TY 2021 Form 990PF

- TIN:

Form990-PF
Click to see list of attachments

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
THOMAS AND SANDRA USHER CAMP

Number and street (or P.O. box number if mail is not delivered to street address)136 LAUREL MOUNTAIN CAMP ROAD
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
RECTOR, PA15677

A Employer identification number

30-0337978

B Telephone number (see instructions)

(724) 238-2400

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

$15,474,018J 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	(c) Adjusted net income	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)		777,636
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...		21,442		21,442	21,442
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10			44,898
b	Gross sales price for all assets on line 6a 263,677
7	Capital gain net income (from Part IV, line 2)...				44,898
8	Net short-term capital gain.........					8,426
9	Income modifications...........
10a	Gross sales less returns and allowances	1,387
b	Less: Cost of goods sold....	1,195
c	Gross profit or (loss) (attach schedule).....			192		192
11	Other income (attach schedule).......			38,156		38,156
12	Total. Add lines 1 through 11........		882,324		66,340	68,216
13	Compensation of officers, directors, trustees, etc.
14	Other employee salaries and wages......		242,136				242,136
15	Pension plans, employee benefits.......		98,087				103,733
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......			8,097			8,097
c	Other professional fees (attach schedule)....			10,936	7,242	7,242	2,231
17	Interest...............
18	Taxes (attach schedule) (see instructions)...			810	810
19	Depreciation (attach schedule) and depletion...			912,872
20	Occupancy..............		74,397			11,851	69,730
21	Travel, conferences, and meetings.......		126			126	3
22	Printing and publications..........
23	Other expenses (attach schedule).......			136,210		48,997	155,618
24	Total operating and administrative expenses.
	Add lines 13 through 23..........		1,483,671		8,052	68,216	581,548
25	Contributions, gifts, grants paid.......		0				0
26	Total expenses and disbursements. Add lines 24 and 25		1,483,671		8,052	68,216	581,548
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements		-601,347
b	Net investment income (if negative, enter -0-)				58,288
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.............	377,490	497,982	497,982
	2	Savings and temporary cash investments.........	37,065	53,035	53,035
	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	649
	8	Inventories for sale or use..............	9,253	5,223	5,223
	9	Prepaid expenses and deferred charges..........	10,011	14,618	14,618
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	1,030,434	1,106,192	1,106,192
	14	Land, buildings, and equipment: basis 25,895,997
		Less: accumulated depreciation (attach schedule) 12,099,329	14,567,673	13,796,668	13,796,668
	15	Other assets (describe )	300	300	300
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	16,032,875	15,474,018	15,474,018
	17	Accounts payable and accrued expenses..........	18,735	25,869
	18	Grants payable.................
	19	Deferred revenue.................	24,102	13,827
	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).........	42,837	39,696
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........	15,990,038	15,434,322
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........
	27	Paid-in or capital surplus, or land, bldg., and equipment fund
	28	Retained earnings, accumulated income, endowment, or other funds
	29	Total net assets or fund balances (see instructions).....	15,990,038	15,434,322
	30	Total liabilities and net assets/fund balances (see instructions).	16,032,875	15,474,018

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

15,990,038

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

-601,347

Other increases not included in line 2 (itemize) bullet

45,631

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

15,434,322

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 .

15,434,322

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	2042.981 BAIRD AGGREGATE BOND FUND #72	P	2018-01-01	2021-08-26
b	2808.511 BLACKROCK CORE BOND PORTFOLIO CL INSTL	P	2020-06-12	2021-08-26
c	1643.463 HARBOR FD LARGE CAP VALUE FD	P	2020-08-28	2021-05-03
d	15 ISHARES CORE MSCI EAFE ETF	P	2018-01-01	2021-08-26
e	50 ISHARES CORE MSCI EMERGING MKTS	P	2018-01-01	2021-08-26
	9.073 LAZARD GLOBAL LISTED INFRASTRUCTURE PORT	P	2020-09-23	2021-08-26
	2533.367 LAZARD GLOBAL LISTED INFRASTRUCTURE PORT	P	2018-01-01	2021-08-26
	288.991 T ROWE PRICE GROWTH STOCK FD #40	P	2021-02-11	2021-05-04
	836.165 PRINCIPAL BLUE CHIP - R6	P	2020-08-28	2021-02-11
	557.520 PRUDENTIAL TOTAL RETURN BOND CL R6	P	2020-03-03	2021-08-26
	570.186 TOUCHSTONE SANDS EM GR - INST FD #565	P	2020-03-03	2021-08-26
	260 VANGUARD TOTAL BOND MARKET ETF	P	2018-01-01	2021-08-26
	JOHN DEERE 757	P	2006-06-30	2021-04-21
	Capital Gain Dividends

(e) Gross sales price		(f) Depreciation allowed (or allowable)	(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	23,576		23,808	-232
b	27,917		29,040	-1,123
c	36,238		29,040	7,198
d	1,143		897	246
e	3,125		3,043	82
	148		139	9
	41,345		35,887	5,458
	30,041		30,110	-69
	30,328		29,040	1,288
	8,229		8,354	-125
	12,909		8,000	4,909
	22,391		21,421	970
	13,000	8,977	8,977	13,000
				13,287

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			-232
b			-1,123
c			7,198
d			246
e			82
			9
			5,458
			-69
			1,288
			-125
			4,909
			970
			13,000

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	44,898
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	8,426

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
3	Add lines 1 and 2...........................	3	810
4	Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	4
5	Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- .....	5	810
6	Credits/Payments:

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

7	Total credits and payments. Add lines 6a through 6d..............		7
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9	810
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax0	Refunded	11

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

$ (2) On foundation managers. bullet

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

on foundation managers. bullet

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

Yes

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

ALAN JONES DIRECTOR OF FINANCE Telephone no. bullet

(724) 238-2400

Located at bullet

136 LAUREL MOUNTAIN CAMP ROADRECTORPA ZIP+4 bullet

15677

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
JIMMY D COMPTON JR	Chairman 1.00	0
18717 PENNINGTON DETROIT,MI48221	Chairman 1.00	0
CARMELENA M MOFFA	Treasurer 1.00	0
820 HIGH RIDGE RD UNIT B9 STAMFORD,CT06905	Treasurer 1.00	0
DR JESSICA E UGWU	Secretary 1.00	0
5236 VISTA DRIVE WEST DES,IA50266	Secretary 1.00	0
EDWARD J GREFENSTETTE	Director 1.00	0
39 HOODRIDGE DR PITTSBURGH,PA15228	Director 1.00	0
MEGAN E WILSON	Director 1.00	0
201 CORNWALL DR PITTSBURGH,PA15238	Director 1.00	0
ARTHUR N MOATS III	Director 1.00	0
1568 CELEBRATION CIRCLE BRIDGEVILLE,PA15017	Director 1.00	0
DR CHRIS M JOHNSON SR	Director 1.00	0
86 MIDDLEBROOK ST HARRISONBURG,VA22801	Director 1.00	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...................

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	FULL TIME PERSONNEL, PART TIME PERSONNEL AND SEASONAL COUNSELORS USED THE FACILITIES, INCLUDING 10 CABINS, SPORTS PAVILION, POOL, LAKE, ARTS & CRAFTS PAVILION, AND DINING HALL TO SERVE DISADVANTAGED KIDS FROM THE INNER CITY OF PITTSBURGH AND SURROUNDING AREAS DURING 8 WEEKLY CAMP SESSIONS DURING THE SUMMER MONTHS.	0
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...................

1,116,205

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

374,840

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

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

1,491,045

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

1,491,045

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

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

22,366

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

1,468,679

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

73,434

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

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

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

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

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

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

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

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

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

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
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......
b Total for prior years:20, 20, 20
3 Excess distributions carryover, if any, to 2021:
a From 2016......
b From 2017......
c From 2018......
d From 2019......
e From 2020......
f Total of lines 3a through e ........
4Qualifying distributions for 2021 from Part
XI, line 4: $
a Applied to 2020, but not more than line 2a
b Applied to undistributed income of prior years (Election required—see instructions).....
c Treated as distributions out of corpus (Election required—see instructions)........
d Applied to 2021 distributable amount.....
e Remaining amount distributed out of corpus
5 Excess distributions carryover applied to 2021.
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
b Prior years’ undistributed income. Subtract line 4b from line 2b ..........
c Enter the amount of prior years’ undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed......
d Subtract line 6c from line 6b. Taxable amount —see instructions ...........
e Undistributed income for 2019. Subtract line 4a from line 2a. Taxable amount—see instructions .............
f Undistributed income for 2021. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2022 ..........
7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (Election may be required - see instructions) .......
8 Excess distributions carryover from 2016 not applied on line 5 or line 7 (see instructions) ...
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......
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
	0				0
b 85% (0.85) of line 2a .........
c Qualifying distributions from Part XI, line 4 for each year listed .....	581,548	766,293	663,469	660,853	2,672,163
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 ....	581,548	766,293	663,469	660,853	2,672,163
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 ..	48,956	38,924	46,703	43,239	177,822
c “Support" alternative test—enter:
(1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

Part XIV

Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)

1Information Regarding Foundation Managers:

aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)

bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.

2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here bullet

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

Total ................................. 3a

bApproved for future payment

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

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 ...........
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	44,898
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory			1	192
11 Other revenue: aOTHER INCOME			1	700
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..				67,232	37,456

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

104,688

(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.)
1a	Program fees are tuition for campers and leaders which is used to help defray the cost of the 8 weekly summer camps for disadvantaged inner city kids. Providing the weekly summer camps accomplishes the religious and educational purpose of the Foundation.

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:	21013475
Software Version:	2021v4.0

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

THOMAS AND SANDRA USHER CAMP

Employer identification number

30-0337978

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 THOMAS AND SANDRA USHER CAMP			Employer identification number 30-0337978

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	CHRISTIAN CAMPS OF PITTSBURGH 111 LAKE GLORIA ROAD BOSWELL, PA15531	$ 425,982		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
2	BENJAMIN PRICE 1651 NW PROFESSIONAL PLAZA COLUMBUS, OH43220	$ 50,000		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
3	KYLE WELCH 11 SHAKER CT ASHEVILLE, NC28805	$ 20,000		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
4	ROY LEUKHARDT 271 HECLA ROAD MT PLEASANT, PA15666	$ 15,000		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
5	JOHN HENNE 5501 WALNUT ST PITTSBURGH, PA15232	$ 5,000		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
6	TIMOTHEUS POPE 421 WEAVER MILL ROAD RECTOR, PA15677	$ 6,879		Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Name of organization THOMAS AND SANDRA USHER CAMP			Employer identification number 30-0337978
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
7	ED GREFENSTETTE 39 HOODRIDGE DRIVE PITTSBURGH, PA15228	$ 5,182		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
8	CITY CHURCH NEW CASTLE 11 S MILL STREET NEW CASTLE, PA16101	$ 5,364		Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions		(d) Type of contribution
9	BRITT HUME 721 S HARBOR DRIVE BOCA GRANDE, FL33921	$ 10,000		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 THOMAS AND SANDRA USHER CAMP		Employer identification number 30-0337978

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 THOMAS AND SANDRA USHER CAMP			Employer identification number 30-0337978
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:	21013475
Software Version:	2021v4.0

- TIN:

TY 2021 AccountingFeesSchedule

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
ACCOUNTING & AUDITING FEE	8,097	0	0	8,097

- TIN:

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

TY 2021 DepreciationSchedule

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Description of Property	Date Acquired	Cost or Other Basis	Prior Years' Depreciation	Computation Method	Rate / Life (# of years)	Current Year's Depreciation Expense
STONE LODGE	2006-01-01	124,121	93,090	SL	20.0000	6,206
STONE LODGE	2007-01-01	146	100	SL	20.0000	7
STONE LODGE	2009-01-01	14,862	8,916	SL	20.0000	743
CHESTNUT LODGE	2006-01-01	159,793	119,848	SL	20.0000	7,990
CHESTNUT LODGE	2007-01-01	176	125	SL	20.0000	9
CEDAR LODGE	2006-01-01	107,009	80,253	SL	20.0000	5,350
CEDAR LODGE	2007-01-01	9,108	6,372	SL	20.0000	455
MAINTENANCE BLDG 381	2006-01-01	124,956	93,719	SL	20.0000	6,248
MAINTENANCE BLDG 381	2007-01-01	29,423	20,595	SL	20.0000	1,471
2376 HOUSE	2006-01-01	125,349	94,008	SL	20.0000	6,267
2376 HOUSE	2007-01-01	115,168	80,614	SL	20.0000	5,758
2376 HOUSE	2008-01-01	20,980	13,637	SL	20.0000	1,049
2376 HOUSE	2009-01-01	11,450	6,874	SL	20.0000	573
509 WEAVER MILL	2007-01-01	178,784	125,147	SL	20.0000	8,939
509 WEAVER MILL	2009-01-01	36,108	21,662	SL	20.0000	1,805
509 WEAVER MILL	2011-01-01	16,524	8,260	SL	20.0000	826
DINING HALL	2007-01-01	8,495	5,949	SL	20.0000	425
DINING HALL	2008-01-01	1,661,208	1,079,782	SL	20.0000	83,060
DINING HALL	2009-01-01	739,676	443,807	SL	20.0000	36,984
CABINS	2007-01-01	16,320	11,424	SL	20.0000	816
CABINS	2008-01-01	823,290	535,143	SL	20.0000	41,165
CABINS	2009-01-01	506,790	304,078	SL	20.0000	25,340
UNIT DIRECTOR'S CABIN	2007-01-01	4,772	3,344	SL	20.0000	239
STORE	2007-01-01	13,030	9,125	SL	20.0000	652
SPORTS PAVILION	2007-01-01	49,602	34,721	SL	20.0000	2,480
SPORTS PAVILION	2008-01-01	1,460,928	949,600	SL	20.0000	73,046
SPORTS PAVILION	2009-01-01	2,059,433	1,235,663	SL	20.0000	102,972
POOL	2007-01-01	5,209	3,643	SL	20.0000	260
POOL	2008-01-01	348,910	226,795	SL	20.0000	17,446
POOL	2009-01-01	531,588	318,950	SL	20.0000	26,579
POOL LOCKER ROOM	2007-01-01	5,361	3,752	SL	20.0000	268
POOL LOCKER ROOM	2008-01-01	46,464	30,200	SL	20.0000	2,323
POOL LOCKER ROOM	2009-01-01	8,152	4,894	SL	20.0000	408
WATER TREATMENT FACILITY	2008-01-01	46,559	30,264	SL	20.0000	2,328
WATER TREATMENT FACILITY	2009-01-01	7,251	4,354	SL	20.0000	363
FIRE PUMP HOUSE	2008-01-01	103,577	67,326	SL	20.0000	5,179
FIRE PUMP HOUSE	2009-01-01	7,612	4,570	SL	20.0000	381
421 WEAVER MILL HOUSE	2008-01-01	235,083	152,803	SL	20.0000	11,754
421 WEAVER MILL HOUSE	2009-01-01	197,564	118,537	SL	20.0000	9,878
421 WEAVER MILL HOUSE	2010-01-01	461,205	253,661	SL	20.0000	23,060
421 WEAVER MILL HOUSE	2011-01-01	4,130	2,069	SL	20.0000	207
OPEN PAVILION	2009-01-01	15,286	9,169	SL	20.0000	764
BUILDING IMPROV. MGMT.	2007-01-01	513,279	359,296	SL	20.0000	25,664
BUILDING IMPROV. MGMT.	2008-01-01	822,227	534,445	SL	20.0000	41,111
BUILDING IMPROV. MGMT.	2009-01-01	417,163	250,297	SL	20.0000	20,858
BUILDING: A&E	2007-01-01	372,620	260,834	SL	20.0000	18,631
BUILDING :A&E	2008-01-01	160,255	104,168	SL	20.0000	8,013
BUILDING:A&E	2009-01-01	71,153	42,695	SL	20.0000	3,558
BUILDING:A&E	2010-01-01	11,241	6,182	SL	20.0000	562
2006 IMPROVEMENTS	2006-01-01	230,198	69,060	SL	50.0000	4,604
SITE-WELL	2007-01-01	15,249	4,300	SL	50.0000	305
SITE-WELL	2009-01-01	8,494	2,040	SL	50.0000	170
SITE-MASTER PLAN	2007-01-01	203,053	56,854	SL	50.0000	4,061
SITE-MASTER PLAN	2008-01-01	991,587	257,815	SL	50.0000	19,832
SITE-MASTER PLAN	2009-01-01	712,983	171,119	SL	50.0000	14,260
SITE-WATER	2007-01-01	8,475	2,377	SL	50.0000	170
SITE-WATER	2008-01-01	643,525	167,321	SL	50.0000	12,871
SITE-SEWAGE	2007-01-01	24,276	6,801	SL	50.0000	486
SITE-SEWAGE	2008-01-01	1,222,518	317,852	SL	50.0000	24,450
SITE-SEWAGE	2009-01-01	5,143	1,235	SL	50.0000	103
SITE-ELECTRIC & PHONE	2007-01-01	3,343	937	SL	50.0000	67
SITE-ELECTRIC & PHONE	2008-01-01	1,853,883	482,012	SL	50.0000	37,078
SITE-ELECTRIC & PHONE	2009-01-01	440,750	105,780	SL	50.0000	8,815
SITE-GRADING/ROADS	2007-01-01	4,746	1,329	SL	50.0000	95
SITE-GRADING/ROADS	2008-01-01	1,004,695	261,221	SL	50.0000	20,094
SITE-GRADING/ROADS	2009-01-01	79,038	18,971	SL	50.0000	1,581
SITE-E&S	2007-01-01	16,007	4,481	SL	50.0000	320
SITE-E&S	2008-01-01	172,794	44,927	SL	50.0000	3,456
POND & BRIDGE #1	2007-01-01	377,417	105,674	SL	50.0000	7,548
POND & BRIDGE #1	2008-01-01	108,484	28,208	SL	50.0000	2,170
POND & BRIDGE #1	2009-01-01	506	120	SL	50.0000	10
BRIDGE #2	2007-01-01	2,247	630	SL	50.0000	45
BRIDGE #2	2008-01-01	25,087	6,525	SL	50.0000	502
BRIDGE #2	2009-01-01	192,412	46,177	SL	50.0000	3,848
LANDSCAPING	2007-01-01	3,530	992	SL	50.0000	71
LANDSCAPING	2008-01-01	2,072	535	SL	50.0000	41
LANDSCAPING	2009-01-01	42,719	10,250	SL	50.0000	854
ENTRY ROAD RELOCATION	2007-01-01	146	41	SL	50.0000	3
FIRE PROTECTION	2007-01-01	2,210	617	SL	50.0000	44
SITE-DEMOLITION	2007-01-01	31,104	8,708	SL	50.0000	622
SITE-DEMOLITION	2008-01-01	99,471	25,859	SL	50.0000	1,989
LAND IMPROVEMENT MGMT.	2007-01-01	518,685	145,234	SL	50.0000	10,374
LAND IMPROVEMENT MGMT.	2008-01-01	296,166	77,001	SL	50.0000	5,923
LAND IMPROVEMENT MGMT.	2009-01-01	178,784	42,911	SL	50.0000	3,576
ROAD/GRADING	2013-05-31	23,565	8,933	SL	20.0000	1,178
TRACK	2013-06-19	72,503	27,188	SL	20.0000	3,625
ROPE COURSE	2013-07-17	1,625	601	SL	20.0000	81
WATER LINES	2013-04-18	1,172	452	SL	20.0000	59
RESIDENCES - APPLIANCE	2014-01-27	1,201	830	SL	10.0000	120
SPORTS EQUIPMENT	2014-07-17	629	577	SL	7.0000	52
ROAD PAVING	2014-05-19	8,071	3,542	SL	15.0000	538
ARENA SOCCER FIELD	2014-07-30	140,719	45,148	SL	20.0000	7,036
FOOTBALL FIELD	2014-08-08	85,497	27,431	SL	20.0000	4,275
IMPROV - 509 WEAVER MILL	2014-06-13	5,531	1,823	SL	20.0000	277
RESIDENCES - CITIKIDZ	2015-12-14	2,898	2,105	SL	7.0000	414
EQUIPMENT & TOOLS	2015-10-22	1,593	1,178	SL	7.0000	228
2009 CABIN IMPROVEMENTS	2015-07-13	46,985	12,920	SL	20.0000	2,349
TELEPHONE SYSTEM	2015-10-06	4,050	3,040	SL	7.0000	579
ROADS - STONE	2016-07-05	1,284	824	SL	7.0000	183
ARENA SOCCER	2016-08-08	2,519	1,113	SL	10.0000	252
RESIDENCES -STAFF (2)	2016-08-01	629,559	92,684	SL	30.0000	20,985
CAMERA EQUIPMENT	2016-11-21	1,000	817	SL	5.0000	183
BICYCLES	2017-06-05	4,495	2,301	SL	7.0000	642
RESIDENCES-IMPROV	2017-09-01	27,944	4,657	SL	20.0000	1,397
2008 PONTIAC G6	2017-05-09	2,750	2,017	SL	5.0000	550
BLEACHERS	2018-04-23	3,326	443	SL	20.0000	166
WRESTLING MATS	2018-05-29	8,962	2,315	SL	10.0000	896
ARCHERY & OTHER	2018-07-24	2,761	667	SL	10.0000	276
TRACK IMPROVEMENTS	2018-06-16	4,722	590	SL	20.0000	236
IMPROV - RESIDENCE	2018-04-25	1,458	195	SL	20.0000	73
NEW OFFICE BUILDING	2021-05-04	19,321		SL	20.0000	644
IMPROV - RESIDENCE	2019-08-01	56,663	4,013	SL	20.0000	2,833
NEW OFFICE BUILDING	2021-05-04	388,060		SL	20.0000	12,935
AUDIO EQUIPMENT	2019-04-23	1,452	484	SL	5.0000	290
WEIGHT TRAINING EQUIP	2019-04-30	2,645	441	SL	10.0000	265
COMPUTER	2019-08-22	2,268	605	SL	5.0000	454
NEW OFFICE BUILDING	2021-05-04	49,200		SL	20.0000	1,640
NEW OFFICE BUILDING	2021-05-04	200,020		SL	20.0000	6,667
RESIDENCE - FLOORING	2020-05-28	500	29	SL	10.0000	50
RESIDENCE - HEAT PUMP	2020-08-08	2,473	103	SL	10.0000	247
WORKOUT EQUIPMENT	2020-02-20	541	45	SL	10.0000	54
KALEO CHAPEL CHAIRS	2020-10-16	7,760	129	SL	10.0000	776
2012 FORD F-250 SUPER DUTY	2019-11-21	16,350	3,543	SL	5.0000	3,270
JD 4044R TRACTOR;BACKHOE;MOWER	2021-04-21	49,650		SL	10.0000	3,310
NEW OFFICE BUILDING	2021-05-04	34,932		SL	20.0000	1,164
BLINDS - OFFICE & CHAPEL	2021-08-17	6,839		SL	10.0000	228
PHONE SYSTEM & WIFI	2021-09-01	5,886		SL	10.0000	196
RESIDENCE - HEAT PUMP & HVAC	2021-09-17	6,170		SL	10.0000	154
AUDIO VISUAL EQUIP & SETUP	2021-12-15	16,390		SL	10.0000	137

- TIN:

TY 2021 InvestmentsOtherSchedule2

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
ISHARES TIPS BOND	FMV	51,680	51,680
ISHARES CORE MSCI EAFE	FMV	101,510	101,510
VANGUARD TOTAL BOND MARKET	FMV	113,141	113,141
ISHARES CORE MSCI EMERGING	FMV	21,849	21,849
SPDR S&P 500 ETF TRUST	FMV	147,238	147,238
SPDR MIDCAP TRUST SERIES 1	FMV	28,472	28,472
BLACKROCK STRATEGIC INCOME	FMV	47,189	47,189
BAIRD AGGREGATE BOND FUND	FMV	114,332	114,332
BLACKROCK EVENT DRIVEN EQ - IS	FMV	11,652	11,652
ANGEL OAK MULTI-STRATEGY INCOME	FMV	9,691	9,691
PRUDENTIAL TOTAL RETURN BOND	FMV	45,135	45,135
FIDELITY REAL ESTATE ETF	FMV	44,962	44,962
ISHARES RUSSELL 2000	FMV	35,592	35,592
PRINCIPAL MIDCAP FUND	FMV	64,256	64,256
TOUCHSTONE SANDS EM GR	FMV	19,340	19,340
TRANSAMERICA SM CAP GROW	FMV	29,844	29,844
AMERICAN BEACON AHL MANAGED	FMV	5,752	5,752
BAIRD INTERMEDIATE BOND FUND	FMV	56,184	56,184
FEDERATED TOTAL RETURN SERS	FMV	57,119	57,119
ISHARES RUSSELL 1000 VALUE	FMV	38,624	38,624
ALLIANCE BERNSTEIN CAP FUND INC	FMV	32,141	32,141
SEAFARER OVERSEAS GROWTH & INCOME	FMV	20,179	20,179
EV GL MACR ABS RTRN ADV FUND	FMV	10,310	10,310

- TIN:

TY 2021 LandEtcSchedule2

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Category / Item	Cost / Other Basis	Accumulated Depreciation	Book Value	End of Year Fair Market Value
Auto./Transportation Equip.	77,364	21,304	56,060	56,060
Furniture and Fixtures	348,084	290,003	58,081	58,081
Buildings	14,300,205	8,988,384	5,311,821	5,311,821
Improvements	9,863,472	2,799,638	7,063,834	7,063,834
Land	1,306,872		1,306,872	1,306,872

- TIN:

TY 2021 OtherAssetsSchedule

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
SECURITY DEPOSIT	300	300	300

- TIN:

TY 2021 OtherExpensesSchedule

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Description	Revenue and Expenses per Books	Adjusted Net Income	Disbursements for Charitable Purposes
ADMINISTRATION	3,766		3,960
FIXED ASSETS PURCHASED			12,340
FOOD COSTS	23,136	23,136
INSURANCE	52,306		51,191
KALEO FUNCTIONS	11,786	5,356	6,430
MAINTENANCE & REPAIRS	20,945	8,701	11,734
OFFICE EXPENSE	5,431		6,697
PROPERTY IMPROVEMENTS			58,989
STAFF DEVELOPMENT & RECRUITMENT	7,673	7,673
SUPPLIES - CAMP PROGRAMS	6,966	4,131
VEHICLE EXPENSE	4,201		4,277

- TIN:

TY 2021 OtherIncomeSchedule2

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
OTHER INCOME	700		700
PROGRAM FEES	37,456		37,456

- TIN:

TY 2021 OtherProfessionalFeesSchedule

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
OTHER CONTRACTED SERVICES	3,694	0	0	2,231
PNC (HAWTHORN) ADVISORY FEES	7,242	7,242	7,242	0

- TIN:

TY 2021 SalesOfInventoryList

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Category	Gross Sales	Cost of Goods Sold	Net (Gross Sales Minus Cost of Goods Sold)
CAMP STORE	1,387	1,195	192

- TIN:

TY 2021 TaxesSchedule

Name:

THOMAS AND SANDRA USHER CAMP

EIN:

30-0337978

Software ID:

21013475

Software Version:

2021v4.0

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
EXCISE TAX	810	810