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 08-01-2021 , and ending 07-31-2022
Name of foundation
ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
 
Number and street (or P.O. box number if mail is not delivered to street address)5 COMMERCE PARK NORTH-WEALTH
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BEDFORD, NH03110
A Employer identification number

02-6004813
B Telephone number (see instructions)

(877) 773-1229
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$547,284
J 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      
4 Dividends and interest from securities... 10,365 10,365  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 69,861
b Gross sales price for all assets on line 6a 224,483
7 Capital gain net income (from Part IV, line 2)... 69,861
8 Net short-term capital gain......... 0
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........ 80,226 80,226  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 10,064 10,064    
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... 850 850 0 0
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... 1,585 88   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... 296 296    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 12,795 11,298 0 0
25 Contributions, gifts, grants paid....... 29,406 29,406
26 Total expenses and disbursements. Add lines 24 and 25 42,201 11,298 0 29,406
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 38,025
b Net investment income (if negative, enter -0-) 68,928
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.............      
2 Savings and temporary cash investments......... 22,696 20,977 20,977
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
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 bullet0      
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)....... 229,318 Click to see attachment283,426 295,555
c Investments—corporate bonds (attach schedule)....... 269,661 Click to see attachment254,817 230,752
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........     0
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) 521,675 559,220 547,284
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
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........ 521,675 559,220
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)..... 521,675 559,220
30 Total liabilities and net assets/fund balances (see instructions). 521,675 559,220
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
521,675
2
Enter amount from Part I, line 27a .....................
2
38,025
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
559,700
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
480
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
559,220
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 23. MORGAN STANLEY GROUP INC. DEAN   2017-05-19 2021-08-05
b 2. NORTHRUP GRUMMAN CORPORATION   2020-05-11 2021-08-05
c 4. JONES LANG LASALLE INC COM   2019-07-24 2021-08-17
d 2. LAM RESEARCH CORPORATION   2020-05-13 2021-08-20
e 34. DOLLAR TREE INC COM   2020-03-13 2021-08-30
1. TEXAS PACIFIC LAND CORP   2020-03-13 2021-09-01
1. TEXAS PACIFIC LAND CORP   2020-03-13 2021-09-08
3. BROADCOM INC   2018-02-09 2021-09-10
4. ADOBE SYSTEMS INC   2021-03-31 2021-09-14
117.386 FIDELITY SPARTAN HIGH INCOME   2020-12-16 2021-09-20
20.546 NEUBERGER BERMAN EQUITY SER GENESIS INSTL   2021-06-18 2021-09-20
11.2 NEUBERGER BERMAN EQUITY SER GENESIS INSTL   2019-03-01 2021-09-20
4. ARISTA NETWORKS INC   2019-06-25 2021-09-22
28. LAMB WESTON HOLDINGS INC   2020-09-16 2021-09-24
5. MICROSOFT CORPORATION   2021-06-18 2021-09-24
6. MICROSOFT CORPORATION   2011-09-08 2021-09-24
4. DANAHER CORP   2012-01-24 2021-09-29
7. DANAHER CORP   2012-01-24 2021-10-08
6. AMERICAN INTL GROUP INC COM NEW   2013-11-29 2021-10-19
3. AMETEK AEROSPACE PRODUCTS INC   2018-08-01 2021-10-19
4. ASPEN TECHNOLOGY INC   2021-08-17 2021-10-19
14. EQUITABLE HOLDINGS INC   2018-07-06 2021-10-19
2. JONES LANG LASALLE INC COM   2019-07-24 2021-10-19
4. MERCK & CO INC NEW COM   2020-04-23 2021-10-19
5. METLIFE INC   2017-04-11 2021-10-19
3. MICROSOFT CORPORATION   2011-09-08 2021-10-19
1. NORTHRUP GRUMMAN CORPORATION   2020-05-11 2021-10-19
4. PIONEER NAT RES CO   2021-03-08 2021-10-19
30. SCHLUMBERGER LTD   2021-06-21 2021-10-19
3. T-MOBILE US INC   2020-09-29 2021-10-19
1. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-10-19
4. WAL MART STORES INC   2020-03-20 2021-10-19
7. WELLS FARGO & CO NEW   2021-06-09 2021-10-19
10. SIGNATURE BANK   2020-12-21 2021-10-20
2. BROADCOM INC   2018-02-09 2021-10-22
3. NORFOLK SOUTHERN CORP COMMON   2019-02-06 2021-10-22
17. BANK AMER CORP COM   2017-01-13 2021-10-29
3. JONES LANG LASALLE INC COM   2019-07-24 2021-10-29
8. NORFOLK SOUTHERN CORP COMMON   2015-08-04 2021-10-29
1. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-10-29
3. JONES LANG LASALLE INC COM   2020-09-17 2021-11-02
2. ARISTA NETWORKS INC   2019-06-25 2021-11-03
3. JONES LANG LASALLE INC COM   2020-09-17 2021-11-03
4. BROADCOM INC   2018-02-09 2021-11-04
2. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-11-04
4. AMETEK AEROSPACE PRODUCTS INC   2018-08-01 2021-11-08
30. BANK AMER CORP COM   2017-01-13 2021-11-08
7. THERMO ELECTRON CORPORATION   2020-04-21 2021-11-08
2. UNITED RENTALS INC   2021-02-25 2021-11-08
4. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-11-08
11. BANK AMER CORP COM   2017-01-13 2021-11-12
8. METLIFE INC   2017-04-11 2021-11-12
1. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-11-12
6. WESTERN ALLIANCE BANCORP   2021-08-05 2021-11-12
31. METLIFE INC   2017-04-12 2021-11-17
13. TJX COMPANIES INC.   2013-02-04 2021-11-17
12. BANK AMER CORP COM   2017-01-13 2021-11-23
4. MICROSOFT CORPORATION   2010-11-22 2021-11-23
18. AMETEK AEROSPACE PRODUCTS INC   2018-05-21 2021-11-24
8. ARISTA NETWORKS INC   2019-06-25 2021-11-29
25. BANK AMER CORP COM   2017-01-13 2021-11-29
8. ARISTA NETWORKS INC   2020-03-20 2021-11-30
4. LINDE PLC   2019-04-18 2021-11-30
2. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-12-03
25. RYMAN HOSPITALITY PROPERTIES   2021-03-08 2021-12-08
33. TJX COMPANIES INC.   2013-02-04 2021-12-09
2. UNITEDHEALTH GROUP INC COM   2013-11-29 2021-12-09
4. SYNEOS HEALTH INC   2021-05-12 2021-12-15
4. CENTENE CORP   2021-12-09 2021-12-21
6. FACEBOOK INC-A   2021-10-29 2021-12-21
9. MICROSOFT CORPORATION   2010-11-22 2021-12-21
7. LINDE PLC   2018-10-30 2021-12-21
22. RAYTHEON TECHNOLOGIES   2021-05-26 2021-12-22
6. MICROSOFT CORPORATION   2010-11-22 2021-12-30
4. NORTHRUP GRUMMAN CORPORATION   2020-07-31 2021-12-30
19. SYNEOS HEALTH INC   2021-05-12 2022-01-05
29. NEXTERA ENERGY PARTNERS LP   2020-12-04 2022-01-07
2. NORTHRUP GRUMMAN CORPORATION   2021-02-03 2022-01-07
2. NORTHRUP GRUMMAN CORPORATION   2020-12-04 2022-01-07
9. VISA INC. - CL A   2013-11-29 2022-01-07
2. NORTHRUP GRUMMAN CORPORATION   2021-02-03 2022-01-10
7. MICRON TECHNOLOGY INC COM   2019-08-07 2022-01-11
6. MICRON TECHNOLOGY INC COM   2021-11-08 2022-01-11
15. MICRON TECHNOLOGY INC COM   2019-06-28 2022-01-12
6. ELECTRONIC ARTS COM   2019-12-04 2022-01-19
1. LAM RESEARCH CORPORATION   2020-05-13 2022-01-19
12. MICRON TECHNOLOGY INC COM   2019-06-28 2022-01-20
6. MIDDLEBY CORP   2021-10-20 2022-01-20
4. ELECTRONIC ARTS COM   2019-03-08 2022-01-21
12. MICRON TECHNOLOGY INC COM   2019-06-28 2022-01-21
3. NEXSTAR MEDIA GROUP INC - CL A   2020-02-27 2022-01-21
1. BERKSHIRE HATHAWAY INC DEL CL B NEW   2021-10-20 2022-01-25
8. ISHARES CORE MSCI EMERGING MARKETS ETF   2021-09-20 2022-01-25
4. MERCK & CO INC NEW COM   2020-04-23 2022-01-25
7. RESTAURANT BRANDS INTERNATIONAL INC   2020-08-10 2022-01-25
16. SCHLUMBERGER LTD   2021-11-08 2022-01-25
17.155 INVESCO INTL GROWTH-Y   2020-12-21 2022-01-26
16. CAPITAL ONE FINANCIAL CORP   2021-04-06 2022-01-26
17.254 FIDELITY SPARTAN HIGH INCOME   2020-12-16 2022-01-26
62.801 OAKMARK INTERNATIONAL FUND   2021-12-21 2022-01-26
41.972 METROPOLITAN WEST FDS #512 TOTAL RET CL I   2020-09-15 2022-01-26
46.348 VANGUARD INTERMEDIATE TERM TREASURY ADMIRAL   2020-09-15 2022-01-26
132.493 VANGUARD SHORT-TERM FED-ADM #549   2020-12-16 2022-01-26
11. EQUITABLE HOLDINGS INC   2018-07-06 2022-01-28
6. UNITED RENTALS INC   2021-03-05 2022-01-31
9. CITRIX SYS INC COM   2021-01-21 2022-02-01
35. CITRIX SYS INC COM   2021-11-24 2022-02-01
10. WAL MART STORES INC   2020-03-20 2022-02-02
68. EQUITABLE HOLDINGS INC   2019-02-06 2022-02-04
5. NEXSTAR MEDIA GROUP INC - CL A   2020-03-13 2022-02-04
12. NEXSTAR MEDIA GROUP INC - CL A   2020-03-13 2022-02-07
16. ELECTRONIC ARTS COM   2019-03-08 2022-02-09
50. AMERICAN INTL GROUP INC COM NEW   2019-02-06 2022-02-14
13. PIONEER NAT RES CO   2021-04-21 2022-02-23
9. PIONEER NAT RES CO   2021-09-08 2022-02-24
3. ZOOM VIDEO COMMUNICATIONS-A   2022-01-31 2022-02-25
5. ZIMMER HLDGS INC   2022-02-01 2022-02-28
23. CENTENE CORP   2021-12-09 2022-03-21
1. CENTENE CORP   2017-12-19 2022-03-21
1. ALPHABET INC CL-C   2019-02-06 2022-03-23
1. AMAZON.COM INC   2021-11-08 2022-03-23
2. FACEBOOK INC-A   2021-10-29 2022-03-23
5. MICROSOFT CORPORATION   2010-11-22 2022-03-23
21.588 NEUBERGER BERMAN EQUITY SER GENESIS INSTL   2021-12-21 2022-03-23
19. ASPEN TECHNOLOGY INC   2020-08-24 2022-03-25
3. ASPEN TECHNOLOGY INC   2021-08-17 2022-03-25
21. T-MOBILE US INC   2020-09-29 2022-04-12
15. VERTEX PHARMACEUTICALS INC   2021-11-08 2022-04-27
33. ECHOSTAR CORP-A   2021-11-29 2022-04-29
35. RESTAURANT BRANDS INTERNATIONAL INC   2020-08-10 2022-05-06
3. MERCK & CO INC NEW COM   2021-12-22 2022-05-16
3. MERCK & CO INC NEW COM   2020-04-23 2022-05-16
1. MERCK & CO INC NEW COM   2020-06-18 2022-05-20
13. MERCK & CO INC NEW COM   2021-12-22 2022-05-20
8. MERCK & CO INC NEW COM   2020-06-18 2022-05-20
5. VMWARE INC CL A   2021-10-22 2022-05-23
31. VMWARE INC CL A   2021-12-30 2022-05-25
16. MERCK & CO INC NEW COM   2020-06-18 2022-05-27
84. SCHLUMBERGER LTD   2021-11-24 2022-06-01
34. LAS VEGAS SANDS CORP COM   2021-11-08 2022-06-02
39. LAS VEGAS SANDS CORP COM   2021-02-19 2022-06-02
6. SCHLUMBERGER LTD   2021-07-23 2022-06-08
4. HUMANA INC   2022-02-01 2022-06-16
157.773 METROPOLITAN WEST FDS #512 TOTAL RET CL I   2020-09-15 2022-06-23
299.775 PIMCO INVESTMENT GRADE CORP BOND FUND CLASS I   2010-11-22 2022-06-23
255.019 VANGUARD INTERMEDIATE TERM TREASURY ADMIRAL   2020-12-16 2022-06-23
609.981 VANGUARD SHORT-TERM FED-ADM #549   2020-12-16 2022-06-23
4. UNITED THERAPEUTICS CORP   2021-08-09 2022-06-28
4. VERTEX PHARMACEUTICALS INC   2021-11-24 2022-06-28
7. VERTEX PHARMACEUTICALS INC   2021-06-15 2022-06-28
44. INTEL CORP COM   2022-03-25 2022-07-15
103. NOV INC   2022-06-08 2022-07-15
103. SABRE CORP   2022-06-02 2022-07-15
202. SABRE CORP   2021-01-11 2022-07-15
17. ALPHABET INC CL-C   2022-06-23 2022-07-25
12. AMAZON.COM INC   2021-08-30 2022-07-25
1. BERKSHIRE HATHAWAY INC DEL CL B NEW   2022-05-25 2022-07-25
9.621 NEUBERGER BERMAN EQUITY SER GENESIS INSTL   2021-12-21 2022-07-26
3. CENTENE CORP   2017-12-19 2022-07-27
14. WAL MART STORES INC   2020-04-02 2022-07-27
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(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 2,245   963 1,282
b 716   657 59
c 951   575 376
d 1,130   502 628
e 3,102   2,523 579
1,333   442 891
1,228   442 786
1,516   700 816
2,596   1,921 675
1,033   1,021 12
1,588   1,513 75
865   620 245
1,412   985 427
1,695   1,804 -109
1,487   1,300 187
1,784   158 1,626
1,225   160 1,065
2,105   279 1,826
353   300 53
390   230 160
655   507 148
462   300 162
508   288 220
317   310 7
328   236 92
925   79 846
399   328 71
763   656 107
1,035   978 57
353   342 11
424   75 349
578   461 117
351   323 28
3,086   1,331 1,755
1,033   467 566
859   336 523
815   391 424
782   431 351
2,361   664 1,697
456   75 381
777   356 421
1,023   493 530
794   318 476
2,189   934 1,255
907   149 758
559   306 253
1,429   690 739
4,324   2,041 2,283
791   597 194
1,841   299 1,542
517   253 264
510   377 133
458   75 383
705   574 131
1,971   1,456 515
974   295 679
567   276 291
1,342   102 1,240
2,571   1,365 1,206
1,005   493 512
1,131   575 556
992   350 642
1,266   675 591
894   149 745
2,063   1,823 240
2,446   750 1,696
947   149 798
392   342 50
331   300 31
1,976   1,955 21
2,902   230 2,672
2,318   1,154 1,164
1,849   1,899 -50
2,048   154 1,894
1,543   1,299 244
1,822   1,623 199
2,254   1,735 519
800   601 199
800   613 187
1,961   460 1,501
800   601 199
656   294 362
562   449 113
1,416   584 832
817   605 212
668   251 417
1,070   467 603
1,147   1,052 95
557   392 165
1,009   467 542
466   338 128
306   286 20
470   493 -23
316   310 6
384   383 1
610   538 72
439   544 -105
2,334   2,124 210
147   150 -3
1,749   1,720 29
447   489 -42
514   565 -51
1,419   1,463 -44
346   233 113
1,917   1,764 153
919   1,151 -232
3,574   3,884 -310
1,405   1,153 252
2,282   1,337 945
835   380 455
2,032   912 1,120
2,135   1,429 706
2,940   2,328 612
2,930   1,998 932
2,033   1,316 717
374   448 -74
632   617 15
2,005   1,708 297
87   51 36
2,787   1,116 1,671
3,305   3,515 -210
431   652 -221
1,506   128 1,378
1,433   1,561 -128
2,981   2,055 926
471   380 91
2,780   2,388 392
4,033   2,933 1,100
779   948 -169
1,845   1,514 331
276   229 47
276   233 43
93   72 21
1,214   992 222
743   578 165
579   661 -82
3,657   3,546 111
1,481   1,155 326
3,922   2,700 1,222
1,199   1,506 -307
1,375   2,273 -898
295   169 126
1,687   1,547 140
1,502   1,821 -319
2,668   3,519 -851
2,642   3,097 -455
6,295   6,720 -425
955   847 108
1,122   741 381
1,963   1,338 625
1,673   2,107 -434
1,450   2,118 -668
578   879 -301
1,133   2,616 -1,483
1,831   1,924 -93
1,447   2,058 -611
287   310 -23
589   696 -107
277   152 125
1,751   1,596 155
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
      11,190
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       1,282
b       59
c       376
d       628
e       579
      891
      786
      816
      675
      12
      75
      245
      427
      -109
      187
      1,626
      1,065
      1,826
      53
      160
      148
      162
      220
      7
      92
      846
      71
      107
      57
      11
      349
      117
      28
      1,755
      566
      523
      424
      351
      1,697
      381
      421
      530
      476
      1,255
      758
      253
      739
      2,283
      194
      1,542
      264
      133
      383
      131
      515
      679
      291
      1,240
      1,206
      512
      556
      642
      591
      745
      240
      1,696
      798
      50
      31
      21
      2,672
      1,164
      -50
      1,894
      244
      199
      519
      199
      187
      1,501
      199
      362
      113
      832
      212
      417
      603
      95
      165
      542
      128
      20
      -23
      6
      1
      72
      -105
      210
      -3
      29
      -42
      -51
      -44
      113
      153
      -232
      -310
      252
      945
      455
      1,120
      706
      612
      932
      717
      -74
      15
      297
      36
      1,671
      -210
      -221
      1,378
      -128
      926
      91
      392
      1,100
      -169
      331
      47
      43
      21
      222
      165
      -82
      111
      326
      1,222
      -307
      -898
      126
      140
      -319
      -851
      -455
      -425
      108
      381
      625
      -434
      -668
      -301
      -1,483
      -93
      -611
      -23
      -107
      125
      155
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 69,861
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ...................
Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 958
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- ..... 5 958
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 784
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  
7 Total credits and payments. Add lines 6a through 6d.............. 7 784
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 9 174
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 taxBullet0 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$   (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
 
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)
    bulletNH
    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 addressbullet  
    14
    The books are in care ofbulletTD Bank NA Telephone no.bullet (877) 773-1229

    Located atbullet5 COMMERCE PARK NORTHBEDFORDNH ZIP+4bullet03110
    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
     
    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
    TD Bank NA Trustee
    1
    10,064    
    5 Commerce Park North
    Bedford,NH03110
    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.........................bullet  
    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
    571,042
    b
    Average of monthly cash balances.......................
    1b
    26,566
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    597,608
    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
    597,608
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    8,964
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    588,644
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    29,432
    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
    29,432
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    958
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    958
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    28,474
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    28,474
    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
    28,474
    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 28,474
    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...... 0
    b From 2017...... 302
    c From 2018...... 238
    d From 2019...... 95
    e From 2020...... 849
    f Total of lines 3a through e ........ 1,484
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 29,406
    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..... 28,474
    e Remaining amount distributed out of corpus 932
    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 2,416
    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) ...
    0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......
    2,416
    10 Analysis of line 9:
    a Excess from 2017.... 302
    b Excess from 2018.... 238
    c Excess from 2019.... 95
    d Excess from 2020.... 849
    e Excess from 2021.... 932
    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).)
    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
    SPAULDING YOUTH CENTER
    72 SPAULDING ROAD
    NORTHFIELD,NH03276
    NONE 501(C)(3) DAILY OPERATIONS 14,703
    CONCORD HOSPITAL
    RICHARD FORD
    250 PLEASANT STREET
    CONCORD,NH03301
    NONE 501(C)(3) DAILY OPERATIONS 14,703
    Total .................................bullet 3a 29,406
    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 ...........
             
    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 69,861  
    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) ..   80,226  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    80,226
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
    EIN:
    02-6004813
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 850 850    

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
    EIN:
    02-6004813
    Name of Bond End of Year Book Value End of Year Fair Market Value
    4181.573 FIDELITY HIGH INCOME 36,044 32,031
    3766.786 METROPOPLITAN WEST FD 39,457 36,877
    7763.003 PIMCO INVESTMENT GRAD 84,449 71,109
    3216920 VANGUARD INTM TERM TRE 36,367 34,067
    5454.107 VANGUARD SHORT-TERM F 58,500 56,668

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
    EIN:
    02-6004813
    Name of Stock End of Year Book Value End of Year Fair Market Value
    76 AMAZON.COM INC 10,296 10,256
    28 CARMAC INC 2,176 2,787
    108 LIBERTY SIRIUSXM GROUP 4,327 4,304
    4 NIKE INC CLASS B 419 460
    23 POLARIS INDS INC 2,775 2,697
    35 STARBUCKS CORP 2,698 2,967
    130 WARNER BROS DISCOVERY INC 3,218 1,950
    8 BOSTON BEER COMPANY 3,065 3,043
    13 CASEY'S GENERAL STORES INC 2,609 2,634
    16 CONSTELLATION BRANDS CL A 3,447 3,941
    59 OCCIDENTAL PETROLEUM CO 2,026 3,879
    70 SCHLUMBERGER LTD 1,917 2,592
    74 ESSENT GROUP LTD 3,413 3,090
    31 BERKSHIRE HATHAWAY INC DEL 8,958 9,319
    1 BLACKROCK INC CL A 761 669
    67 CITIGROUP INC 4,379 3,477
    36 FIDELITY NATL INFORMATION S 4,322 3,678
    75 KKR & CO INC - A 2,103 4,160
    206 MACERICH CO COM 3,861 2,186
    63 VENTAS INC COM REIT 3,343 3,388
    87 WELLS FARGO & CO NEW 3,903 3,817
    44 WESTERN ALLIANCE BANCORP 2,721 3,361
    7 ALIGN TECHNOLOGY INC 1,700 1,967
    15 BIOGEN INC 3,344 3,226
    58 BOSTON SCIENTIFIC 2,433 2,381
    61 CENTENE CORP 2,988 5,671
    61 GILEAD SCIENCES INC 3,932 3,645
    25 MODERNA INC 3,408 4,102
    13 UNITED THERAPEUTICS CORP 2,686 3,004
    25 UNIVERSAL HLTH SVCS INC CL 3,400 2,812
    36 SENSATA TECHNOLOGIES HOLDIN 2,238 1,601
    52 BERRY PLASTICS GROUP INC 3,643 2,998
    17 BOEING CO 3,031 2,708
    10 EQUIFAX INC COM 2,270 2,089
    6 GENERAC HLDGS INC 1,679 1,610
    53 GENERAL ELECTRIC CO 5,397 3,917
    21 JACOBS ENGR GROUP INC DEL 1,369 2,883
    14 MIDDLEBY CORP 1,674 2,026
    1 NVR INC 4,593 4,393
    10 UNIVERSAL DISPLAY CORP COM 1,044 1,155
    7 ADOBE SYSTEMS INC 3,203 2,871
    2 BROADCOM INC 1,022 1,071
    43 COTERRA ENERGY 1,135 1,315
    142 DROPBOX INC - CLASS A 2,702 3,229
    6 LAM RESEARCH CORPORATION 1,802 3,003
    40 MICROSOFT CORPORATION 4,601 11,230
    29 PAYPAL HOLDINGS INC 3,030 2,509
    37 SS&C TECHNOLOGIES HOLDINGS 2,557 2,189
    22 SALESFORCE COM INC 5,066 4,048
    18 SKYWORKS SOLUTIONS INC 2,836 1,960
    18 SPLUNK INC 2,053 1,870
    9 AIR PRODUCTS & CHEMICALS INC 2,190 2,234
    6 ECOLAB INC 954 991
    83 ALPHABET INC CL-C 5,950 9,681
    72 COMCAST CORP NEW CL A 3,572 2,701
    47 FACEBOOK INC-A 9,019 7,478
    16 T-MOBILE US INC 1,719 2,289
    1097.079 INVESCO INTL GROWTH-Y 29,322 24,827
    775.653 OAKMARK INTERNATIONAL 17,612 18,150
    314 ISHARES CORE MSCI EMERGING 16,089 15,405
    712.779 NEUBERGER BERMAN EQUIT 39,426 45,661

    TY 2021 OtherDecreasesSchedule
    Name:
    ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
    EIN:
    02-6004813
    Description Amount
    ROUNDING ADJUSTMENT 64
    RETURN OF CAPITAL ADJUSTMENT 416


    TY 2021 OtherExpensesSchedule
    Name:
    ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
    EIN:
    02-6004813
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OTHER NON-ALLOCABLE EXPENSE - 148 148   0
    OTHER NON-ALLOCABLE EXPENSE - 148 148   0


    TY 2021 TaxesSchedule
    Name:
    ALICE P FORD TESTAMENTARY TRUST XXX-XX-XXXX
    EIN:
    02-6004813
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 10 10   0
    FEDERAL TAX PAYMENT - PRIOR YE 713 0   0
    FEDERAL ESTIMATES - PRINCIPAL 784 0   0
    FOREIGN TAXES ON QUALIFIED FOR 55 55   0
    FOREIGN TAXES ON NONQUALIFIED 23 23   0