0	0	1,496
	0	0	0	9,475
	0	0	0	1,565
	0	0	0	3,145
	0	0	0	122
	0	0	0	8,724
	0	0	0	2,260
	0	0	0	13,728
	0	0	0	3,114

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	52,350
3	Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
	If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 ...................		3	13,362

1a	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2	Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	2	0
3	Add lines 1 and 2...........................	3	1,598
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	1,598
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	789
b	Exempt foreign organizations—tax withheld at source......	6b
c	Tax paid with application for extension of time to file (Form 8868)...	6c	2,500
d	Backup withholding erroneously withheld ...........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7	3,289
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.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	1,691
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax1,691	Refunded	11

(a) Name and address	(b) Title, and average hours per week devoted to position	(c) Compensation (If not paid, enter -0-)	(d) Contributions to employee benefit plans and deferred compensation	(e) Expense account, other allowances
Mark R Donatelli	Director 5.00	15,000	0	0
15 Salt Creek Lane 312 Hinsdale,IL60521
Peter Coules	Director 5.00	15,000	0	0
15 Salt Creek Lane 312 Hinsdale,IL60521
LeRoy Rosasco	Director 5.00	15,000	0	0
1009 Bonnie Brae Place 3c River Forest,IL60305

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	Eisenhower Medical Center	154,509
2


3


4

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

		(a) Corpus	(b) Years prior to 2020	(c) 2020	(d) 2021
1 Distributable amount for 2021 from Part X, line 7					0
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......
b Total for prior years:20, 20, 20
3 Excess distributions carryover, if any, to 2021:
a From 2016......	144,987
b From 2017......	170,682
c From 2018......	158,964
d From 2019......	166,736
e From 2020......	179,141
f Total of lines 3a through e ........		820,510
4Qualifying distributions for 2021 from Part
XI, line 4: $
a Applied to 2020, but not more than line 2a
b Applied to undistributed income of prior years (Election required—see instructions).....
c Treated as distributions out of corpus (Election required—see instructions)........		0
d Applied to 2021 distributable amount.....
e Remaining amount distributed out of corpus		0
5 Excess distributions carryover applied to 2021.
(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		820,510
b Prior years’ undistributed income. Subtract line 4b from line 2b ..........			0
c Enter the amount of prior years’ undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed......
d Subtract line 6c from line 6b. Taxable amount —see instructions ...........			0
e Undistributed income for 2019. Subtract line 4a from line 2a. Taxable amount—see instructions .............				0
f Undistributed income for 2021. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2022 ..........					0
7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (Election may be required - see instructions) .......
8 Excess distributions carryover from 2016 not applied on line 5 or line 7 (see instructions) ...		144,987
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......		675,523
10 Analysis of line 9:
a Excess from 2017....	170,682
b Excess from 2018....	158,964
c Excess from 2019....	166,736
d Excess from 2020....	179,141
e Excess from 2021....	0

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2021	(b) 2020	(c) 2019	(d) 2018	(e) Total
	0	0	0	0	0
b 85% (0.85) of line 2a .........
c Qualifying distributions from Part XI, line 4 for each year listed .....		179,141	166,736	158,964	504,841
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 ....	0	179,141	166,736	158,964	504,841
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......	2,723,634	2,509,835	2,391,632	2,118,188	9,743,289
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)	2,723,634	2,509,835	2,391,632	2,118,188	9,743,289
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

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:

3 Grants and Contributions Paid During the Year or Approved for Future Payment
aPaid during the year
Eisenhower Health 39000 Bob Hope Drive Ranchero Mirage,CA92270		501c3	Primary CareInitiative	154,509
Total ................................. 3a	154,509

Line No.	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.)

(a) Line No.	(b) Amount involved	(c) Name of noncharitable exempt organization	(d) Description of transfers, transactions, and sharing arrangements

(a) Name of organization	(b) Type of organization	(c) Description of relationship

	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)


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check .............
3	Interest on savings and temporary cash investments	232		232
4	Dividends and interest from securities...	51,430		51,430
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10
b	Gross sales price for all assets on line 6a
7	Capital gain net income (from Part IV, line 2)...			52,350
8	Net short-term capital gain.........				13,362
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....		0
11	Other income (attach schedule).......		181,942	23,734
12	Total. Add lines 1 through 11........	233,604		127,746	13,362
13	Compensation of officers, directors, trustees, etc.	45,000
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........		2,106
b	Accounting fees (attach schedule).......		0
c	Other professional fees (attach schedule)....		12,200	12,200
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		1,132	607
19	Depreciation (attach schedule) and depletion...		0
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		0
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	60,438		12,807		0
25	Contributions, gifts, grants paid.......	154,509				0
26	Total expenses and disbursements. Add lines 24 and 25	214,947		12,807		0
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	18,657
b	Net investment income (if negative, enter -0-)			114,939
c	Adjusted net income (if negative, enter -0-)...				13,362

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

Enter gross amounts unless otherwise indicated.	Unrelated business income		Excluded by section 512, 513, or 514		(e) Related or exempt function income (See instructions.)
1Program service revenue:	(a) Business code	(b) Amount	(c) Exclusion code	(d) Amount	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments ....
3 Interest on savings and temporary cash investments ...........	522100	232
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 ............
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) ..		51,662

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

Software ID:
Software Version:
Part VI Line 7 -Original Return Overpayment:	-3,289


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









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

3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient	If recipient is an individual, show any relationship to any foundation manager or substantial contributor	Foundation status of recipient	Purpose of grant or contribution	Amount
Name and address (home or business)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
Eisenhower Health 39000 Bob Hope Drive Ranchero Mirage,CA92270		501c3	Primary CareInitiative	154,509
Total ................................. 3a				154,509

bApproved for future payment

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

Name of organization Anthony J & Elaine M Scrugli Charitable Trust Foundation

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
1	Anthony & Elaine Scrugli Trust 15 Salt Creek Lane 312 Hinsdale, IL60521	$ 157,751	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Name of organization Anthony J & Elaine M Scrugli Charitable Trust Foundation		Employer identification number 27-4405237

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)


Name of organization Anthony J & Elaine M Scrugli Charitable Trust Foundation			Employer identification number 27-4405237
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

Category/ Item	Book Value	End of Year Fair Market Value
Invesco European Small	10,005	11,865
iShares MSCI Emerging Markets ETF	30,478	29,066
iShares Russell 2000 ETF	32,253	47,159
iShares Russell Mid Cap ETF	93,547	203,707
iShares Trust	37,052	85,592
SPDR S&P 500 ETF Trust	66,364	163,386
Vanguard FTSE Developed Markets ETF	146,844	182,335
Vanguard Sector Index FDS	12,625	75,140
Vanguard Specialized Funds	16,092	40,361
JPMorgan Tr I	180,010	173,460
Virtus Strategy Tr Allianz Conv FD CL A	15,005	16,968
Virtus Strategy Tr Allianz Conv FD CL C	30,005	27,929
JPMorgan Chase & Co Alerian MLP Index ETN	15,967	6,251
iShares Core S&P 500 ETF	81,769	262,345
Vanguard Equity Income Fund	31,840	45,517
Vanguard High Dividend Yield ETF	28,053	47,871
Champlain Mid Cap Fund	35,342	45,344
Nuance Mid Cap Value Fund	27,612	24,869
Vanguard Extended Market Index Fund	39,483	46,742
Segall Bryant & Hamill Small Cap Value Fund	30,906	34,333
Vulcan Value Partners Small Cap Fund	24,455	26,107
Harbor International Growth Fund	29,250	32,702
JOHCM International Select Fund	41,978	46,037
Artisan International Small-Mid Fund	21,311	23,595
Vanguard FTSE All-World Ex-US Small-Cap Index Fund	9,257	10,678
Artisan Developing World Fund	16,115	18,965
Touchstone Sands Capital Emerbing Markets Growth Fund	13,365	12,668
Vanguard Real Estate ETF	25,217	26,682
BlackRock Total Return Fund	102,938	98,000
Hartford Total Return Bond Fund	77,976	76,388
Mainstay Mackay U.S. Infrastructure Bond Fund	75,386	75,222
Vanguard ST Investment Grade Fund	31,692	31,805
Angel Oak Multi-Strat Income Fund	16,100	15,052
Artisan High Income Fund	28,155	28,263
PIMCO Preferred and Capital Security Fund	43,544	42,712
Mainstay Mackay High Yield Muni Bond Fund	30,884	31,645
JPMorgan Opportunistic Equity L/S Fund	20,905	21,812
BlackRock Systemic Multi-Strat Fund	23,567	24,045
Infinity Q Diversified Alpha Fund	16,782	46

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
Interest & Dividends Receivable	-961	-813	-813
Scrugli Trust Receivable	168,193	0	0

Description	Revenue And Expenses Per Books	Net Investment Income
Income from Scrugli
Trust #27-6362738	157,751
Cap. gain distributions	22,931	22,931
Other Income	1,260	803

Description	Amount
Gain on sale of investments	52,351
Non dividend distributions	82