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 07-01-2021 , and ending 06-30-2022

Name of foundation
CLYDE E & ZADA V PETERS CHARITABLE TRUST

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 3215
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
LANCASTER, PA176043215

A Employer identification number

23-7865062

B Telephone number (see instructions)

(717) 291-2726

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

$383,766J 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)
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...	11,766		11,766
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		15,156
b	Gross sales price for all assets on line 6a 119,198
7	Capital gain net income (from Part IV, line 2)...			15,156
8	Net short-term capital gain.........				0
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....
11	Other income (attach schedule).......		62	62
12	Total. Add lines 1 through 11........	26,984		26,984
13	Compensation of officers, directors, trustees, etc.	6,063		6,063
14	Other employee salaries and wages......			0	0	0
15	Pension plans, employee benefits.......			0	0
16a	Legal fees (attach schedule).........					0
b	Accounting fees (attach schedule).......
c	Other professional fees (attach schedule)....					0
17	Interest...............					0
18	Taxes (attach schedule) (see instructions)...		477	57		0
19	Depreciation (attach schedule) and depletion...		0	0
20	Occupancy..............
21	Travel, conferences, and meetings.......			0	0
22	Printing and publications..........			0	0
23	Other expenses (attach schedule).......
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	6,540		6,120	0	0
25	Contributions, gifts, grants paid.......	22,330				22,330
26	Total expenses and disbursements. Add lines 24 and 25	28,870		6,120	0	22,330
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-1,886
b	Net investment income (if negative, enter -0-)			20,864
c	Adjusted net income (if negative, enter -0-)...				0

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2021)

Form 990-PF (2021)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............
	2	Savings and temporary cash investments.........	12,234	14,652	14,652
	3	Accounts receivable
		Less: allowance for doubtful accounts		0	0
	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 0
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	387,310	384,706	369,114
	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)	399,544	399,358	383,766
	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
		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........	399,544	399,358
	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).....	399,544	399,358
	30	Total liabilities and net assets/fund balances (see instructions).	399,544	399,358

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

399,544

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

-1,886

Other increases not included in line 2 (itemize) bullet

1,700

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

399,358

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 .

399,358

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	38.678 EDGEWOOD GROWTH FUND INSTL CL		2020-09-15	2021-08-04
b	8.991 EDGEWOOD GROWTH FUND INSTL CL		2020-09-15	2021-10-20
c	49.918 GQG PARTNERS EMERGING MARKETS EQ FD INSTL SHS		2020-09-15	2021-08-04
d	13.43 GQG PARTNERS EMERGING MARKETS EQ FD INSTL SHS		2020-09-15	2021-10-29
e	2.736 GQG PARTNERS EMERGING MARKETS EQ FD INSTL SHS		2020-09-15	2022-06-16
	11.211 CALAMOS MARKET NEUTRAL INC FD I SHARES		2020-09-15	2021-10-29
	12.838 CALAMOS MARKET NEUTRAL INC FD I SHARES		2020-09-15	2022-01-31
	3.485 CAUSEWAY INTL VALUE FD INSTL SHS		2019-01-31	2021-08-04
	18.965 CAUSEWAY INTL VALUE FD INSTL SHS		2019-01-31	2021-10-29
	23.622 CAUSEWAY INTL VALUE FD INSTL SHS		2019-01-31	2022-01-31
	7.68 DIAMOND HILL LONG SHORT FD CL I		2015-06-30	2021-10-29
	4.461 DIAMOND HILL LARGE CAP FD CL I		2020-09-15	2021-10-20
	4.708 DIAMOND HILL LARGE CAP FD CL I		2020-09-15	2021-10-29
	36.032 DIAMOND HILL LARGE CAP FD CL I		2022-01-31	2022-06-16
	166.731 DIAMOND HILL LARGE CAP FD CL I		2021-01-29	2022-06-16
	1.123 DIAMOND HILL LARGE CAP FD CL I		2021-08-04	2022-06-16
	4.523 FPA CRESCENT FUND INSTL CL		2017-07-31	2021-10-29
	152.011 FEDERATED HIGH YIELD BD FD INSTL CL -900		2021-01-29	2021-08-04
	46.941 FEDERATED HIGH YIELD BD FD INSTL CL -900		2021-04-30	2021-08-04
	782.68 FEDERATED HIGH YIELD BD FD INSTL CL -900		2019-10-31	2021-08-04
	18.212 FEDERATED MDT SM CAP GRTH INSTL CL		2018-06-29	2021-10-29
	6.067 FEDERATED MDT SM CAP GRTH INSTL CL		2021-08-04	2022-06-16
	224.241 FEDERATED MDT SM CAP GRTH INSTL CL		2020-09-15	2022-06-16
	96.974 FEDERATED MDT SM CAP GRTH INSTL CL		2022-01-31	2022-06-16
	46.425 FEDERATED TOTAL RETURN BD FD INSTL CL -328		1998-06-30	2021-10-29
	63.187 FEDERATED TOTAL RETURN BD FD INSTL CL -328		2010-04-30	2022-01-31
	3.176 GS INTL SM CAP INSIGHT FD INSTL SHS		2019-01-31	2021-08-04
	1.282 GS INTL SM CAP INSIGHT FD INSTL SHS		2019-01-31	2022-06-16
	14.152 GS ABSOLUTE RETURN TR CL I		2020-09-15	2021-10-29
	21.217 GOLDMAN SACHS GQG PARTNERS INTL OPPORT INSTL SHS		2020-09-15	2021-10-29
	27.546 GOLDMAN SACHS GQG PARTNERS INTL OPPORT INSTL SHS		2020-09-15	2022-06-16
	29.875 HARDING LOEVNER INSTL EMRG MKTS FD INSTL CL		2017-10-31	2021-08-04
	4.064 HARDING LOEVNER INSTL EMRG MKTS FD INSTL CL		2017-10-31	2021-10-29
	246.898 HARDING LOEVNER INSTL EMRG MKTS FD INSTL CL		2021-01-29	2022-04-29
	11.535 HARDING LOEVNER INSTL EMRG MKTS FD INSTL CL		2022-01-31	2022-04-29
	9.077 HARDING LOEVNER INSTL EMRG MKTS FD INSTL CL		2021-04-30	2022-04-29
	45.567 T ROWE PRICE INSTL LARGE CAP GRTH FD		2018-06-29	2021-08-04
	6.957 T ROWE PRICE INSTL LARGE CAP GRTH FD		2018-06-29	2021-10-20
	7.187 JOHCM INTERNATIONAL SELECT FD INSTL SHS		2017-04-28	2021-10-29
	9.509 JOHN HANCOCK III DISCP VAL MID CAP FD CL I		2017-01-31	2021-10-29
	39.217 JOHN HANCOCK III DISCP VAL MID CAP FD CL I		2017-10-31	2022-06-16
	37.17 LORD ABBETT SHT DUR INCOME FD CL I		2015-06-30	2021-10-29
	94.903 LORD ABBETT SHT DUR INCOME FD CL I		2015-06-30	2022-01-31
	24.522 MORGAN STANLEY GLOBAL FIXED INCOME OPPORTUNITIES		2020-09-15	2021-10-29
	53.996 MORGAN STANLEY GLOBAL FIXED INCOME OPPORTUNITIES		2020-09-15	2022-01-31
	32.59 PIMCO TOTAL RETURN FUND INSTL CL -35		2011-08-31	2021-10-29
	93.234 PIMCO TOTAL RETURN FUND INSTL CL -35		2011-08-31	2022-01-31
	5.028 PIMCO INTL BOND FD INST CL -103 US DOLLAR HEDGED		2021-08-04	2021-10-29
	39.155 PIMCO INTL BOND FD INST CL -103 US DOLLAR HEDGED		2021-08-04	2022-01-31
	864.014 PIMCO INTL BOND FD INST CL -103 US DOLLAR HEDGED		2021-08-04	2022-04-29
	930.453 PIMCO INTERNATIONAL BD FD UNHEDGED INSTL SHS		2021-01-29	2021-08-04
	.926 PIMCO ALL ASSET FUND INSTL CL		2014-01-31	2021-10-29
	2.228 PIMCO ALL ASSET FUND INSTL CL		2014-01-31	2022-01-31
	53.808 PIMCO INCOME FD INSTL SHS		2015-10-30	2021-10-29
	495.331 PIMCO INCOME FD INSTL SHS		2015-10-30	2022-01-31
	8.98 PRINCIPAL MID CAP FD INSTL CL		2017-10-31	2021-08-04
	9.736 PRINCIPAL MID CAP FD INSTL CL		2017-10-31	2021-10-29
	17.489 PRINCIPAL MID CAP FD INSTL CL		2018-06-29	2022-06-16
	79.017 T ROWE PRICE INSTL FLOATING RATE FD		2021-04-30	2021-10-29
	5.599 SMEAD VALUE FUND Y SHS		2016-08-31	2021-08-04
	4.492 SMEAD VALUE FUND Y SHS		2016-10-31	2021-10-20
	7.746 SMEAD VALUE FUND Y SHS		2016-10-31	2022-06-16
	12.289 TIAA-CREF LG CAP VAL IDX FD INSTL CL		2019-01-31	2021-10-20
	103.777 TIAA-CREF LG CAP VAL IDX FD INSTL CL		2019-01-31	2021-10-29
	.625 TIAA-CREF LG CAP VAL IDX FD INSTL CL		2019-01-31	2022-01-31
	26.077 TIAA-CREF LG CAP VAL IDX FD INSTL CL		2019-01-31	2022-06-16
	9.294 TIAA-CREF LG CAP GRTH IDX FD INSTL CL		2018-04-30	2021-10-20
	127.184 TIAA-CREF LG CAP GRTH IDX FD INSTL CL		2019-01-31	2021-10-29
	7.934 UMB VALUE FD CL L -1368		2019-01-31	2021-10-29
	4.125 UMB VALUE FD CL L -1368		2019-01-31	2022-01-31
	4.773 VANGUARD MID CAP VAL IDX FD ADM CL		2019-01-31	2021-10-29
	3.469 VANGUARD MID CAP VAL IDX FD ADM CL		2019-01-31	2022-01-31
	18.495 VANGUARD MID CAP VAL IDX FD ADM CL		2019-06-28	2022-06-16
	2.308 VANGUARD MID CAP GRTH IDX FD ADM CL		2019-02-01	2021-08-04
	4.193 VANGUARD MID CAP GRTH IDX FD ADM CL		2019-02-01	2021-10-29
	62.711 VANGUARD MID CAP GRTH IDX FD ADM CL		2019-08-30	2022-06-16
	8.805 VANGUARD MID CAP GRTH IDX FD ADM CL		2022-01-31	2022-06-16
	4.287 VANGUARD INFL PROTECTED SEC FD ADM SHS		2021-01-29	2021-08-04
	5.854 VANGUARD INFL PROTECTED SEC FD ADM SHS		2021-01-29	2021-10-29
	3.081 VANGUARD INFL PROTECTED SEC FD ADM SHS		2021-01-29	2022-01-31
	19.434 VANGUARD INFL PROTECTED SEC FD ADM SHS		2021-04-30	2022-04-29
	313.351 VANGUARD INFL PROTECTED SEC FD ADM SHS		2021-01-29	2022-04-29
	1.277 VANGUARD INSTL INDEX FD -94		2019-06-28	2021-10-20
	1.612 VANGUARD INSTL INDEX FD -94		2019-06-28	2021-10-29
	4.611 VANGUARD INSTL INDEX FD -94		2019-06-28	2022-01-31
	.77 VANGUARD INSTL INDEX FD -94		2019-06-28	2022-06-16
	19.486 VANGUARD SMALL CAP INDEX FD ADM CL		2021-01-29	2021-08-04
	1.991 VANGUARD SMALL CAP INDEX FD ADM CL		2021-01-29	2021-10-29
	2.091 VANGUARD SMALL CAP INDEX FD ADM CL		2021-01-29	2022-06-16
	1.185 VICTORY TRIVALENT INTL SMALL CAP FD I SHS		2019-01-31	2021-08-04
	4.135 VICTORY TRIVALENT INTL SMALL CAP FD I SHS		2019-01-31	2021-10-29
	27.697 APPLIED FINANCE SELECT FD I SHS		2018-04-30	2021-10-20
	20.776 APPLIED FINANCE SELECT FD I SHS		2018-04-30	2021-10-29
	27.151 APPLIED FINANCE SELECT FD I SHS		2018-04-30	2022-01-31
	70.388 APPLIED FINANCE SELECT FD I SHS		2018-04-30	2022-06-16
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	2,521	1,898	623
b	580	441	139
c	910	782	128
d	240	210	30
e	38	43	-5
	162	153	9
	185	175	10
	62	51	11
	337	277	60
	420	345	75
	241	188	53
	166	125	41
	175	132	43
	1,040	1,255	-215
	4,812	4,678	134
	32	40	-8
	184	156	28
	1,520	1,477	43
	469	468	1
	7,827	7,862	-35
	703	481	222
	119	215	-96
	4,397	5,830	-1,433
	1,902	2,532	-630
	526	492	34
	690	688	2
	47	35	12
	14	14
	151	135	16
	436	366	70
	476	475	1
	789	655	134
	104	89	15
	4,582	5,915	-1,333
	214	275	-61
	168	240	-72
	3,330	1,885	1,445
	520	288	232
	233	145	88
	273	209	64
	911	916	-5
	155	165	-10
	391	420	-29
	141	142	-1
	304	313	-9
	336	356	-20
	937	1,017	-80
	54	55	-1
	417	430	-13
	8,709	9,487	-778
	9,630	9,850	-220
	12	11	1
	28	27	1
	643	643
	5,835	5,917	-82
	384	234	150
	431	267	164
	514	483	31
	772	771	1
	367	219	148
	322	168	154
	464	288	176
	307	228	79
	2,583	1,925	658
	15	12	3
	545	484	61
	553	273	280
	7,790	3,760	4,030
	664	482	182
	343	250	93
	360	259	101
	263	188	75
	1,209	1,026	183
	241	133	108
	464	241	223
	4,534	3,968	566
	637	841	-204
	125	122	3
	168	167	1
	86	88	-2
	520	549	-29
	8,382	8,915	-533
	506	340	166
	649	429	220
	1,774	1,228	546
	240	205	35
	2,056	1,856	200
	219	190	29
	171	199	-28
	22	15	7
	77	51	26
	545	326	219
	407	245	162
	527	320	207
	1,179	828	351
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685
			7,685

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			623
b			139
c			128
d			30
e			-5
			9
			10
			11
			60
			75
			53
			41
			43
			-215
			134
			-8
			28
			43
			1
			-35
			222
			-96
			-1,433
			-630
			34
			2
			12

			16
			70
			1
			134
			15
			-1,333
			-61
			-72
			1,445
			232
			88
			64
			-5
			-10
			-29
			-1
			-9
			-20
			-80
			-1
			-13
			-778
			-220
			1
			1

			-82
			150
			164
			31
			1
			148
			154
			176
			79
			658
			3
			61
			280
			4,030
			182
			93
			101
			75
			183
			108
			223
			566
			-204
			3
			1
			-2
			-29
			-533
			166
			220
			546
			35
			200
			29
			-28
			7
			26
			219
			162
			207
			351

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	15,156
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	290
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	290
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	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	0
d	Backup withholding erroneously withheld ...........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7	400
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8	0
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	110
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax110	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

$ (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 .............................

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

The books are in care of bullet

FULTON BANK NA Telephone no. bullet

(717) 291-2726

Located at bullet

ONE PENN SQUARELANCASTERPA ZIP+4 bullet

17602

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)

Yes

(5) Transfer any income or assets to a disqualified person (or make any of either available

for the benefit or use of a disqualified person)? ......................

1a(5)

(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
FULTON BANK N A	TRUSTEE 0	6,063
PO BOX 3215 LANCASTER,PA176043215	TRUSTEE 0	6,063

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

428,361

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

12,777

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

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

441,138

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

441,138

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

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

6,617

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

434,521

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

21,726

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

21,726

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

290

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

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

290

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

21,436

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

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

21,436

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

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

21,436

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					21,436
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......				13,450
b Total for prior years:20, 20, 20			0
3 Excess distributions carryover, if any, to 2021:
a From 2016......	0
b From 2017......	0
c From 2018......	0
d From 2019......	0
e From 2020......	0
f Total of lines 3a through e ........		0
4Qualifying distributions for 2021 from Part
XI, line 4: $ 22,330
a Applied to 2020, but not more than line 2a				13,450
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.....					8,880
e Remaining amount distributed out of corpus		0
5 Excess distributions carryover applied to 2021.		0			0
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5		0
b Prior years’ undistributed income. Subtract line 4b from line 2b ..........			0
c Enter the amount of prior years’ undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed......			0
d Subtract line 6c from line 6b. Taxable amount —see instructions ...........			0
e Undistributed income for 2019. Subtract line 4a from line 2a. Taxable amount—see instructions .............				0
f Undistributed income for 2021. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2022 ..........					12,556
7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (Election may be required - see instructions) .......		0
8 Excess distributions carryover from 2016 not applied on line 5 or line 7 (see instructions) ...		0
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......		0
10 Analysis of line 9:
a Excess from 2017....	0
b Excess from 2018....	0
c Excess from 2019....	0
d Excess from 2020....	0
e Excess from 2021....	0

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).)

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
BETHESDA MISSION 2101 N FRONT ST BLDG 1-301 HARRISBURG,PA17105	N/A	PC	OPERATIONS	7,366
SKYLINE VIEW BRETHRENCHRIST CHURCH 7733 HILLCREST AVE HARRISBURG,PA17112	N/A	PC	OPERATIONS	7,482
ARTHRITIS FOUNDATION INC 1330 WEST PEACHTREE ST ATLANTA,GA30309	N/A	PC	OPERATIONS	7,482
Total ................................. 3a				22,330

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	15,156
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: aREFUNDED MUTUAL FD			14	62
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..				26,984

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

26,984

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

Part XV-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See instructions.)

Form 990-PF (2021)

Page 13

Part XVI

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

Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?

Yes

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

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

1a(1)

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

1a(2)

Other transactions:

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

1b(1)

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

1b(2)

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

1b(3)

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

1b(4)

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

1b(5)

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

1b(6)

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

If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

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

Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........Yes No

If "Yes," complete the following schedule.

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

Sign Here

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

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

Form 990-PF (2021)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2021 InvestmentsOtherSchedule2

Name:

CLYDE E & ZADA V PETERS CHARITABLE TRUST

EIN:

23-7865062

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
MUTUAL FUNDS - SEE ATTACHED	AT COST	384,706	369,114

- TIN:

TY 2021 OtherIncomeSchedule2

Name:

CLYDE E & ZADA V PETERS CHARITABLE TRUST

EIN:

23-7865062

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
REFUNDED MUTUAL FD FEES	62	62

- TIN:

TY 2021 OtherIncreasesSchedule

Name:

CLYDE E & ZADA V PETERS CHARITABLE TRUST

EIN:

23-7865062

Description	Amount
BASIS ADJUST MUTUAL FD DISBURSE/RECEIPT	1,700

- TIN:

TY 2021 TaxesSchedule

Name:

CLYDE E & ZADA V PETERS CHARITABLE TRUST

EIN:

23-7865062

Category	Amount	Net Investment Income
FEDERAL TAX PAYMENT - PRIOR YE	20	0
FEDERAL ESTIMATES - PRINCIPAL	400	0
FOREIGN TAXES ON QUALIFIED FOR	52	52
FOREIGN TAXES ON NONQUALIFIED	5	5