Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
THE BURKEHAVEN FAMILY FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)1834 CENTRE ST 589
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WEST ROXBURY, MA02132
A Employer identification number

82-6746205
B Telephone number (see instructions)

(617) 419-0156
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$46,559,630J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 44 44  
4 Dividends and interest from securities... 895,459 895,459  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 2,044,407
b Gross sales price for all assets on line 6a 4,832,722
7 Capital gain net income (from Part IV, line 2)... 2,044,407
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 2,939,910 2,939,910 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 195,120 9,756 0 185,364
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 4,408 1,102 0 3,306
c Other professional fees (attach schedule).... Click to see attachment 67,822 67,410 0 412
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 34,100 22,834 0 11,266
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 483 0 0 483
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 6,117 0 0 6,117
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 308,050 101,102 0 206,948
25 Contributions, gifts, grants paid....... 2,326,000 2,326,000
26 Total expenses and disbursements. Add lines 24 and 25 2,634,050 101,102 0 2,532,948
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 305,860
b Net investment income (if negative, enter -0-) 2,838,808
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 705,325 367,657 367,657
2 Savings and temporary cash investments......... 732,466 1,285,139 1,285,139
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 4,462    
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 23,984,906 Click to see attachment12,958,845 13,297,213
c Investments—corporate bonds (attach schedule)....... 11,293,755 Click to see attachment21,671,636 31,027,014
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 0 Click to see attachment768,144 582,607
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 36,720,914 37,051,421 46,559,630
Liabilities 17 Accounts payable and accrued expenses.......... 39  
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment981 Click to see attachment3,753
23 Total liabilities (add lines 17 through 22)......... 1,020 3,753
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 36,719,894 37,047,668
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
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)..... 36,719,894 37,047,668
30 Total liabilities and net assets/fund balances (see instructions). 36,720,914 37,051,421
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
36,719,894
2
Enter amount from Part I, line 27a .....................
2
305,860
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
21,914
4
Add lines 1, 2, and 3 ..........................
4
37,047,668
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
37,047,668
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a PUBLICLY TRADED SECURITIES P    
b CAPITAL GAINS DIVIDENDS P    
c
d
e
(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 3,953,000   2,788,315 1,164,685
b 879,722     879,722
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       1,164,685
b       879,722
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 2,044,407
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 39,459
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 39,459
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 75,285
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 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 75,285
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 35,826
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet35,826 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMA, NH
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletTHE FOUNDATION Telephone no.bullet (617) 419-0156

    Located atbullet1834 CENTRE ST 589WEST ROXBURYMA ZIP+4bullet02132
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    IRFAN ALIBHAI PRESIDENT
    40.00     		195,120 0 0
    1834 CENTRE STREET 589
    WEST ROXBURY,MA02132
    CAROL WALLACE VICE PRESIDENT
    1.00     		0 0 0
    1834 CENTRE STREET 589
    WEST ROXBURY,MA02132
    MICHAEL JEWCZYN SECRETARY/TREASURER
    1.00     		0 0 0
    1834 CENTRE STREET 589
    WEST ROXBURY,MA02132
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    FIDUCIARY INVESTMENT ADVISORS INVESTMENT ADVISOR 67,272
    BOSTON
    BOSTON,MA02119
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    45,107,526
    b
    Average of monthly cash balances.......................
    1b
    612,326
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    45,719,852
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    45,719,852
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    685,798
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    45,034,054
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    2,251,703
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    2,251,703
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    39,459
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    39,459
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    2,212,244
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    2,212,244
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    2,212,244
    Part XI
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 2,212,244
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 544,822
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 2,532,948
    a Applied to 2020, but not more than line 2a 544,822
    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..... 1,988,126
    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 ..........     		224,118
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    CAROL WALLACE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    ABBOTT LIBRARY FOUNDATION
    PO BOX 66
    SUNAPEE,NH03782     		  PC GENERAL CHARITABLE SUPPORT 10,000
    ACCOUNTABILITY COUNSEL
    244 KEARNY STREET FLOOR 6
    SAN FRANCISCO,CA94108     		  PC GENERAL CHARITABLE SUPPORT 50,000
    AGA KHAN FOUNDATION USA
    1825 K ST NW STE 901
    WASHINGTON,DC20006     		  PC GENERAL CHARITABLE SUPPORT 10,000
    AGA KHAN FOUNDATION USA
    1825 K ST NW STE 901
    WASHINGTON,DC20006     		  PC GENERAL CHARITABLE SUPPORT 10,000
    BAKER SCHOOL PTO
    205 BEVERLY RD
    BROOKLINE,MA02467     		  PC GENERAL CHARITABLE SUPPORT 500
    BROOKLINE FOOD PANTRY
    PO BOX 45
    BROOKLINE,MA02446     		  PC GENERAL CHARITABLE SUPPORT 2,500
    BROOKLINE SCHOOLS STAFF CHILDRENS CENTER
    162 GODDARD AVE
    BROOKLINE,MA02445     		  PC GENERAL CHARITABLE SUPPORT 5,000
    BROOKLINE SCHOOLS STAFF CHILDRENS CENTER
    162 GODDARD AVE
    BROOKLINE,MA02445     		  PC GENERAL CHARITABLE SUPPORT 10,000
    BROOKLINE SCHOOLS STAFF CHILDRENS CENTER
    162 GODDARD AVE
    BROOKLINE,MA02445     		  PC GENERAL CHARITABLE SUPPORT 15,000
    CARE USA
    151 ELLIS STREET NORTHEAST
    ATLANTA,GA30303     		  PC INDIA COVID-19 RELIEF 10,000
    CENTER FOR THE ARTS NEW HAMPSHIRE
    PO BOX 872
    NEW LONDON,NH03257     		  PC RESTRICTED FOR SUNAPEE REGION ARTS ATLAS 5,000
    CHESTER ELEMENTARY SCHOOL PARENT TEACHER ORGANIZATION
    23 RIDGE ROAD
    CHESTER,CT06412     		  PC GENERAL CHARITABLE SUPPORT 4,500
    COMMUNITY FOUNDATION OF MIDDLESEX COUNTY INC
    49 MAIN STREET
    MIDDLETOWN,CT06457     		  PC OPEN-AIR MEETING SPACE AT CHESTER ELEMENTARY SCHOOL 6,000
    COMMUNITY FOUNDATION OF MIDDLESEX COUNTY INC
    49 MAIN STREET
    MIDDLETOWN,CT06457     		  PC CHESTER LEADERSHIP FUND 10,000
    COMMUNITY SERVINGS
    179 AMORY ST
    JAMAICA PLAIN,MA02130     		  PC GENERAL CHARITABLE SUPPORT 2,000
    CONNECTICUT CHILDRENS MEDICAL CENTER FOUNDATION
    282 WASHINGTON STREET
    HARTFORD,CT06106     		  PC GENERAL CHARITABLE SUPPORT 2,500
    DIGDEEP
    PO BOX 26779
    LOS ANGELES,CA90026     		  PC GENERAL CHARITABLE SUPPORT 50,000
    DIGDEEP
    PO BOX 26779
    LOS ANGELES,CA90026     		  PC GENERAL CHARITABLE SUPPORT 50,000
    EAST HAMPTON ROTARY FOUNDATION
    PO BOX 358
    EAST HAMPTON,CT06424     		  PC RED MCKINNEY SCHOLARSHIP FUND 2,500
    FIREKEEPERS INTERNATIONAL
    PO BOX 10
    MOHAWK,TN37810     		  PC GENERAL CHARITABLE SUPPORT 10,000
    FIVE LOAVES & TWO FISHES FOOD BANK
    COAL HERITAGE HWY
    KIMBALL,WV24853     		  PC GENERAL CHARITABLE SUPPORT 2,000
    FOS FEMINISTA
    125 MAIDEN LANE
    NEW YORK,NY10038     		  PC GENERAL CHARITABLE SUPPORT 2,000
    GEORGIA AQUARIUM
    225 BAKER STREET NORTHWEST
    ATLANTA,GA30313     		  PC GENERAL CHARITABLE SUPPORT 5,000
    GIRAFFE CONSERVATION FOUNDATION
    17 SOUTH MAGNOLIA AVENUE
    ORLANDO,FL32801     		  PC GENERAL CHARITABLE SUPPORT 2,500
    GIRLS INC OF NEW HAMPSHIRE
    1711 S WILLOW ST UNIT 5
    MANCHESTER,NH03103     		  PC NEW PLAYGROUND AT 340 VARNEY ST, MANCHESTER, NH LOCATION 125,000
    GIRLS INC OF NEW HAMPSHIRE
    1711 S WILLOW ST UNIT 5
    MANCHESTER,NH03103     		  PC FREEZER REPAIR 10,000
    GIRLS INC OF NEW HAMPSHIRE
    1711 S WILLOW ST UNIT 5
    MANCHESTER,NH03103     		  PC GENERAL CHARITABLE SUPPORT 50,000
    GIRLS INC OF NEW HAMPSHIRE
    1711 S WILLOW ST UNIT 5
    MANCHESTER,NH03103     		  PC FACILITY IMPROVEMENTS 100,000
    GIRLS INC OF NEW HAMPSHIRE
    1711 S WILLOW ST UNIT 5
    MANCHESTER,NH03103     		  PC FACILITY IMPROVEMENTS 50,000
    GOT LUNCH
    20 CHURCH ST
    NEWPORT,NH03773     		  PC GENERAL CHARITABLE SUPPORT 10,000
    GREENLIGHT FUND
    50 MILK STREET 16TH FLOOR
    BOSTON,MA02109     		  PC NATIONAL OPERATIONS 150,000
    GREENLIGHT FUND
    50 MILK STREET 16TH FLOOR
    BOSTON,MA02109     		  PC BOSTON OPERATIONS 150,000
    HARTFORD YOUTH SCHOLARS
    133 ALLEN PLACE
    HARTFORD,CT06106     		  PC GENERAL CHARITABLE SUPPORT 2,000
    KALAMAZOO COLLEGE
    1200 ACADEMY ST
    KALAMAZOO,MI49006     		  PC GENERAL CHARITABLE SUPPORT 10,000
    KALAMAZOO COMMUNITY FOUNDATION
    402 EAST MICHIGAN AVENUE
    KALAMAZOO,MI49007     		  PC REMEMBERING MAGGIE FUND 10,000
    KIDS CLOTHES CLUB
    108 UPLAND ROAD
    BROOKLINE,MA02445     		  PC GENERAL CHARITABLE SUPPORT 5,000
    LAKE SUNAPEE PROTECTIVE ASSOCIATION
    PO BOX 683
    SUNAPEE,NH03782     		  PC GENERAL CHARITABLE SUPPORT 5,000
    LAS MARGARITAS FOUNDATION
    PO BOX 1995
    CLIFFSIDE PARK,NJ07010     		  PC GENERAL CHARITABLE SUPPORT 10,000
    LIBRARY ARTS CENTER
    58 N MAIN STREET
    NEWPORT,NH03773     		  PC GENERAL CHARITABLE SUPPORT 5,000
    LOVIN' SPOONFULS
    1304 COMMONWEALTH AVENUE SUITE E
    BOSTON,MA02134     		  PC GENERAL CHARITABLE SUPPORT 50,000
    LOVIN' SPOONFULS
    1304 COMMONWEALTH AVENUE SUITE E
    BOSTON,MA02134     		  PC GENERAL CHARITABLE SUPPORT 50,000
    MAIN STREET VENTURES
    1311 VINE STREET
    CINCINNATI,OH45202     		  PC GENERAL CHARITABLE SUPPORT 2,000
    MAIN STREET WARNER
    17 CHURCH STREET
    WARNER,NH03278     		  PC WARNER CONNECTS NH FOOD PANTRY AND COMMUNITY RESOURCE CENTER 1,000
    MAKOCE IKIKCUPI (LAND RECOVERY)
    PO BOX 21
    GRANITE FALLS,MN56241     		  PC GENERAL CHARITABLE SUPPORT 2,000
    MIDDLESEX HOSPITAL
    28 CRESCENT STREET
    MIDDLETOWN,CT06457     		  PC PURCHASE OF AMBULANCE 250,000
    MIDDLESEX HOSPITAL
    28 CRESCENT STREET
    MIDDLETOWN,CT06457     		  PC WOMEN'S WELLNESS FUND 10,000
    MISSING AND MURDERED INDIGENOUS WOMEN
    11640 SOUTHWEST BOONES FERRY ROAD
    PORTLAND,OR97219     		  PC GENERAL CHARITABLE SUPPORT 2,000
    NASHUA SOUP KITCHEN AND SHELTER INC
    PO BOX 3116
    NASHUA,NH030613116     		  PC GENERAL CHARITABLE SUPPORT 10,000
    NASHUA SOUP KITCHEN AND SHELTER INC
    PO BOX 3116
    NASHUA,NH030613116     		  PC GENERAL CHARITABLE SUPPORT 125,000
    NEW ENGLAND AQUARIUM
    CENTRAL WHARF
    BOSTON,MA02110     		  PC GENERAL CHARITABLE SUPPORT 5,000
    NEW ENGLAND AQUARIUM
    CENTRAL WHARF
    BOSTON,MA02110     		  PC GENERAL CHARITABLE SUPPORT 2,500
    NEW HAMPSHIRE FOOD BANK
    700 EAST INDUSTRIAL PARK DRIVE
    MANCHESTER,NH03109     		  PC NEWPORT FOOD PANTRY 1,000
    NEW HAMPSHIRE FOOD BANK
    700 EAST INDUSTRIAL PARK DRIVE
    MANCHESTER,NH03109     		  PC GENERAL CHARITABLE SUPPORT 10,000
    NEW HAMPSHIRE PUBLIC RADIO
    2 PILLSBURY STREET 6TH FLOOR
    CONCORD,NH03301     		  PC GENERAL CHARITABLE SUPPORT 5,000
    NEW LONDON BARN PLAYHOUSE
    84 MAIN STREET
    NEW LONDON,NH03257     		  PC GENERAL CHARITABLE SUPPORT 5,000
    NEW LONDON HOSPITAL
    273 COUNTY RD
    NEW LONDON,NH03257     		  PC CONSTRUCTION OF EXPRESS CARE CENTER 300,000
    NEWPORT MONTESSORI SCHOOL
    96 PINE STREET / PO BOX 634
    NEWPORT,NH03773     		  PC GENERAL CHARITABLE SUPPORT 10,000
    NIS'TO INCORPORATED
    215 WEST PINE ST
    SISSETON,SD57262     		  PC GENERAL CHARITABLE SUPPORT 10,000
    NIS'TO INCORPORATED
    215 WEST PINE ST
    SISSETON,SD57262     		  PC NEW LAND AND BUILDINGS 10,000
    NORTHEAST FARMERS OF COLOR LAND TRUST
    PO BOX 301240
    BOSTON,MA02130     		  PC GENERAL CHARITABLE SUPPORT 10,000
    NORTHERN STAGE COMPANY
    76 GATES STREET
    HARTFORD,VT05001     		  PC GENERAL CHARITABLE SUPPORT 5,000
    PERKINS SCHOOL FOR THE BLIND
    175 NORTH BEACON STREET
    WATERTOWN,MA02472     		  PC GENERAL CHARITABLE SUPPORT 25,000
    PERKINS SCHOOL FOR THE BLIND
    175 NORTH BEACON STREET
    WATERTOWN,MA02472     		  PC GENERAL CHARITABLE SUPPORT 5,000
    PILLARS FUND
    200 W MADISON ST 3RD FLOOR
    CHICAGO,IL60606     		  PC GENERAL CHARITABLE SUPPORT 5,000
    POMEGRANATEAID
    2543 SOUTH 1700 EAST
    SALT LAKE CITY,UT84106     		  PC GENERAL CHARITABLE SUPPORT 15,000
    ROSLINDALE FOOD COLLECTIVE
    25 CUMMINS HWY
    ROSLINDALE,MA02131     		  PC GENERAL CHARITABLE SUPPORT 2,500
    SAVE THE CHILDREN
    501 KINGS HIGHWAY EAST
    FAIRFIELD,CT06825     		  PC GENERAL CHARITABLE SUPPORT 5,000
    SEPSIS ALLIANCE
    3180 UNIVERSITY AVENUE
    SAN DIEGO,CA92104     		  PC GENERAL CHARITABLE SUPPORT 2,000
    SHANTI BHAVAN CHILDREN'S PROJECT
    141 HAWKINS PLACE PMB 192
    BOONTON,NJ07005     		  PC GENERAL CHARITABLE SUPPORT 5,000
    SHANTI BHAVAN CHILDREN'S PROJECT
    141 HAWKINS PLACE PMB 192
    BOONTON,NJ07005     		  PC GENERAL CHARITABLE SUPPORT 10,000
    SHELL & BEE STUDIO
    500 MAIN STREET
    DEEP RIVER,CT06417     		  PC GENERAL CHARITABLE SUPPORT 10,000
    SHINING HOPE FOR COMMUNITIES INC
    11 PARK PLACE 3RD FLOOR
    NEW YORK,NY10007     		  PC GENERAL CHARITABLE SUPPORT 20,000
    SHINING HOPE FOR COMMUNITIES INC
    11 PARK PLACE 3RD FLOOR
    NEW YORK,NY10007     		  PC GENERAL CHARITABLE SUPPORT 10,000
    SHORELINE SOUP KITCHENS & PANTRIES
    PO BOX 804
    ESSEX,CT06426     		  PC GENERAL CHARITABLE SUPPORT 2,500
    SOUL FIRE FARM
    1972 NEW YORK 2
    PETERSBURG,NY12138     		  PC GENERAL CHARITABLE SUPPORT 10,000
    SOUTH CONGREGATIONAL CHURCH
    20 CHURCH ST
    NEWPORT,NH03773     		  PC GENERAL CHARITABLE SUPPORT 8,000
    STRONG GIRLS UNITED FOUNDATION
    670 YORK STREET
    YORK,ME03909     		  PC GENERAL CHARITABLE SUPPORT 2,000
    SUNAPEE FIRE DEPARTMENT ASSOCIATION
    PO BOX 30
    SUNAPEE,NH03782     		  PC ARGO AMPHIBIOUS RESCUE VEHICLE 35,000
    SUNAPEE HISTORICAL SOCIETY
    PO BOX 501
    SUNAPEE,NH03782     		  PC GENERAL CHARITABLE SUPPORT 8,000
    THE ALS ASSOCIATION
    1300 WILSON BOULEVARD SUITE 600
    ARLINGTON,VA22209     		  PC GENERAL CHARITABLE SUPPORT 10,000
    THE AMERICAN CIVIL LIBERTIES UNION FOUNDATION
    125 BROAD ST 18TH FLOOR
    NEW YORK,NY10004     		  PC GENERAL CHARITABLE SUPPORT 10,000
    THE ATLANTA MUSIC PROJECT
    883 DILL AVENUE SOUTHWEST
    ATLANTA,GA30310     		  PC GENERAL CHARITABLE SUPPORT 2,000
    THE CENTER FOR POPULAR DEMOCRACY
    449 TROUTMAN STREET SUITE A
    BROOKLYN,NY11237     		  PC COVID-19 VACCINATION EFFORTS 10,000
    THE CHAPTER HOUSE
    1438 ALLESANDRO STREET
    LOS ANGELES,CA90026     		  PC GENERAL CHARITABLE SUPPORT 2,000
    THE FELLS
    456 ROUTE 103A PO BOX 276
    NEWBURY,NH03255     		  PC GENERAL CHARITABLE SUPPORT 2,000
    THE KWEK SOCIETY
    3469 N EDISON ST
    ARLINGTON,VA22207     		  PC GENERAL CHARITABLE SUPPORT 20,000
    THE LIVERY - SUNAPEE HERITAGE ALLIANCE
    PO BOX 72
    SUNAPEE,NH03782     		  PC GENERAL CHARITABLE SUPPORT 10,000
    THE MONTEREY BAY AQUARIUM FOUNDATION
    886 CANNERY ROW
    MONTEREY,CA93940     		  PC GENERAL CHARITABLE SUPPORT 2,500
    THE PEOPLE'S CONSERVATORY
    6738 BANNING DRIVE
    OAKLAND,CA94611     		  PC GENERAL CHARITABLE SUPPORT 2,000
    THE PHOENIX
    54 NEWMARKET SQUARE
    BOSTON,MA02118     		  PC GENERAL CHARITABLE SUPPORT 2,000
    TRI-TOWN YOUTH SERVICES BUREAU INC
    PO BOX 897 56 HIGH STREET
    DEEP RIVER,CT06417     		  PC GENERAL CHARITABLE SUPPORT 5,000
    VERMONT INSTITUTE OF NATURAL SCIENCE
    VINS NATURE CENTER PO BOX 1281
    QUECHEE,VT05059     		  PC GENERAL CHARITABLE SUPPORT 2,000
    VERONICA ROBLES CULTURAL CENTER
    282 MERIDIAN STREET
    BOSTON,MA02128     		  PC GENERAL CHARITABLE SUPPORT 2,000
    WBUR
    890 COMMONWEALTH AVENUE 3RD FLOOR
    BOSTON,MA02215     		  PC GENERAL CHARITABLE SUPPORT 2,500
    WEST CENTRAL BEHAVIORAL HEALTH
    9 HANOVER STREET SUITE 2
    LEBANON,NH03766     		  PC MENTAL HEALTH SERVICE EXPANSION 50,000
    WEST CENTRAL BEHAVIORAL HEALTH
    9 HANOVER STREET SUITE 2
    LEBANON,NH03766     		  PC MENTAL HEALTH SERVICE EXPANSION 75,000
    WGBH
    1 GUEST STREET
    BOSTON,MA02135     		  PC GENERAL CHARITABLE SUPPORT 2,500
    WIKIMEDIA FOUNDATION
    PO BOX 98204
    WASHINGTON,DC20090     		  PC GENERAL CHARITABLE SUPPORT 1,000
    WILDLIFE CONSERVATION SOCIETY - BRONX ZOO
    2300 SOUTHERN BOULEVARD
    THE BRONX,NY10460     		  PC GENERAL CHARITABLE SUPPORT 7,000
    WOMEN'S FOUNDATION OF BOSTON
    126 BROOKLINE AVE 3RD FLOOR
    BOSTON,MA02215     		  PC GENERAL CHARITABLE SUPPORT 75,000
    WORKING ON WOMANHOOD
    50 MILK STREET
    BOSTON,MA02109     		  PC GENERAL CHARITABLE SUPPORT 2,000
    WUMB RADIO
    100 MORRISSEY BOULEVARD
    BOSTON,MA02125     		  PC GENERAL CHARITABLE SUPPORT 2,500
    ZOO NEW ENGLAND
    ONE FRANKLIN PARK ROAD
    BOSTON,MA02121     		  PC GENERAL CHARITABLE SUPPORT 2,500
    Total .................................bullet 3a 2,326,000
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 44  
    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 ............     		    14 2,044,407  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 2,939,910 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    2,939,910
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
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    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 4,408 1,102 0 3,306

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BOND FUNDS 21,671,636 31,027,014

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Name of Stock End of Year Book Value End of Year Fair Market Value
    EQUITY FUNDS 12,958,845 13,297,213

    TY 2021 InvestmentsOtherSchedule2
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    ALTERNATIVE INVESTMENTS FMV 768,144 582,607

    TY 2021 OtherExpensesSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE SUPPLIES & SOFTWARE 2,157 0 0 2,157
    RESEARCH SERVICES 3,960 0 0 3,960


    TY 2021 OtherIncreasesSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Description Amount
    TIMING DIFFERENCE 21,914


    TY 2021 OtherLiabilitiesSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Description Beginning of Year - Book Value End of Year - Book Value
    PAYROLL LIABILITIES 981 3,753


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OTHER PROFESSIONAL FEES 550 138 0 412
    INVESTMENT ADVISORY 67,272 67,272 0 0


    TY 2021 TaxesSchedule
    Name:
    THE BURKEHAVEN FAMILY FOUNDATION
    EIN:
    82-6746205
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PAYROLL TAXES 11,859 593 0 11,266
    FOREIGN TAX 21,916 21,916 0 0
    MA FILING FEE 250 250 0 0
    NH FILING FEE 75 75 0 0