TY 2021 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
bullet

Go 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
WAYNE G BASLER CHARITABLE FOUNDATION

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 2049
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
KINGSPORT, TN37662

A Employer identification number

62-1347054

B Telephone number (see instructions)

(423) 306-4215

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$11,418,863J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

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


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check .............
3	Interest on savings and temporary cash investments	115		115
4	Dividends and interest from securities...	201,471		193,074
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		381,768
b	Gross sales price for all assets on line 6a 1,787,787
7	Capital gain net income (from Part IV, line 2)...			363,383
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).......		-16,346	-225
12	Total. Add lines 1 through 11........	567,008		556,347
13	Compensation of officers, directors, trustees, etc.	0		0	0
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......		16,043	8,022	8,021
c	Other professional fees (attach schedule)....		109,239	109,239	0
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		8,599	2,599	0
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		312	250	0
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	134,193		120,110	8,021
25	Contributions, gifts, grants paid.......	451,000			451,000
26	Total expenses and disbursements. Add lines 24 and 25	585,193		120,110	459,021
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-18,185
b	Net investment income (if negative, enter -0-)			436,237
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	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.............
	2	Savings and temporary cash investments.........	225,282	250,747	250,747
	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).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)	648,925	788,751	788,844
	b	Investments—corporate stock (attach schedule).......	7,351,927	7,293,905	10,027,525
	c	Investments—corporate bonds (attach schedule).......	345,275	351,465	351,747
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )	1,419	0	0
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	8,572,828	8,684,868	11,418,863
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........	0	0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	0	0
	27	Paid-in or capital surplus, or land, bldg., and equipment fund	0	0
	28	Retained earnings, accumulated income, endowment, or other funds	8,572,828	8,684,868
	29	Total net assets or fund balances (see instructions).....	8,572,828	8,684,868
	30	Total liabilities and net assets/fund balances (see instructions).	8,572,828	8,684,868

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

8,572,828

Enter amount from Part I, line 27a .....................

-18,185

Other increases not included in line 2 (itemize) bullet

131,644

Add lines 1, 2, and 3 ..........................

8,686,287

Decreases not included in line 2 (itemize) bullet

1,419

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

8,684,868

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
1 a	PUBLICLY TRADED SECURITIES	P
b	CAPITAL GAINS DIVIDENDS	P
c
d
e

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	1,783,160	1,424,404	358,756
b	4,627		4,627
c
d
e

Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69			(l) Gains (Col. (h) gain minus col. (k), but not less than -0-) or Losses (from col.(h))
(i) F.M.V. as of 12/31/69	(j) Adjusted basis as of 12/31/69	(k) Excess of col. (i) over col. (j), if any
a			358,756
b			4,627
c
d
e

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	363,383
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

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 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	6,064
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	6,064
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	4,606
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	7,000
d	Backup withholding erroneously withheld ...........	6d	0

7	Total credits and payments. Add lines 6a through 6d..............		7	11,606
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.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	5,542
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax5,542	Refunded	11	0

Part VI-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:

(1) On the foundation. bullet

$ 0(2) On foundation managers. bullet

$ 0

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

$ 0

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?.........

Yes

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Yes

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2021)

Page 5

Part VI-A

Statements Regarding Activities (continued)

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

SHARI HILLMAN KING Telephone no. bullet

(423) 306-4215

Located at bullet

PO BOX 2049KINGSPORTTN ZIP+4 bullet

37662

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

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

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)

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? ..............................

1a(2)

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........

1a(3)

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............

1a(4)

(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)

(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)

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 ..........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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? .............

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)):

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?....................

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year? ..............................

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.) .....................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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? ..

Form 990-PF (2021)

Page 6

Part VI-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........

5a(1)

(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)

(3) Provide a grant to an individual for travel, study, or other similar purposes? .............

5a(3)

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions ........................

5a(4)

(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)

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 ........

Organizations relying on a current notice regarding disaster assistance check here ......... bullet

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? .................

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? .............................

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....

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? .........................

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
WAYNE G BASLER	TRUSTEE 0.00	0	0	0
PO BOX 2049 KINGSPORT,TN37662	TRUSTEE 0.00	0	0	0
SHARI L HILLMAN KING	FOUNDATION MANAGER 7.00	0	0	0
PO BOX 2049 KINGSPORT,TN37662	FOUNDATION MANAGER 7.00	0	0	0

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...................				0

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............. 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


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)

Page 8

Part IX

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

11,019,116

Average of monthly cash balances.......................

279,278

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

11,298,394

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

11,298,394

Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see

instructions) .............................

169,476

Net value of noncharitable-use assets. Subtract line 4 from line 3. .......

11,128,918

Minimum investment return. Enter 5% (0.05) of line 5................

556,446

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.)

Minimum investment return from Part IX, line 6..................

556,446

Tax on investment income for 2021 from Part V, line 5.......

6,064

Income tax for 2021. (This does not include the tax from Part V.) ...

265

Add lines 2a and 2b............................

6,329

Distributable amount before adjustments. Subtract line 2c from line 1............

550,117

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

550,117

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...

550,117

Part XI

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

Program-related investments—total from Part VIII-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.

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				550,117
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......			446,115
b Total for prior years:20, 20, 20		0
3 Excess distributions carryover, if any, to 2021:
a From 2016......
b From 2017......
c From 2018......
d From 2019......
e From 2020......
f Total of lines 3a through e ........	0
4Qualifying distributions for 2021 from Part
XI, line 4: $ 459,021
a Applied to 2020, but not more than line 2a			446,115
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.....				12,906
e Remaining amount distributed out of corpus	0
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	0
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 ..........				537,211
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 ......	0
10 Analysis of line 9:
a Excess from 2017....
b Excess from 2018....
c Excess from 2019....
d Excess from 2020....
e Excess from 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 4942(j)(3) or4942(j)(5)

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

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

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).)

WAYNE G BASLER

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

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions

aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:

SHARI HILLMAN KING
PO BOX 2049
KINGSPORT,TN37662
(423) 246-4546

bThe form in which applications should be submitted and information and materials they should include:

WRITTEN APPLICATION - INCLUDE NATURE OF ORGANIZATION & PROOF OF CHARITABLE STATUS

cAny submission deadlines:

SEPTEMBER 30

dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:

CHARITABLE ORGANIZATIONS ONLY

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
FIRST PRESBYTERIAN CHURCH 4815 FRANKLIN PIKE NASHVILLE,TN37220	NONE	PC	GENERAL PURPOSES	1,000
PAT SUMMITT FOUNDATION 520 W SUMMIT HILL DRIVE SUITE 1101 KNOXVILLE,TN37902	NONE	PC	GENERAL PURPOSES	100,000
SECOND HARVEST FOOD BANK OF NORTHEAST TENNESSEE 1020 JERICHO DR KINGSPORT,TN37663	NONE	PC	GENERAL PURPOSES	30,000
ST JUDE'S CHILDREN'S RESEARCH HOSPITAL 262 DANNY THOMAS PL MEMPHIS,TN38105	NONE	PC	GENERAL PURPOSES	100,000
UNITED WAY OF KINGSPORT 301 LOUIS ST SUITE 201 KINGSPORT,TN37660	NONE	PC	GENERAL PURPOSES	20,000
HUNTER'S HOPE FOUNDATION PO BOX 643 ORCHARD PARK,NY14127	NONE	PC	GENERAL PURPOSES	10,000
SENIOR ACTION INC 3715 E NORTH ST STE K GREENVILLE,SC29615	NONE	PC	GENERAL PURPOSES	10,000
EMMA FILA FOUNDATION 2948 TOPSIDE RD UNIT 517 LOUISVILLE,TN37777	NONE	PC	GENERAL PURPOSES	100,000
BEULAH BAPTIST CHURCH 491 BEULAH CHURCH RD KINGSPORT,TN37663	NONE	PC	GENERAL PURPOSES	5,000
RIZE PREVENTION 117 MOSLEY RD SIMPSONVILLE,SC29680	NONE	PC	GENERAL PURPOSES	25,000
KINGSPORT HOMELESS MINISTRY PO BOX 1125 KINGSPORT,TN37662	NONE	PC	GENERAL PURPOSES	50,000
Total ................................. 3a				451,000

bApproved for future payment

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

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	(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 ...........			14	115
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 ............	523000	18,385	18	363,383
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: aPARTNERSHIP INCOME/LOSS	523000	-16,121	14	-225
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..		2,264		564,744	0

13Total. Add line 12, columns (b), (d), and (e)..................

567,008

(See worksheet in line 13 instructions to verify calculations.)

Part XV-B

Relationship of Activities to the Accomplishment of Exempt Purposes

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.)

Form 990-PF (2021)

Page 13

Part XVI

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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? ...........Yes No

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.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

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.

Form 990-PF (2021)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2021 AccountingFeesSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
ACCOUNTING FEES	16,043	8,022		8,021

- TIN:

TY 2021 AppliedToPriorYearElection

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Election:

PURSUANT TO CODE SEC. 4942(H) AND REG 53.4942(A)-3(D)(2) THE FOUNDATION HEREBY ELECTS TO TREAT CURRENT YEAR QUALIFYING DISTRIBUTIONS IN EXCESS OF THE IMMEDIATELY PRECEDING TAX YEAR'S UNDISTRIBUTED INCOME AS BEING MADE OUT OF UNDISTRIBUTED INCOME FROM THE TAX YEAR 2020 IN THE FOLLOWING AMOUNT-$65,405.THE ISSUE DISCLOSED IN THE FOOTNOTE BELOW, AND INCLUDED IN THE TAX YEAR 2019 RETURN, WAS REMEDIED THROUGH THE DISTRIBUTION OF $65,405 IN 2020 OF PRIOR UNDISTRIBUTED AMOUNTS ORIGINATING FROM TAX YEAR 2018.THE FOLLOWING FOOTNOTE WAS INCLUDED IN THE 2019 TAX RETURN:FORM 4720, PAGE 1 QUESTION BTHE TAXPAYER INADVERTENTLY DID NOT DISTRIBUTE THE INCOME EARNED IN TAX YEAR 2018 BEFORE THE END OF 2019. UPON DISCOVERY OF THE SITUATION, THE FOUNDATION MANAGER MADE A QUALIFYING DISTRIBUTION IN EXCESS OF THE AMOUNT NEEDED TO REDUCE UNDISTRIBUTED INCOME FOR THAT YEAR TO ZERO.

- TIN:

TY 2021 InvestmentsCorpBondsSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Name of Bond	End of Year Book Value	End of Year Fair Market Value
GOLDMAN SACHS GROUP	24,008	23,893
WELLS FARGO & CO	20,237	21,034
ENTERPRISE PRODUCTS OPERATING LLC	14,243	14,881
ABBVIE INC	16,231	15,956
BP CAPITAL MARKETS AMERICA INC	14,144	14,940
ABBVIE INC	22,762	22,141
CVS HEALTH CORP	16,920	16,492
BANK OF AMERICA CORP	11,025	11,715
CAPITAL ONE FINANCIAL CORP	10,214	10,895
JPMORGAN CHASE & CO FXD	11,402	11,954
VERIZON COMMUNICATIONS INC	15,281	14,779
MARSH & MCLENNAN COS INC	12,610	13,690
FISERV INC	16,407	17,222
BANK OF AMERICA CORP FXD	24,374	25,357
CIGNA CORP	16,531	16,146
ORACLE CORP	19,886	18,222
APPLE INC	15,257	14,613
NEXTERA ENERGY CAPITAL HOLDINGS INC	15,658	14,924
JPMORGAN CHASE & CO FXD	21,325	20,569
COMCAST CORP	16,765	16,067
BANK OF AMERICA CORP FXD	16,185	16,257

- TIN:

TY 2021 InvestmentsCorpStockSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Name of Stock	End of Year Book Value	End of Year Fair Market Value
AGREE REALTY CORP (ADC)	7,766	8,777
ALAMO GROUP INC (ALG)	7,647	13,982
ALLEGIANT TRAVEL (ALGT)	6,925	8,978
AMERIS BANCORP (ABCB)	13,462	18,680
AMERISAFE INC (AMSF)	7,796	8,936
APPLE INC (AAPL)	12,330	18,822
ATRICURE INC COM (ATRC)	4,725	12,098
AVIENT CORPORATION (AVNT)	16,998	26,129
AZENTA INC (AZTA)	8,493	12,167
BALCHEM CP (BCPC)	3,187	9,273
BOOT BARN HLDGS INC COM (BOOT)	3,965	14,889
CASTLE BIOSCIENCES INC (CSTL)	6,527	4,844
CATHAY GENERAL BANCORP (CATY)	12,162	16,078
CENTRAL GARDEN & PET CO CL A (CENTA)	12,380	17,178
CERENCE INC (CRNC)	8,171	8,354
CHEMOCENTRYX INC (CCXI)	4,923	4,843
CHENIERE ENERGY INC (LNG)	24,607	47,363
CHURCHILL DOWNS INC (CHDN)	5,416	13,009
CHUYS HOLDINGS INC (CHUY)	5,060	5,482
COHEN & STEERS INC (CNS)	4,600	15,634
COVERTUS INC (CVET)	9,859	8,467
CRYOLIFE INC (CRY)	9,878	8,425
CRYOPORT INC (CYRX)	3,406	10,828
DESCARTES SYSTEMS GROUP INC (DSGX)	5,996	13,146
DT MIDSTREAM INC (DTM)	22,558	23,558
ENBRIDGE INC (ENB)	37,525	47,248
ENDAVA PLC ADR (DAVA)	6,834	15,617
ENERGY TRANSFER LP COM UT LTD (ET)	53,756	44,253
ENTERPRISE PROD PRTNRS L.P. (EPD)	42,965	40,362
EQUITRANS MIDSTREAM CORPORATION (ETRN)	16,067	32,064
FIVE BELOW (FIVE)	1,225	7,448
GLACIER BANCORP INC NEW (GBCI)	5,582	16,273
GLOBUS MEDICAL INC A (GMED)	5,954	19,422
GRAND CANYON ED INC COM (LOPE)	5,146	10,371
HALOZYME THERAPEUTICS INC (HALO)	12,175	14,596
HEATHEQUITY INC COM (HQY)	10,031	8,538
HEARTLAND EXPRESS INC (HTLD)	2,408	2,977
HELEN OF TROY (HELE)	3,847	9,045
HELIOS TECHNOLOGIES INC (HLIO)	5,939	16,091
HESS MIDSTREAM LP CL A (HESM)	15,559	16,467
HORACE MANN EDUCATORS CP (HMN)	12,587	11,533
HOULIHAN LOKEY INC CL A (HLI)	8,732	19,048
ICF INTL INC (ICFI)	8,228	15,895
ICU MEDICAL INC (ICUI)	1,154	7,358
IDACORP (IDA)	10,062	14,617
INDEPENDENT BK MASS (INDB)	7,223	8,561
INTEGRA LIFESCIENCES CRP NEW (IART)	10,629	12,996
INTRA-CELLULAR THERAPIES INC (ITCI)	2,878	3,140
KINDER MORGAN INCORP (KMI)	26,727	30,578
LHC GRP (LHCG)	6,614	8,783
LITHIA MOTORS INC A (LAD)	3,078	10,690
MACOM TECHNOLOGY SOLU HLDS (MTSI)	10,952	24,508
MAGELLAN MIDSTREAM PARTNERS LP (MMP)	27,357	32,183
MAGNOLIA OIL & GAS CORP CL A (MGY)	9,487	14,454
MATADOR RES CO (MTDR)	10,171	11,334
MEDPACE HOLDINGS, INC. (MEDP)	8,408	15,452
MICROSOFT CORP (MSFT)	13,567	20,852
MINERALS TECHNOLOGY INC (MTX)	8,664	11,777
MPLX LP COM UNIT REP LTD (MPLX)	44,178	47,196
NATIONAL HEALTH INVESTORS INC (NHI)	7,963	10,057
NORTHWESTERN CORP (NWE)	8,609	12,118
NOVANTA INC (NOVT)	9,330	19,044
OCEAN FIRST FINANCIAL CORP (OCFC)	7,474	9,146
OLLIES BARGAIN OUTLET HLDG INC (OLLI)	7,559	5,631
ONEOK INC (OKE)	15,404	14,631
OPEN LENDING CORP (LPRO)	5,519	3,417
OXFORD INDUSTRIES INC (OXM)	7,318	12,385
PACIFIC PREMIER BANCORP INC (PPBI)	15,911	16,092
PATRICK INDUSTRIES (PATK)	11,239	17,671
PAYCOR HMC INC (PYCR)	8,245	8,240
PAYLOCITY HOLDING CORPORATION (PCTY)	3,220	11,808
PEMBINA PIPELINE CORP COM (PBA)	13,820	15,741
PERFORMANCE FOOD GROUP CO (PFGC)	10,003	15,557
PHREESIA INC (PHR)	10,800	13,581
PLAINS ALL AMERN PIPELINE L P (PAA)	66,714	46,532
PRIMORIS SVCS CORP COM (PRIM)	8,775	10,935
PROGYNY INC (PGNY)	6,855	13,393
PROLOGIS INC COM (PLD)	13,273	21,550
RAPID7 INC (RPD)	9,294	19,772
RBC BEARINGS INC (ROLL)	4,963	14,542
REVOLVE GROUP INC (RVLV)	3,907	5,100
RITCHIE BROTHERS AUCTIONEERS (RBA)	4,528	14,017
RYMAN HOSPITALITY PPTYS INC (RHP)	9,300	10,391
SEACOST BANKING CORPOF FLORI (SBCF)	12,687	17,695
SHYFT GROUP INC (SHYF)	5,078	9,335
SILGAN HLDGS INC (SLGN)	1,784	6,683
SILICON LAB INC (SLAB)	4,727	14,037
SKYLINE CORP (SKY)	7,252	23,299
SPX CP (SPXC)	13,594	13,488
STAG INDL INC COM (STAG)	9,946	21,006
STIFEL FINANCIAL CORPORATION (SF)	4,851	13,873
SUPERNUS PHARMACEUTICALS INC (SUPN)	8,833	10,089
SYNEOS HEALTH INC CL A (SYNH)	7,701	18,482
TARGA RESOURCES CORP (TRGP)	19,440	46,076
TC ENERGY CORP (TRP)	14,819	15,777
TEREX CP NEW DEL (TEX)	5,927	5,538
TEXAS ROADHOUSE INC CL A (TXRH)	6,179	22,677
UFP INDUSTRIES INC (UFPI)	1,823	16,470
US ECOLOGY INC (ECOL)	5,750	6,260
VERACYTE INC COM (VCYT)	5,344	7,869
VIAVI SOLUTIONS INC COM (VIAV)	9,758	13,902
WESTERN MIDSTREAM PARTNERS L P (WES)	13,211	25,032
WILLIAMS CO INC (WMB)	23,768	37,655
WOLVERINE WORLD WIDE (WWW)	5,373	8,154
COMM SERV SELECT SECTOR SPDR (XLC)	22,498	34,723
CONS DISCRET SEL SECT SPDR FD (XLY)	37,613	77,687
CONS STAPLES SECT SPDR FD (XLP)	22,270	29,919
ENERGY SEL SECT SPDR FD (XLE)	18,897	20,424
GLOBAL X US INF DEV ETF (PAVE)	25,766	40,536
GOLDMAN ACTIVEBETA US LC ETF (GSLC)	123,097	248,981
HEALTH CARE SEL SECT SPDR FD (XLV)	54,596	91,015
INDUSTRIAL SEL SEC SPDR FD (XLI)	17,691	30,685
INVESCO QQQ TRUST, SERIES 1 (QQQ)	18,443	55,699
ISHARES 10-20 YR TREAS BD ETF (TLH)	17,433	20,331
ISHARES 20+ YR TREASU BOND ETF (TLT)	33,415	37,196
ISHARES CORE DIVIDEND GROWTH (DGRO)	19,120	27,790
ISHARES CORE MSCI EAFE ETF (IEFA)	1,517,832	1,989,753
ISHARES CORE S&P 500 ETF (IW)	869,623	1,764,863
ISHARES MBS ETF (MBB)	81,309	84,225
ISHARES S&P MIDCAP 400 INDEX (IJH)	536,070	897,081
ISHARES US FIN SERVICES ETF (IYG)	48,580	88,238
JPMORGAN EQUITY PREMIUM INCO (JEPI)	137,515	141,230
MATERIALS SEL SECT SPDR FD (XLB)	15,316	25,914
PIMCO ENHANCED MTRT EXC (MINT)	493,846	493,480
SPDR PORTF AGGREGATE BND ETF (SPAB)	267,765	261,930
THE TECHNOLOGY SEL SEC SPDR FD (XLK)	51,064	131,793
VANGUARD COMMUNICATION SVCS ETF (VOX)	12,406	20,741
VANGUARD INTERMEDIATE TERM COR (VCIT)	161,237	171,328
VANGUARD INTERMEDIATE TERM GOV (VGIT)	73,478	76,440
VANGUARD LONG-TERM CORPORATE (VCLT)	23,482	24,131
VANGUARD SHORT-TERM CORPORATE (VCSH)	819,004	829,990
VANGUARD TOTAL BOND MARKET (BND)	235,460	250,436
BLACKROCK BATS: SERIES M PTF (BRAMX)	335,100	334,025
BLACKROCK BATS: SERIES C PTF (BRACX)	23,493	22,759
BLACKROCK BATS: SERIES S PTF (BRASX)	38,072	37,767

- TIN:

TY 2021 InvestmentsGovtObligationsSch

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

US Government Securities - End of Year Book Value:

788,751

US Government Securities - End of Year Fair Market Value:

788,844

State & Local Government Securities - End of Year Book Value:

State & Local Government Securities - End of Year Fair Market Value:

- TIN:

TY 2021 OtherAssetsSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
DIVIDENDS RECEIVABLE	1,419

- TIN:

TY 2021 OtherDecreasesSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Description	Amount
PRIOR PERIOD ADJUSTMENT	1,419

- TIN:

TY 2021 OtherExpensesSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Description	Revenue and Expenses per Books	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
PARTNERSHIP EXPENSES	312	250		0

- TIN:

TY 2021 OtherIncomeSchedule2

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
PARTNERSHIP INCOME/LOSS	-16,346	-225	-16,346

- TIN:

TY 2021 OtherIncreasesSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Description	Amount
ADJUSTMENT TO TAX BASIS	131,644

- TIN:

TY 2021 OtherProfessionalFeesSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
INVESTMENT MANAGEMENT EXPENSES	109,239	109,239		0

- TIN:

TY 2021 TaxesSchedule

Name:

WAYNE G BASLER CHARITABLE FOUNDATION

EIN:

62-1347054

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
FOREIGN TAX EXPENSE	2,599	2,599		0
FEDERAL EXCISE TAX	6,000	0		0