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
CARLSON FAMILY LIGHTSHIELD FOUNDATION

Number and street (or P.O. box number if mail is not delivered to street address)11591 217TH AVE NW
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
ELK RIVER, MN55330

A Employer identification number

83-4534853

B Telephone number (see instructions)

(763) 284-7063

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

$5,486,136J 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)	25,143
2	Check .............
3	Interest on savings and temporary cash investments	121		121
4	Dividends and interest from securities...	72,674		72,674
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		339,175
b	Gross sales price for all assets on line 6a 1,307,248
7	Capital gain net income (from Part IV, line 2)...			339,175
8	Net short-term capital gain.........
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....
11	Other income (attach schedule).......
12	Total. Add lines 1 through 11........	437,113		411,970
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).......		10,195	5,098	5,097
c	Other professional fees (attach schedule)....		31,834	31,834	0
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		18,418	3,470	0
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	60,447		40,402	5,097
25	Contributions, gifts, grants paid.......	508,950			508,950
26	Total expenses and disbursements. Add lines 24 and 25	569,397		40,402	514,047
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-132,284
b	Net investment income (if negative, enter -0-)			371,568
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.............	1,070,678	762,744	762,744
	2	Savings and temporary cash investments.........
	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)
	b	Investments—corporate stock (attach schedule).......	4,064,556	4,723,392	4,723,392
	c	Investments—corporate bonds (attach schedule).......
	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 )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	5,135,234	5,486,136	5,486,136
	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	5,135,234	5,486,136
	29	Total net assets or fund balances (see instructions).....	5,135,234	5,486,136
	30	Total liabilities and net assets/fund balances (see instructions).	5,135,234	5,486,136

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

5,135,234

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

-132,284

Other increases not included in line 2 (itemize) bullet

483,186

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

5,486,136

Decreases not included in line 2 (itemize) bullet

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

5,486,136

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	PUBLICLY TRADED SECURITIES
b
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	1,307,248	968,073	339,175
b
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			339,175
b
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	339,175
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	5,165
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	5,165
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	7,400
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	7,400
d	Backup withholding erroneously withheld ...........	6d	0

7	Total credits and payments. Add lines 6a through 6d..............		7	14,800
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8	23
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	9,612
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax9,612	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?.........

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

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. Click to see attachment

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

Yes

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

CHRIS CARLSON Telephone no. bullet

(763) 284-7063

Located at bullet

11591 217TH AVE NWELK RIVERMN ZIP+4 bullet

55330

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)

Yes

(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
CHRISTOPHER D CARLSON	PRESIDENT & DIRECTOR 1.00	0	0	0
11591 217TH AVENUE NW ELK RIVER,MN55330	PRESIDENT & DIRECTOR 1.00	0	0	0
DEBRA L CARLSON	VICE PRESIDENT & DIRECTOR 1.00	0	0	0
11591 217TH AVENUE NW ELK RIVER,MN55330	VICE PRESIDENT & DIRECTOR 1.00	0	0	0
TAYLOR G SCHROER	TREASURER & DIRECTOR 1.00	0	0	0
11591 217TH AVENUE NW ELK RIVER,MN55330	TREASURER & DIRECTOR 1.00	0	0	0
ANDREW C CARLSON	SECRETARY & DIRECTOR 1.00	0	0	0
11591 217TH AVENUE NW ELK RIVER,MN55330	SECRETARY & DIRECTOR 1.00	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...................

4,441,038

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

919,285

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

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

5,360,323

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

5,360,323

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

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

80,405

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

5,279,918

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

263,996

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

263,996

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

5,165

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

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

5,165

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

258,831

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

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

258,831

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

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

258,831

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					258,831
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......
b From 2017......
c From 2018......
d From 2019......
e From 2020......	218,713
f Total of lines 3a through e ........		218,713
4Qualifying distributions for 2021 from Part
XI, line 4: $ 514,047
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.....					258,831
e Remaining amount distributed out of corpus		255,216
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		473,929
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 ......		473,929
10 Analysis of line 9:
a Excess from 2017....
b Excess from 2018....
c Excess from 2019....
d Excess from 2020....	218,713
e Excess from 2021....	255,216

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).)

CHRISTOPHER D CARLSON

DEBRA L CARLSON

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 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)

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
BIG LAKE COMMUNITY FOOD SHELF PO BOX 501 160 LAKE ST NORTH BIG LAKE,MN55309	NONE	PC	GENERAL SUPPORT	5,000
BILLY SANDERSON 11591 217TH AVE NW ELK RIVER,MN55330	NONE	I	FINANCIAL NEED GRANT	1,000
CHILDREN'S CANCER RESEARCH 7301 OHMS LANE SUITE 355 MINNEAPOLIS,MN55439		PC	GENERAL SUPPORT	500
CITY OF ELK RIVER 13065 ORONO PARKWAY ELK RIVER,MN55330	NONE	GOV	DOCK PROJECT	57,500
COMMUNITY AID ELK RIVER 12621 ELK LAKE ROAD NW ELK RIVER,MN55330	NONE	PC	KIDZ KITZ	25,000
FISHING FOR LIFE PO BOX 19320 MINNEAPOLIS,MN55419	NONE	PC	GENERAL SUPPORT	35,000
GATEWAY CHURCH 13913 185TH AVE NW ELK RIVER,MN55330	NONE	PC	GENERAL SUPPORT	290,000
IGNACIO CALDERON 11591 217TH AVE NW ELK RIVER,MN55330	NONE	I	FINANCIAL NEED GRANT	250
JAN WLASCHIN 11591 217TH AVE NW ELK RIVER,MN55330	NONE	I	FINANCIAL NEED GRANT	500
KEN MITCHELL 11591 217TH AVE NW ELK RIVER,MN55330	NONE	I	POSTCARD MINISTRY	2,200
LIVIN FDN 2168 7TH AVE PO BOX 652 ANOKA,MN55303	NONE	PC	2021 LIVIN MUSIC FESTIVAL	5,000
MICHAEL WILLEM 11591 217TH AVE NW ELK RIVER,MN55330	NONE	I	FINANCIAL NEED GRANT	2,000
MINNESOTA FCA 7368 146TH AVENUE NORTHWEST RAMSEY,MN55303	NONE	PC	GENERAL SUPPORT	10,000
MN ADULT TEEN CHALLENGE (LAKESIDE ACADEMY) 740 EAST 24TH STREET MINNEAPOLIS,MN55404	NONE	PC	GENERAL SUPPORT, COVID RELIEF & LAKESIDE ENTRY ARCH SUPPORT	25,000
NAZARENE FUND 1918 E RANCH RD EAGLE MOUNTAIN,UT84005	NONE	PC	GENERAL SUPPORT	1,000
PAUL HANSON'S FAMILY 11591 217TH AVE NW ELK RIVER,MN55330	NONE	I	FINANCIAL NEED GRANT	5,000
RACERS FOR CHRIST 1250 E BASELINE RD SUITE 101 TEMPE,AZ85283	NONE	PC	DIRT SPORT MINISTRIES	1,000
ST JUDE AND THE DYLAN WITSCHEN FOUNDATION 17065 WACO ST NW ANDOVER,MN55304	NONE	PC	GENERAL SUPPORT	500
STMA BREAKFAST CLUB 10192 KARSTON AVE NE 100 ALBERTVILLE,MN55301	NONE	PC	GENERAL SUPPORT	40,000
SUICIDE AWARENESS VOICES OF EDUCATION 7900 XERXES AVE S SUITE 810 MINNEAPOLIS,MN55431	NONE	PC	GENERAL SUPPORT	1,000
BAME FOUNDATION 900 MENDELSSOHN AVE N GOLDEN VALLEY,MN55427	NONE	PF	GENERAL SUPPORT	500
FAMILY ENHANCEMENT CENTER 4826 CHICAGO AVE S SUITE 105 MINNEAPOLIS,MN55417	NONE	PC	GENERAL SUPPORT	500
THUMBS UP HIGH PO BOX 478 ELK RIVER,MN55330	NONE	PC	GENERAL SUPPORT	500
Total ................................. 3a				508,950

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	121
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	339,175
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..		0		411,970	0

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

411,970

(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:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

CARLSON FAMILY LIGHTSHIELD FOUNDATION

Employer identification number

83-4534853

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization CARLSON FAMILY LIGHTSHIELD FOUNDATION

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
1	ENVISION COMPANY 11591 217TH AVE NW ELK RIVER, MN55330	$ 25,143	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization CARLSON FAMILY LIGHTSHIELD FOUNDATION		Employer identification number 83-4534853

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

Schedule B (Form 990) (2021)

Page 4


Name of organization CARLSON FAMILY LIGHTSHIELD FOUNDATION			Employer identification number 83-4534853
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

TY 2021 AccountingFeesSchedule

Name:

CARLSON FAMILY LIGHTSHIELD FOUNDATION

EIN:

83-4534853

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
ACCOUNTING	10,195	5,098		5,097

- TIN:

TY 2021 InvestmentsCorpStockSchedule

Name:

CARLSON FAMILY LIGHTSHIELD FOUNDATION

EIN:

83-4534853

Name of Stock	End of Year Book Value	End of Year Fair Market Value
POLARIS INC	21,982	21,982
ADVANCE AUTO PARTS INC	33,822	33,822
AECOM	19,646	19,646
ALEXANDRIA REAL ESTATE	15,607	15,607
AMERICAN WATER WORKS CO INC	16,620	16,620
AMERIPRISE FINANCIAL INC	28,054	28,054
AMETEK INC	31,320	31,320
AVANTOR INC	30,636	30,636
BOOZ ALLEN HAMILTON HLDG CORP	27,642	27,642
BRIGHT HORIZONS FAMILY SOLUTIONS INC	21,903	21,903
BURLINGTON STORES INC	29,443	29,443
CITIZENS FINANCIAL GROUP INC	30,335	30,335
CURTIS WRIGHT CORP	22,742	22,742
DARDEN RESTAURANTS INC	31,634	31,634
EASTMAN CHEMICAL CO	22,006	22,006
ENTEGRIS INC	24,529	24,529
EPAM SYSTEMS INC	30,080	30,080
FIRST REP BANK	25,607	25,607
FMC CORP NEW	22,418	22,418
FORTINET INC	25,877	25,877
FORTIVE CORP	19,988	19,988
HOULIHAN LOKEY INC	26,087	26,087
INGERSOLL RAND INC	37,060	37,060
JAZZ PHARMACEUTICALS PLC	15,798	15,798
KEYSIGHT TECHNOLOGIES INC COM	28,705	28,705
LABORATORY CORP AMER HLDGS NEW	25,137	25,137
LOGITECH INTL SA REG NAMEN-AKT CHF	10,557	10,557
MASIMO CORP	14,346	14,346
MATCH GROUP INC	20,234	20,234
ON SEMICONDUCTOR CORP	21,463	21,463
PALO ALTO NETWORKS INC	25,611	25,611
PIONEER NAT RES CO	28,373	28,373
RPM INTL INC (DELA)	22,826	22,826
SERVICE CORP INTL	22,859	22,859
TAKE-TWO INTERACTIVE SOFTWARE	22,748	22,748
TELEFLEX INC	22,994	22,994
TIMKEN CO	20,579	20,579
VAIL RESORTS INC	22,953	22,953
VONTIER CORP COM	18,315	18,315
VOYA FINL INC COM	24,999	24,999
ACCENTURE PLC IRELAND CL A	19,483	19,483
AMER ELECTRIC POWER CO	10,321	10,321
AMGEN INC	22,497	22,497
ANALOG DEVICES INC	27,420	27,420
AUTOMATIC DATA PROCESSING INC	20,466	20,466
BLACKROCK INC	25,636	25,636
BROADCOM INC	29,943	29,943
CHUBB LTD CHF	25,904	25,904
CISCO SYSTEMS INC	32,572	32,572
COCO COLA CO	31,559	31,559
COMCAST CORP NEW CL A	29,997	29,997
DIAGEO PLC NEW GB SPON ADR	26,197	26,197
DISCOVER FINANCIAL SERVICES	16,063	16,063
EOG RESOURCES INC	25,583	25,583
HOME DEPOT INC	19,090	19,090
JOHNSON & JOHNSON COM	39,346	39,346
JP MORGAN CHASE & CO	33,254	33,254
LINDE PLC EUR	31,525	31,525
LOCKHEED MARTIN	18,837	18,837
MARSH & MCLENNAN COS INC	21,032	21,032
MCDONALDS CORP	30,828	30,828
MEDTRONIC PLC	26,794	26,794
MICROSOFT CORP	76,345	76,345
MORGAN STANLEY	15,607	15,607
NEXTERA ENERGY INC COM	12,884	12,884
NOVARTIS AG SPON ADR	15,045	15,045
PHILLIPS 66	14,202	14,202
PROCTER & GAMBLE CO	26,991	26,991
RAYTHEON TECHNOLOGIES CORP	30,723	30,723
REPUBLIC SERVICES INC	18,407	18,407
ROCKWELL AUTOMATION INC NEW	16,745	16,745
STARBUCKS CORP	18,832	18,832
TEXAS INSTRUMENTS	25,255	25,255
TRUIST FINL CORP	27,401	27,401
UNION PACIFIC CORP	20,910	20,910
UNITED POSTAL SERVICE	26,578	26,578
UNITED HEALTH GROUP	20,588	20,588
VF CORP	19,403	19,403
ABBOTT LABS	24,769	24,769
ADOBE INC.	22,115	22,115
ALPHABET INC CL A	81,117	81,117
AMAZON.COM INC	83,359	83,359
AMERICAN TOWER CORP REIT	15,503	15,503
AMERIPRISE FINANCIAL	23,529	23,529
APPLE INC	64,635	64,635
APPLIED MATERIALS INC	21,244	21,244
BOOKING HLDGS INC	11,996	11,996
BOSTON SCIENTIFIC CORP	17,502	17,502
COSTCO WHOLESALE CORP	19,870	19,870
DANAHER CORP	13,489	13,489
DOLLAR GEN CORP NEW	15,565	15,565
FIDELITY NATL INFORMAITON SVCS	18,010	18,010
HOME DEPOT INC	26,976	26,976
HONEYWELL INTL INC	12,094	12,094
INTERCONTINENTALEXCHANGEGROUP	15,318	15,318
LAUDER ESTEE COS CL A	10,736	10,736
LOWES COMPANIES INC	26,106	26,106
META PLATFORMS INC CL A	51,125	51,125
MICROSOFT CORP	127,802	127,802
NIKE INC CL B	13,167	13,167
O'REILLY AUTOMOTIVE INC	23,306	23,306
PARKER HANNIFIN CORP	21,632	21,632
ROCKWELL AUTOMATION INC NEW	10,117	10,117
S&P GLOBAL INC	10,854	10,854
SALESFORCE.COM INC	25,159	25,159
SHERWIN WILLIAMS CO	19,017	19,017
TEXAS INSTRUMENTS	19,789	19,789
THERMO FISHER SCIENTIFIC INC	12,678	12,678
TJX COS INC NEW	30,975	30,975
UNION PACIFIC CORP	24,185	24,185
UNITEDHEALTH GROUP INC	21,090	21,090
VISA INC CL A	37,274	37,274
ACUSHNET HLDGS CORP	47,665	47,665
APTARGROUP INC	11,022	11,022
ARTISAN PARTNERS ASSET MGMT INC	18,913	18,913
ASPEN TECHNOLOGY INC DEL	38,354	38,354
ATRION CORP DELA	12,688	12,688
AUTOHOME INC SPON ADR	14,858	14,858
CLEARWATER ANALYTICS HLDGS INC	12,248	12,248
CORVEL CORP	45,760	45,760
DONALDSON CO INC	11,911	11,911
DRIL - QUIP INC	7,498	7,498
EMCOR GROUP INC	52,103	52,103
FACTSET RESH SYSTEMS INC	36,451	36,451
FIRST HAWAIIAN INC	40,339	40,339
FTI CONSULTING INC	59,834	59,834
GRACO INC	40,794	40,794
HENRY JACK & ASSOC INC	15,363	15,363
LANDSTAR SYSTEMS INC	44,218	44,218
LCI INDUSTRIES	20,419	20,419
MANHATTAN ASSOC INC	40,894	40,894
MOELIS & CO CL A	32,255	32,255
PRICESMART INC	14,049	14,049
PRIMERICA INC	40,157	40,157
RBC BEARINGS INC	29,892	29,892
RIGHTMOVE PLC ADR	43,353	43,353
RLI CORP	20,514	20,514
SIMPSON MANUFACTURING CO INC DELA	54,794	54,794
TELEDYNE TECHNOLOGIES INC	27,087	27,087
TORO CO	33,670	33,670
WATTS WATER TECHNOLOGIES INC CL A	43,106	43,106
ADIDAS AG SPON ADR	11,377	11,377
ADYEN N V ADR	12,949	12,949
AIA GROUP LTD SPON ADR	14,355	14,355
ALLIANZ SE ADR	15,441	15,441
ANGLO AMERN PLC SPON ADR	12,122	12,122
ASML HLDG NV SPON ADR	32,642	32,642
ASSA ABLOY AB ADR	12,735	12,735
ATLAS COPCO AB NEW REPSTG COM	16,219	16,219
AXA ADR	13,188	13,188
BHP GROUP LTD SPON ADR	18,165	18,165
BNP PARIBAS SA ADR	9,532	9,532
CAPGEMINI SE UNSPONSORED ADR	17,423	17,423
CARLSBERG AS SPON ADR	10,972	10,972
COLOPLAST AS SPON ADR	7,770	7,770
DBS GROUP HLDGS LTD SPON ADR	20,348	20,348
DEUTSCHE BOERSE ADR	9,003	9,003
DIAGEO PLC NEW GB SPON ADR	30,599	30,599
FANUC CORP ADR	8,261	8,261
FERGUSON PLC SPON ADR	20,271	20,271
GENMAB A/S SPON ADR	8,703	8,703
GLAXO SMITHKLINE PLC ADR	13,495	13,495
HDFC BANK LTD ADR REPSTG 3 ORD SHS	6,832	6,832
HOLCIM LTD NEW SPON ADR	5,842	5,842
HONG KONG EXCHANGE & CLEARING	12,087	12,087
HOYA CORP SPON ADR	21,987	21,987
IBERDROLA SA SPON ADR	11,850	11,850
INDUSTRIA DE DISENO TEXTIL IND ADR	7,528	7,528
ING GROEP N V NL SPON ADR	11,247	11,247
KBC GROUP NV ADR	10,215	10,215
KERING S A UN SPONSORED ADR	9,581	9,581
KONE OYJ ADR	11,690	11,690
KUBOTA CORP ADR JAPAN ADR	9,496	9,496
LEGAL & GENL GROUP PLC SPON ADR	10,124	10,124
LONDON STK EXCHANGE UNSPONSORED ADR	9,554	9,554
LONZA GROUP AG ADR	17,869	17,869
LOREAL CO ADR FRANCE ADR	17,080	17,080
LVMH MOET HENNESSY LOUIS NEW ADR	27,473	27,473
MAKITA CORP ADR JAPAN ADR	9,385	9,385
MUNICH RE GROUP ADR	9,445	9,445
NESTLE S A SPONSORED ADR	31,864	31,864
NIDEC CORP ADR	11,952	11,952
NOVO NORDISK ADR DENMARK ADR	34,384	34,384
ORSTED A/S UNSPONSORED ADR	7,136	7,136
PRUDENTIAL PLC ADR UNITED KINGDOM	11,775	11,775
RECRUIT HLDGS CO LTD UN SPONSORED ADR	11,461	11,461
RELX PLC SPON ADR	14,772	14,772
RIO TINTO PLC SPON ADR	9,773	9,773
RWE AG ADR	8,084	8,084
SAFRAN SA ADR	7,617	7,617
SCHNEIDER ELEC SE UNSPONSORED ADR	21,173	21,173
SEA LTD ADR	7,382	7,382
SHIN ETSU CHEM CO LTD ADR	12,331	12,331
SMC CORP SPON ADR	12,673	12,673
SMITH & NEPHEW PLC NEW	7,201	7,201
SONY CORP ADR NEW JAPAN ADR	20,856	20,856
STRAUMANN HLDG AG ADR	12,636	12,636
SVENSKA HANDELBANKEN AB ADR	11,954	11,954
SYMRISE AG ADR	12,678	12,678
SYSMEX CORP UNSPONSORED ADR	8,200	8,200
TAIWAN SEMICONDUCTOR MFG CO LTD ADR	26,709	26,709
TENCENT HLDGS LTD ADR	8,745	8,745
TOKYO ELECTRON LTD ADR	25,758	25,758
TOTALENERGIES SE SPON ADR	21,169	21,169
VINCI S.A. ADR	15,444	15,444
VOLKSWAGEN AG UNSPONSORED ADR	9,418	9,418
VOLVO AB-A SHS UNSPONSORED ADR	9,282	9,282

- TIN:

TY 2021 OtherIncreasesSchedule

Name:

CARLSON FAMILY LIGHTSHIELD FOUNDATION

EIN:

83-4534853

Description	Amount
UNREALIZED GAIN	483,186

- TIN:

TY 2021 OtherProfessionalFeesSchedule

Name:

CARLSON FAMILY LIGHTSHIELD FOUNDATION

EIN:

83-4534853

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
INVESTMENT MANAGEMENT FEES	31,834	31,834		0

- TIN:

TY 2021 SubstantialContributorsSch

Name:

CARLSON FAMILY LIGHTSHIELD FOUNDATION

EIN:

83-4534853

Name	Address
CHRISTOPHER D CARLSON	11591 217TH AVE NW ELK RIVER,MN55330
DEBRA L CARLSON	11591 217TH AVE NW ELK RIVER,MN55330

- TIN:

TY 2021 TaxesSchedule

Name:

CARLSON FAMILY LIGHTSHIELD FOUNDATION

EIN:

83-4534853

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
FOREIGN TAXES PAID	3,470	3,470		0
FEDERAL TAX PAYMENTS	14,948	0		0