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
WAGMORE FOUNDATION AGENCY
 
Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 3168
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PORTLAND, OR97208
A Employer identification number

45-3660440
B Telephone number (see instructions)

(503) 464-3580
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$423,100J 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) 402,000
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 4,615 4,615  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 595,821
b Gross sales price for all assets on line 6a 935,016
7 Capital gain net income (from Part IV, line 2)... 595,821
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)....... Click to see attachment 1,742    
12 Total. Add lines 1 through 11........ 1,004,178 600,436  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
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)....... Click to see attachment 1,500 0 0 1,500
c Other professional fees (attach schedule).... Click to see attachment 3,653 3,331   322
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 19 19   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)....... Click to see attachment 58,644     58,644
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 63,816 3,350 0 60,466
25 Contributions, gifts, grants paid....... 678,802 678,802
26 Total expenses and disbursements. Add lines 24 and 25 742,618 3,350 0 739,268
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 261,560
b Net investment income (if negative, enter -0-) 597,086
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............. 75,651 364,533 364,533
2 Savings and temporary cash investments......... 8,849 6,979 6,979
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
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 bullet0      
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)....... 56,739 Click to see attachment2,415 1,971
c Investments—corporate bonds (attach schedule)....... 12,997 Click to see attachment18,978 18,527
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 5,000 Click to see attachment27,954 31,090
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) 159,236 420,859 423,100
Liabilities 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 bullet)    
23 Total liabilities (add lines 17 through 22).........   0
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...........    
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........ 159,236 420,859
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)..... 159,236 420,859
30 Total liabilities and net assets/fund balances (see instructions). 159,236 420,859
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
159,236
2
Enter amount from Part I, line 27a .....................
2
261,560
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
67
4
Add lines 1, 2, and 3 ..........................
4
420,863
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
4
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
420,859
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 176. APPLE COMPUTER INC   2008-10-31 2021-01-29
b 97. ECOLAB INC   1991-09-19 2021-01-29
c 86. MICROSOFT CORP   2011-03-15 2021-01-29
d 1778. APPLE COMPUTER INC   2008-10-31 2021-02-04
e 595. ECOLAB INC   1991-09-19 2021-02-04
410. MICROSOFT CORP   2011-03-15 2021-02-04
42.347 PRINCIPAL GL R E SEC INS     2021-02-04
27.467 ROBECO BOSTON PARTNERS L S RSRCH     2021-02-04
170.478 TCW EMERGING MARKETS INCOME FUND     2021-02-04
12. AIA GROUP LTD ADR   2016-10-26 2021-02-16
20. ALFA LAVAL AB A D R   2017-04-11 2021-02-16
40. ALLIANZ SE UNSP A D R   2016-04-27 2021-02-16
26.842 CALVERT SHORT DURATION INCOME I   2018-10-31 2021-02-16
.148 CALVERT SHORT DURATION INCOME I   2020-12-02 2021-02-16
10. DBS GROUP HOLDINGS LTD - SPON ADR   2015-07-13 2021-02-16
15. DENTSU INC UNSPON A D R   2019-12-30 2021-02-16
129.227 DOUBLELINE TOTAL RET BD I   2015-07-15 2021-02-16
30. ICICI BANK LTD A D R   2019-12-30 2021-02-16
65. ITAU UNIBANCO HOLDINGS SA A D R   2013-10-24 2021-02-16
8. LOREAL UNSPONSORED A D R   2015-09-30 2021-02-16
7. NEOGEN CORP   2013-11-25 2021-02-16
8. PROS HOLDINGS INC   2016-06-13 2021-02-16
7. PROTO LABS INC   2015-07-13 2021-02-16
12. ROCHE HLDG LTD SPONSORED ADR   2016-03-03 2021-02-16
35. SYMRISE AG UNSPON A D R   2016-03-03 2021-02-16
20. SYSMEX CORP UNSPON A D R   2013-09-30 2021-02-16
8. TAIWAN SEMICONDUCTOR MFG CO LTD SPONSORED ADR   2015-07-13 2021-02-16
20. AMPHENOL CORP CL A   2017-08-10 2021-04-07
1. BOOKING HOLDINGS INC   2016-02-10 2021-04-07
5. CANADIAN NATL RY CO COM   2015-08-04 2021-04-07
1. CHEMED CORP   2013-10-24 2021-04-07
4. ELECTRONIC ARTS   2018-01-09 2021-04-07
4. FIVE BELOW   2013-11-25 2021-04-07
10. FORTIVE CORP WI   2017-08-22 2021-04-07
20. GENTEX CORPORATION COMMON STOCK   2016-03-03 2021-04-07
10. GRAND CANYON EDUCATION INC   2015-08-04 2021-04-07
4. HEICO CORP   2016-02-10 2021-04-07
10. INTEL CORP   2016-06-13 2021-04-07
1. INTUITIVE SURGICAL INC NEW   2017-08-10 2021-04-07
4. MARSH & MCLENNAN COS INC COM   2016-06-13 2021-04-07
15. NATIONAL INSTRS CORP   2013-10-30 2021-04-07
4. NESTLE S A SPONSORED ADR REPSTG REG SH   2015-08-04 2021-04-07
8. NEXTERA ENERGY INC   2015-11-18 2021-04-07
15. RITCHIE BROS AUCTIONEERS INC   2015-07-13 2021-04-07
7. TEXAS INSTRS INC   2016-06-13 2021-04-07
2. TYLER TECHNOLOGIES INC   2018-09-06 2021-04-07
4. VEEVA SYSTEMS INC-CLASS A   2017-04-11 2021-04-07
4. VONTIER CORPORATION COM   2017-08-22 2021-04-07
20. GENPACT LIMITED   2017-08-10 2021-04-07
4. MEDTRONIC PLC   2015-08-04 2021-04-07
7. CHECKPOINT SOFTWARE COM   2017-01-10 2021-04-07
134.416 AMERICAN BEACON STEPHENS MID CAP GR   2021-02-16 2021-05-03
242.952 ANGEL OAK MULTI STRATEGY INCOME   2021-02-16 2021-05-03
25. APPLE COMPUTER INC   2008-10-31 2021-05-03
4. BANK OF AMERICA CORP   2018-09-20 2021-05-03
.114 BARON EMERGING MARKETS INSTITUTIONAL   2021-02-16 2021-05-03
128.137 BARON EMERGING MARKETS INSTITUTIONAL   2016-06-22 2021-05-03
1. CME GROUP INC   2016-06-13 2021-05-03
137.423 CAUSEWAY EMERGING MARKETS INSTL   2015-08-04 2021-05-03
2. CISCO SYS INC   2016-03-03 2021-05-03
289.148 COLUMBIA CORPORATE INC FD INSTL     2021-05-03
702.492 COLUMBIA CORPORATE INC FD INSTL     2021-05-03
64.806 COLUMBIA SMALL CAP GROWTH I FUND   2021-02-16 2021-05-03
3. COMCAST CORP CL A   2017-08-10 2021-05-03
1. DANAHER CORP   2017-08-10 2021-05-03
17. ECOLAB INC   1991-09-19 2021-05-03
1. EDWARDS LIFESCIENCES CORP COM   2017-04-11 2021-05-03
4. FASTENAL CO   2015-09-30 2021-05-03
15. ISHARES CORE S P 500 ETF   2021-02-16 2021-05-03
84. ISHARES MIDCAP INDEX FD   2021-02-16 2021-05-03
65. ISHARES CORE MSCI EAFE ETF   2021-02-16 2021-05-03
1. J P MORGAN CHASE & CO   2016-06-13 2021-05-03
1. JOHNSON & JOHNSON   2016-06-13 2021-05-03
1. LAUDER ESTEE COS INC CL A   2018-01-09 2021-05-03
15. MICROSOFT CORP   2011-03-15 2021-05-03
73.979 NUVEEN REAL ESTATE SECS I     2021-05-03
.638 NUVEEN REAL ESTATE SECS I   2020-10-14 2021-05-03
1. PROCTER & GAMBLE CO   2016-06-13 2021-05-03
346.021 PGIM TOTAL RETURN BOND CL R6   2020-01-02 2021-05-03
351.904 PGIM TOTAL RETURN BOND CL R6   2021-02-16 2021-05-03
6. ROLLINS INC   2014-03-18 2021-05-03
1. ROPER INDS INC   2017-08-10 2021-05-03
1. SHERWIN WILLIAMS CO   2018-09-20 2021-05-03
2. SMITH A O CORP   2017-08-22 2021-05-03
3. T J X COS INC NEW   2016-06-13 2021-05-03
1. UNION PACIFIC CORPORATION COMMON STOCK   2017-08-10 2021-05-03
26.853 VANGUARD INTERNATIONAL GROWTH FUND   2021-02-16 2021-05-03
1. VERISK ANALYTICS INC CL A COM   2015-07-13 2021-05-03
1. VISA INC   2015-07-13 2021-05-03
1. ZOETIS INC   2017-08-10 2021-05-03
1. LINDE PLC   2019-12-30 2021-05-03
121.448 AMERICAN BEACON STEPHENS MID CAP GR   2021-02-16 2021-07-28
25. APPLE COMPUTER INC   2008-10-31 2021-07-28
3. CME GROUP INC   2016-06-13 2021-07-28
220.113 CAUSEWAY EMERGING MARKETS INSTL   2021-02-16 2021-07-28
13.048 CAUSEWAY EMERGING MARKETS INSTL   2015-08-04 2021-07-28
904.159 COLUMBIA CORPORATE INC FD INSTL   2021-02-16 2021-07-28
17. ECOLAB INC   1991-09-19 2021-07-28
16. FASTENAL CO   2015-09-30 2021-07-28
289.757 FEDERATED HERMES INSTL HI YLD BD IS   2021-02-16 2021-07-28
258.052 FEDERATED HERMES INSTL HI YLD BD IS     2021-07-28
88. ISHARES MIDCAP INDEX FD   2021-02-16 2021-07-28
48. ISHARES CORE MSCI EAFE ETF   2021-02-16 2021-07-28
21. MICROSOFT CORP   2011-03-15 2021-07-28
674.764 PGIM TOTAL RETURN BOND CL R6   2021-02-16 2021-07-28
24. ROLLINS INC   2014-03-18 2021-07-28
2. ROPER INDS INC   2017-08-10 2021-07-28
8. SMITH A O CORP   2017-08-22 2021-07-28
21.481 VANGUARD INTERNATIONAL GROWTH FUND   2021-02-16 2021-07-28
210.025 AMERICAN BEACON STEPHENS MID CAP GR   2021-02-16 2021-08-12
464.04 ANGEL OAK MULTI STRATEGY INCOME   2021-02-16 2021-08-12
37. APPLE COMPUTER INC   2008-10-31 2021-08-12
7. BANK OF AMERICA CORP   2018-09-20 2021-08-12
244.966 BARON EMERGING MARKETS INSTITUTIONAL   2021-02-16 2021-08-12
158.647 CAUSEWAY EMERGING MARKETS INSTL   2021-02-16 2021-08-12
3. CISCO SYS INC   2016-03-03 2021-08-12
1496.355 COLUMBIA CORPORATE INC FD INSTL   2021-02-16 2021-08-12
126.738 COLUMBIA SMALL CAP GROWTH I FUND   2021-02-16 2021-08-12
6. COMCAST CORP CL A   2017-08-10 2021-08-12
2. DANAHER CORP   2017-08-10 2021-08-12
26. ECOLAB INC   1991-09-19 2021-08-12
2. EDWARDS LIFESCIENCES CORP COM   2017-04-11 2021-08-12
660.999 FEDERATED HERMES INSTL HI YLD BD IS   2021-02-16 2021-08-12
31. ISHARES CORE S P 500 ETF   2021-02-16 2021-08-12
134. ISHARES MIDCAP INDEX FD   2021-02-16 2021-08-12
105. ISHARES CORE MSCI EAFE ETF   2021-02-16 2021-08-12
1. J P MORGAN CHASE & CO   2016-06-13 2021-08-12
2. JOHNSON & JOHNSON   2016-06-13 2021-08-12
2. LAUDER ESTEE COS INC CL A   2018-01-09 2021-08-12
19. MICROSOFT CORP   2011-03-15 2021-08-12
2. PROCTER & GAMBLE CO   2016-06-13 2021-08-12
1036.266 PGIM TOTAL RETURN BOND CL R6   2021-02-16 2021-08-12
2. SHERWIN WILLIAMS CO   2018-09-20 2021-08-12
6. T J X COS INC NEW   2016-06-13 2021-08-12
2. THERMO ELECTRON CORP COM W/RTS ATTACHED EXP 01/29/2006   2017-08-10 2021-08-12
2. UNION PACIFIC CORPORATION COMMON STOCK   2017-08-10 2021-08-12
2. UNITEDHEALTH GRP INC COM   2013-11-25 2021-08-12
42.767 VANGUARD INTERNATIONAL GROWTH FUND   2021-02-16 2021-08-12
2. VERISK ANALYTICS INC CL A COM   2015-07-13 2021-08-12
2. VISA INC   2015-07-13 2021-08-12
1. ZOETIS INC   2017-08-10 2021-08-12
2. LINDE PLC   2019-12-30 2021-08-12
1. ALPHABET INC CL C   2015-07-13 2021-11-29
252.288 AMERICAN BEACON STEPHENS MID CAP GR   2021-02-16 2021-11-29
591.085 ANGEL OAK MULTI STRATEGY INCOME   2021-02-16 2021-11-29
44. APPLE COMPUTER INC   2008-10-31 2021-11-29
9. BANK OF AMERICA CORP   2018-09-20 2021-11-29
199.886 BARON EMERGING MARKETS INSTITUTIONAL   2021-02-16 2021-11-29
205.011 CAUSEWAY EMERGING MARKETS INSTL   2021-02-16 2021-11-29
5. CISCO SYS INC   2016-03-03 2021-11-29
30.30197 COLUMBIA CORPORATE INC FD INSTL   2021-02-16 2021-11-29
430.52803 COLUMBIA CORPORATE INC FD INSTL   2021-02-16 2021-11-29
107.825 COLUMBIA SMALL CAP GROWTH I FUND   2021-02-16 2021-11-29
6. COMCAST CORP CL A   2017-08-10 2021-11-29
31. ECOLAB INC   1991-09-19 2021-11-29
3. EDWARDS LIFESCIENCES CORP COM   2017-04-11 2021-11-29
512.295 FEDERATED HERMES INSTL HI YLD BD IS   2021-02-16 2021-11-29
86. ISHARES MIDCAP INDEX FD   2021-02-16 2021-11-29
42. ISHARES CORE MSCI EAFE ETF   2021-02-16 2021-11-29
2. J P MORGAN CHASE & CO   2016-06-13 2021-11-29
4. JOHNSON & JOHNSON   2016-06-13 2021-11-29
24. MICROSOFT CORP     2021-11-29
4. PROCTER & GAMBLE CO   2016-06-13 2021-11-29
1320.016 PGIM TOTAL RETURN BOND CL R6   2021-02-16 2021-11-29
6. T J X COS INC NEW   2016-06-13 2021-11-29
52.371 VANGUARD INTERNATIONAL GROWTH FUND   2021-02-16 2021-11-29
2. ZOETIS INC   2017-08-10 2021-11-29
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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 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 23,816   678 23,138
b 20,239   373 19,866
c 20,203   2,185 18,018
d 241,742   6,848 234,894
e 123,186   2,286 120,900
99,661   10,418 89,243
420   403 17
398   410 -12
1,435   1,302 133
647   324 323
608   390 218
951   690 261
446   425 21
2   2  
782   621 161
511   514 -3
1,375   1,407 -32
547   456 91
337   490 -153
602   278 324
617   260 357
359   133 226
1,352   489 863
526   382 144
1,102   560 542
1,132   321 811
1,121   182 939
1,359   783 576
2,429   1,037 1,392
582   314 268
457   71 386
567   452 115
790   212 578
717   562 155
722   306 416
1,099   429 670
514   113 401
661   325 336
764   312 452
496   265 231
661   441 220
462   302 160
619   201 418
916   411 505
1,354   434 920
865   494 371
1,045   202 843
122   97 25
888   590 298
482   308 174
809   622 187
5,242   5,428 -186
2,527   2,527  
3,313   96 3,217
162   125 37
2   2  
2,483   1,406 1,077
204   95 109
2,200   1,528 672
102   54 48
3,120   3,171 -51
7,580   7,068 512
2,214   2,472 -258
171   123 48
255   79 176
3,867   65 3,802
94   31 63
212   73 139
6,303   5,930 373
6,552   6,267 285
4,879   4,754 125
154   64 90
165   117 48
292   131 161
3,772   381 3,391
1,593   1,593  
14   12 2
135   83 52
5,010   4,998 12
5,096   5,201 -105
227   54 173
446   232 214
278   159 119
141   108 33
216   114 102
224   104 120
4,460   4,866 -406
189   74 115
231   69 162
176   61 115
289   212 77
5,006   4,904 102
3,611   96 3,515
630   286 344
3,405   3,771 -366
202   145 57
10,027   9,901 126
3,738   65 3,673
867   290 577
2,906   2,906  
2,588   2,463 125
6,982   6,565 417
3,605   3,510 95
6,074   534 5,540
10,020   9,973 47
879   216 663
984   464 520
561   433 128
3,608   3,893 -285
8,640   8,481 159
4,831   4,826 5
5,450   143 5,307
294   219 75
4,652   5,277 -625
2,462   2,718 -256
168   80 88
16,415   16,385 30
4,324   4,834 -510
353   246 107
622   159 463
5,717   100 5,617
223   63 160
6,590   6,630 -40
13,799   12,254 1,545
10,813   9,997 816
8,051   7,679 372
161   64 97
348   234 114
653   263 390
5,478   483 4,995
285   166 119
15,254   15,316 -62
605   319 286
427   229 198
1,075   344 731
452   209 243
815   148 667
7,372   7,750 -378
382   148 234
465   139 326
199   61 138
615   424 191
2,898   539 2,359
10,609   10,187 422
6,112   6,147 -35
7,002   169 6,833
408   282 126
3,504   4,305 -801
2,950   3,512 -562
276   134 142
329   332 -3
4,671   4,714 -43
3,487   4,112 -625
306   246 60
7,011   119 6,892
335   94 241
5,015   5,138 -123
7,039   6,416 623
3,079   3,072 7
322   128 194
636   468 168
8,084   889 7,195
594   332 262
19,127   19,510 -383
422   229 193
8,573   9,491 -918
447   122 325
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
      339
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       23,138
b       19,866
c       18,018
d       234,894
e       120,900
      89,243
      17
      -12
      133
      323
      218
      261
      21
       
      161
      -3
      -32
      91
      -153
      324
      357
      226
      863
      144
      542
      811
      939
      576
      1,392
      268
      386
      115
      578
      155
      416
      670
      401
      336
      452
      231
      220
      160
      418
      505
      920
      371
      843
      25
      298
      174
      187
      -186
       
      3,217
      37
       
      1,077
      109
      672
      48
      -51
      512
      -258
      48
      176
      3,802
      63
      139
      373
      285
      125
      90
      48
      161
      3,391
       
      2
      52
      12
      -105
      173
      214
      119
      33
      102
      120
      -406
      115
      162
      115
      77
      102
      3,515
      344
      -366
      57
      126
      3,673
      577
       
      125
      417
      95
      5,540
      47
      663
      520
      128
      -285
      159
      5
      5,307
      75
      -625
      -256
      88
      30
      -510
      107
      463
      5,617
      160
      -40
      1,545
      816
      372
      97
      114
      390
      4,995
      119
      -62
      286
      198
      731
      243
      667
      -378
      234
      326
      138
      191
      2,359
      422
      -35
      6,833
      126
      -801
      -562
      142
      -3
      -43
      -625
      60
      6,892
      241
      -123
      623
      7
      194
      168
      7,195
      262
      -383
      193
      -918
      325
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 2 595,821
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 8,299
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 8,299
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 964
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 7,336
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 8,300
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 1
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet1 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$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
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
Yes
 
If "Yes," attach the statement required by General Instruction T.Click to see attachment
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)
    bulletFL
    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 addressbullet  
    14
    The books are in care ofbulletJEANNETTE PETERS Telephone no.bullet (503) 464-4908

    Located atbullet5015 NW 24TH DRIVEGAINESVILLEFL ZIP+4bullet32605
    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
    GLADYS COFRIN BOARD MEMBER
    1     		0    
    14720 NW 13TH PLACE
    NEWBERRY,FL32669
    PEGEEN HANRAHAN BOARD MEMBER
    1     		0    
    14720 NW 13TH PLACE
    NEWBERRY,FL32669
    ROBERT HUTCHINSON BOARD MEMBER
    1     		0    
    14720 NW 13TH PLACE
    NEWBERRY,FL32669
    MARY IPPOLITI-SMITH BOARD MEMBER
    1     		0    
    14720 NW 13TH PLACE
    NEWBERRY,FL32669
    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
    NONE
    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.........................bullet  
    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
    288,539
    b
    Average of monthly cash balances.......................
    1b
    59,710
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    348,249
    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
    348,249
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    5,224
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    343,025
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    17,151
    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
    17,151
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    8,299
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    8,299
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    8,852
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    8,852
    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
    8,852
    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 8,852
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 265,427
    b From 2017...... 322,740
    c From 2018...... 376,984
    d From 2019...... 570,753
    e From 2020...... 701,354
    f Total of lines 3a through e ........ 2,237,258
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 739,268
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 8,852
    e Remaining amount distributed out of corpus 730,416
    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 2,967,674
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		265,427
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		2,702,247
    10 Analysis of line 9:
    a Excess from 2017.... 322,740
    b Excess from 2018.... 376,984
    c Excess from 2019.... 570,753
    d Excess from 2020.... 701,354
    e Excess from 2021.... 730,416
    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).)
    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 e-mail address of the person to whom applications should be addressed:
    JEANNETTE PETERS
    5015 NW 24TH DRIVE
    GAINESVILLE,FL32605
    (352) 371-7412
    bThe form in which applications should be submitted and information and materials they should include:
    CONTACT FOUNDATION MANAGER
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    ANIMAL RESCUE
    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
    FOSTER PARROTS
    PO BOX 34
    HOPE VALLEY,RI02832     		NONE PC GENERAL OPERATING 25,000
    SHELDRICK WILDLIFE TRUST
    25283 CABOT ROAD STE 101
    LAGUNA HILLS,CA92653     		NONE PC GENERAL OPERATING 10,000
    GRACE MARKETPLACE
    3055 NE 28TH DRIVE
    GAINESVILLE,FL32609     		NONE PC GENERAL OPERATING 91,794
    WORKING DOGS FOR CONSERVATION
    10971 RUSTIC ROAD
    MISSOULA,MT59802     		NONE PC GENERAL OPERATING 46,116
    BAT CONSERVATION INTERNATIONAL
    1
    500 N CAPITAL OF TX HWY BLDG 1
    AUSTIN,TX78746     		NONE PC GENERAL OPERATING 5,000
    HAILES ANGELS PET RESCUE
    5231 SW 91ST DRIVE
    GAINESVILLE,FL32608     		NONE PC GENERAL OPERATING 34,904
    RAINFOREST TRUST
    PO BOX 841
    WARRENTON,VA20188     		NONE PC GENERAL OPERATING 25,000
    PERFORMING ANIMAL WELFARE SOCIETY
    PO BOX 849
    GALT,CA95632     		NONE PC GENERAL OPERATING 2,000
    EPISCOPAL CHILDREN'S SERVICES
    8843 BAYMEADOWS RD STE 1
    JACKSONVILLE,FL322587440     		NONE PC GENERAL OPERATING 14,500
    PANAFRICAN SANCTUARY ALLIANCE
    3428 SW ARNOLD ST
    PORTLAND,OR97219     		NONE PC GENERAL OPERATING 18,550
    ELEPHANT SANCTUARY TENNESSEE
    PO BOX 393
    HOGENWALD,TN38462     		NONE PC GENERAL OPERATING 20,000
    HOME VAN PET CARE PROJECT
    PO BOX 14305
    GAINESVILLE,FL32604     		NONE PC GENERAL OPERATING 8,130
    ANIMAL GRANTMAKERS
    PO BOX 150485
    LAKEWOOD,CO80215     		NONE PC GENERAL OPERATING 1,250
    FREELAND USA
    PO BOX 522
    GREEN LAKE,WI54941     		NONE PC GENERAL OPERATING 10,000
    ARCAS
    140 S DEARBORNST STE 1510
    CHICAGO,IL50603     		NONE PC GENERAL OPERATING 4,500
    UF SCASV
    2015 SW 16TH AVENUE
    GAINESVILLE,FL32610     		NONE PC GENERAL OPERATING 5,000
    LUBEE BAT CONSERVANCY
    1309 NW 192ND AVE
    GAINSEVILLE,FL32609     		NONE PC GENERAL OPERATING 1,000
    NONHUMAN RIGHTS PROJECT
    5195 NW 112TH TER
    CORAL SPRINGS,FL33076     		NONE PC GENERAL OPERATING 2,000
    ALACHUA COUNTY HUMANE SOCIETY
    4205 NW 6TH STREET
    GAINESVILLE,FL32609     		NONE PC GENERAL OPERATING 204,738
    COMMUNITY FOUNDATION OF NORTH CE
    3919 W NEWBERRY ROAD
    GAINESVILLE,FL32607     		NONE PC GENERAL OPERATING 134,320
    AMBOSELI ELEPHANT TRUST
    10 STATE ST
    NEWBURYPORT,MA01950     		NONE PC GENERAL OPERATING 10,000
    MACAW CONSERVATIONCOSTA RICA
    PO BOX 34
    HOPE VALLEY,RI02832     		NONE PC GENERAL OPERATING 5,000
    Total .................................bullet 3a 678,802
    bApproved for future payment
    Total .................................bullet 3b  
    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 ...........     		         
    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 ............     		    18 595,821  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aFEDERAL TAX REFUND     		    1 1,742  
    bOTHER INCOME     1    
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   602,178  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    602,178
    (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
    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.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    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
    Schedule B
    (Form 990)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    WAGMORE FOUNDATION AGENCY
     
    Employer identification number

    45-3660440
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    WAGMORE FOUNDATION AGENCY
          		Employer identification number
    45-3660440
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    GLADYS COFRIN
    14720 NW 13TH PLACE
     
    NEWBERRY, FL32669

    		$ 15,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    GLADYS G COFRIN REVOCABLE TRUST
    14720 NW 13TH PLACE
     
    NEWBERRY, FL32669

    		$ 387,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    WAGMORE FOUNDATION AGENCY
          		Employer identification number

    45-3660440
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    WAGMORE FOUNDATION AGENCY
          		Employer identification number

    45-3660440
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,500     1,500

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Name of Bond End of Year Book Value End of Year Fair Market Value
    87234N765 TCW EMERGING MARKETS    
    19765N518 COLUMBIA CORPORATE I 16,152 15,730
    258620103 DOUBLELINE TOTAL RET    
    31420B300 FEDERATED HERMES INS 2,826 2,797
    13161T401 CALVERT SHORT DURATI    

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Name of Stock End of Year Book Value End of Year Fair Market Value
    032095101 AMPHENOL CORP CL A    
    12572Q105 CME GROUP INC    
    92826C839 VISA INC    
    20030N101 COMCAST CORP CL A    
    02079K107 ALPHABET INC CL C    
    670678507 NUVEEN REAL ESTATE S    
    015393101 ALFA LAVAL AB SWEDEN    
    34959J108 FORTIVE CORP WI    
    235851102 DANAHER CORP    
    16359R103 CHEMED CORP    
    571748102 MARSH MCLENNAN COS I    
    883556102 THERMO FISHER SCIENT    
    641069406 NESTLE SA SPONSORED    
    872540109 TJX COMPANIES INC    
    371901109 GENTEX CORP    
    465562106 ITAU UNIBANCO HOLDIN    
    640491106 NEOGEN CORP    
    767744105 RITCHIE BROS AUCTION    
    09857L108 BOOKING HOLDINGS INC    
    922475108 VEEVA SYSTEMS INC-CL    
    458140100 INTEL CORP    
    742718109 PROCTER GAMBLE CO    
    74346Y103 PROS HOLDINGS INC    
    98978V103 ZOETIS INC    
    149498107 CAUSEWAY EMERGING MA    
    74254V273 PRINCIPAL GL R E SEC    
    87155N109 SYMRISE AG UNSPON A    
    06828M876 BARON EMERGING MARKE 2,415 1,971
    74925K581 ROBECO BOSTON PARTNE    
    775711104 ROLLINS INC    
    776696106 ROPER INDS INC    
    311900104 FASTENAL CO    
    M22465104 CHECK POINT SOFTWARE    
    136375102 CANADIAN NATL RY CO    
    502117203 LOREAL UNSPONSORED A    
    23304Y100 DBS GROUP HLDGS LTD    
    87184P109 SYSMEX CORP UNSPON A    
    28176E108 EDWARDS LIFESCIENCES    
    46625H100 J P MORGAN CHASE CO    
    G5960L103 MEDTRONIC PLC    
    G3922B107 GENPACT LIMITED    
    771195104 ROCHE HOLDINGS LTD S    
    874039100 TAIWAN SEMICONDUCTOR    
    743713109 PROTO LABS INC    
    060505104 BANK OF AMERICA CORP    
    902252105 TYLER TECHNOLOGIES I    
    422806109 HEICO CORP    
    92345Y106 VERISK ANALYTICS INC    
    33829M101 FIVE BELOW    
    001317205 AIA GROUP LTD ADR    
    38526M106 GRAND CANYON EDUCATI    
    824348106 SHERWIN WILLIAMS CO    
    518439104 LAUDER ESTEE COS INC    
    91324P102 UNITED HEALTH GROUP    
    65339F101 NEXTERA ENERGY INC    
    46120E602 INTUITIVE SURGICAL I    
    882508104 TEXAS INSTRUMENTS IN    
    831865209 SMITH A O CORP    
    17275R102 CISCO SYSTEMS INC    
    636518102 NATIONAL INSTRS CORP    
    037833100 APPLE INC    
    478160104 JOHNSON JOHNSON    
    907818108 UNION PACIFIC CORP    
    594918104 MICROSOFT CORP    
    285512109 ELECTRONIC ARTS INC    
    018820100 ALLIANZ SE UNSP A D    
    G5494J103 LINDE PLC    
    928881101 VONTIER CORPORATION    
    45104G104 ICICI BANK LTD A D R    
    278865100 ECOLAB INC    
    249034109 DENTSU INC UNSPON A    

    TY 2021 InvestmentsOtherSchedule2
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    74440B884 PGIM TOTAL RETURN BO      
    46432F842 ISHARES CORE MSCI EA AT COST 6,143 6,270
    19765P596 COLUMBIA SMALL CAP G AT COST 2,082 1,567
    464287200 ISHARES CORE S P 500 AT COST 13,835 16,695
    464287499 ISHARES RUSSELL MID AT COST 5,894 6,558

    TY 2021 LiquidationExplanationStmt
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Statement:
    THE FOUNDATION DISTRIBUTED GRANTS TO BENEFICIARIES NAMED IN PART XIV IN EXCESS OF 25% OF ITS FMV.


    TY 2021 OtherDecreasesSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Description Amount
    PY RETURN OF CAPITAL ADJ 1
    CY SALES RETURN OF CAPITAL ADJ 3


    TY 2021 OtherExpensesSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    GRANT RESEARCH 22,189 0   22,189
    MANAGEMENT FEES 36,455 0   36,455


    TY 2021 OtherIncomeSchedule2
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    FEDERAL TAX REFUND 1,742 0  
    OTHER INCOME   0  


    TY 2021 OtherIncreasesSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Description Amount
    COST BASIS ADJUSTMENT 67


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TRUST FEES 3,222 2,900   322
    INESTMENT MANAGEMENT FEES 431 431    


    TY 2021 TaxesSchedule
    Name:
    WAGMORE FOUNDATION AGENCY
    EIN:
    45-3660440
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 12 12   0
    FOREIGN TAXES ON NONQUALIFIED 7 7   0