Form990-PF
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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 06-01-2021 , and ending 05-31-2022
Name of foundation
Camden Area Senior Assistance
 
Number and street (or P.O. box number if mail is not delivered to street address)8 Harrison Avenue
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Camden, ME04843
A Employer identification number

01-0248064
B Telephone number (see instructions)

(207) 691-6836
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$3,524,388J 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) 9,535
2 Check bullet.............
3 Interest on savings and temporary cash investments 16 16 16
4 Dividends and interest from securities... 112,904 112,904 112,904
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 637,737
b Gross sales price for all assets on line 6a 2,185,162
7 Capital gain net income (from Part IV, line 2)... 637,737
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........ 760,192 750,657 112,920
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 17,700     17,700
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 2,175 1,088   1,087
c Other professional fees (attach schedule).... Click to see attachment 5,339 5,339    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 2,394 84   2,310
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see list of attachments 1,242     1,242
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 28,850 6,511   22,339
25 Contributions, gifts, grants paid....... 239,271 239,271
26 Total expenses and disbursements. Add lines 24 and 25 268,121 6,511   261,610
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 492,071
b Net investment income (if negative, enter -0-) 744,146
c Adjusted net income (if negative, enter -0-)... 112,920
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.............      
2 Savings and temporary cash investments......... 82,906 35,255 35,255
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.......... 2,500 655 655
10a Investments—U.S. and state government obligations (attach schedule) 270,978 Click to see attachment431,006 349,927
b Investments—corporate stock (attach schedule)....... 657,486 Click to see attachment1,166,327 2,699,039
c Investments—corporate bonds (attach schedule)....... 604,791 Click to see attachment477,489 439,512
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
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) 1,618,661 2,110,732 3,524,388
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........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 1,618,661 2,110,732
29 Total net assets or fund balances (see instructions)..... 1,618,661 2,110,732
30 Total liabilities and net assets/fund balances (see instructions). 1,618,661 2,110,732
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
1,618,661
2
Enter amount from Part I, line 27a .....................
2
492,071
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
2,110,732
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,110,732
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 Ameriprise - princ P 2020-01-01 2022-05-31
b 110 GNMA 4.50 P 2015-06-04 2021-06-21
c 2178 Federated Hermes Govt P 2010-01-01 2021-07-20
d 7297 Vanguard Admiral P 2010-01-01 2021-07-21
e 6060 AT&T Inc P 2016-01-01 2021-07-26
3620 Camden National P 2010-01-01 2021-07-26
307 HSBC Holdings P 2018-06-20 2021-07-26
517 Invesco P 2018-06-20 2021-07-26
.43 Analog Devices P 2010-01-01 2021-08-26
38 Analog Devices P 2021-07-26 2021-09-10
199 Ishares Broad USD P 2021-07-26 2021-09-10
51 Ishares 3-7 Yr Treas P 2021-07-26 2021-09-10
18730 Putnam Inc Cl Y P 2020-11-18 2021-09-10
13260 Camden National P 2010-01-01 2021-09-23
Ameriprise ST P 2021-09-01 2021-10-01
4241 JP Morgan Short Dur P 2021-09-01 2021-11-19
Ameriprise ST P 2021-09-01 2022-01-07
.79 Advanced Micro Dev P 2021-07-26 2022-02-15
Ameriprise ST P 2022-01-01 2022-03-11
Ameriprise ST P 2022-01-01 2022-04-01
Ameriprise ST P 2022-01-01 2022-05-06
(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 30,237   30,237  
b 5,469   13,297 -7,828
c 24,386   24,939 -553
d 78,690   77,448 1,242
e 170,285   222,606 -52,321
159,818   779 159,039
8,482   15,284 -6,802
12,853   14,345 -1,492
72   67 5
6,502   5,942 560
12,117   12,173 -56
6,683   6,710 -27
132,982   141,379 -8,397
620,614   2,853 617,761
153,615   158,944 -5,329
41,431   41,784 -353
152,575   146,496 6,079
95   63 32
261,229   277,309 -16,080
197,319   229,807 -32,488
109,708   124,963 -15,255
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        
b       -7,828
c       -553
d       1,242
e       -52,321
      159,039
      -6,802
      -1,492
      5
      560
      -56
      -27
      -8,397
      617,761
      -5,329
      -353
      6,079
      32
      -16,080
      -32,488
      -15,255
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 2 637,737
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 -71,314
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  
3 Add lines 1 and 2........................... 3 10,344
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 10,344
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 1,800
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,800
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 8,544
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet0 RefundedBullet 11  
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
 
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)
    bulletME
    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
    Yes
     
    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 ofbulletJean Payne Telephone no.bullet (207) 691-6836

    Located atbullet8 Harrison AveCamdenME ZIP+4bullet04843
    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
     
    No
    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
    Sam Jones Trustee
    1.00     		0    
    PO Box 573
    Camden,ME04843
    Roe Chiacchio Trustee
    1.00     		350    
    42 Moody Mountain Road
    Lincolnville,ME04849
    Jean Payne Secretary/Treas
    9.00     		12,550    
    8 Harrison Ave
    Camden,ME04843
    Brian Powers Trustee
    1.00     		450    
    Harts Mill Road
    South Hope,ME04847
    Elaine Davis Trustee
    1.00     		500    
    13 Limerock St
    Camden,ME04843
    Frank Morong President
    2.00     		400    
    51 Rollins Rd
    Camden,ME04843
    Linda Annis Trustee
    1.00     		500    
    3 Ledgewood Drive
    Rockport,ME04856
    Marie Berry Trustee
    1.00     		500    
    183 Church St
    Hope,ME04847
    Richard Lane Trustee
    1.00     		300    
    127 West St Ext
    Rockport,ME04856
    Rosemary Winslow Trustee
    1.00     		250    
    6 Winslow Dr
    Lincolnville,ME04849
    Sheila McFarland Trustee
    1.00     		550    
    448 Youngtown Rd
    Lincolnville,ME04849
    Tom Jackson Vice President
    1.00     		350    
    PO Box 895
    Camden,ME04843
    William Dickey Trustee
    1.00     		400    
    268 High St
    Lincolnville,ME04849
    Gregg Haining Trustee
    1.00     		550    
    3 Boulder Way
    Rockport,ME04856
    Beth Ward Trustee
    1.00     		50    
    48 Pearl St
    Camden,ME04843
    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  
    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.............bullet  
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 Financial support is given to needy individuals who live in the Maine towns of Camden, Hope, Lincolnville and Rockport. This support is used for groceries, real estate taxes, heating and medical costs. The maximum support given per individual is $2,500. This cap can be exceeded in extraordinary circumstances. There are approximately 120 annual recipients.Financial support is also given to area nonprofit organizations that support the mission of Camden Area Senior Assistance by providing food, medical care and other assistance to the individuals served by our organization. Donations were $35,500 in the current fiscal year to those nonprofit organizations. 0
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    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
    3,632,720
    b
    Average of monthly cash balances.......................
    1b
    59,081
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    3,691,801
    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
     
    3
    Subtract line 2 from line 1d.........................
    3
    3,691,801
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) Click to see attachment.............................
    4
    55,377
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    3,636,424
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    181,821
    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
     
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
     
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
     
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
     
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
     
    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 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........  
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$  
    a Applied to 2020, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount.....  
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2021.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		 
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    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
    1972-05-19
    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
    112,920 128,791 127,548 135,865 505,124
    b 85% (0.85) of line 2a ......... 95,982 109,472 108,416 115,485 429,355
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		261,610 284,013 256,521 254,098 1,056,242
    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 ....     		261,610 284,013 256,521 254,098 1,056,242
    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 ..     		121,214 118,576 117,177 122,885 479,852
    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:
    Jean Payne
    8 Harrison Street
    Camden,ME04843
    (207) 691-6836
    bThe form in which applications should be submitted and information and materials they should include:
    Applicant completes standard form, no additional information or materials required.
    cAny submission deadlines:
    None - grant process is ongoing.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Awards are limited to elderly residents of the towns of Camden, Hope, Lincolnville and Rockport, Maine, as well as the organizations that serve them. Awards are based on need, and are for groceries, prescriptions, heating fuel & firewood, home improvements, and real estate taxes.
    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
    Albano Michael Kerry
    10 Black Brook Drive
    Lincolnville,ME04849     		None I Real estate taxes 1,000
    Albano Michael Kerry
    10 Black Brook Drive
    Lincolnville,ME04849     		None I Groceries 1,500
    Ball Kathy
    12 Highland Park Drive Apt 21
    Camden,ME04843     		None I Groceries 1,500
    Ballou Jr Richard
    81 Ballou Drive
    Lincolnville,ME04849     		None I Groceries 1,000
    Berry Charles
    15 Sand Street
    Camden,ME04843     		None I Real estate taxes 1,000
    Berry Charles
    15 Sand Street
    Camden,ME04843     		None I Groceries 1,500
    Botley Eva
    2391 Belfast Road
    Lincolnville,ME04849     		None I Heating Oil 500
    Brown Edith
    15 Highland Park Apt 34
    Camden,ME04843     		None I Groceries 1,500
    Brown Howard Katherine
    14 Ames Terrace
    Camden,ME04843     		None I Groceries 1,500
    Camden Area Christian Food Pantry
    PO Box 337
    Camden,ME04843     		None PC Annual campaign 5,000
    Camden Area District Nursing Assn
    PO Box 547
    Camden,ME04843     		None PC Annual campaign 10,000
    Carle Robert Judy
    590 Barnestown Road
    Hope,ME04847     		None I Real estate taxes 1,000
    Carle Robert Judy
    590 Barnestown Road
    Hope,ME04847     		None I Groceries 1,500
    Carroll Dot
    63 West Street Extension
    Rockport,ME04856     		None I Groceries 1,500
    Chapin Georgia
    31 Annis Road
    Camden,ME04843     		None I Real estate taxes 1,000
    Chapin Georgia
    31 Annis Road
    Camden,ME04843     		None I Groceries 1,500
    Clark Marguerite
    7 Sand Street
    Camden,ME04843     		None I Real estate taxes 500
    Clark Marguerite
    7 Sand Street
    Camden,ME04843     		None I Groceries 1,500
    Coastal Family Hospice Volunteers
    PO Box 122
    Rockport,ME04856     		None PC Annual campaign 2,000
    Coastal Opportunities
    PO Box 637
    Camden,ME04843     		None PC Annual campaign 8,000
    Conrad Jeff
    PO Box 176
    Camden,ME04843     		None I Groceries 1,500
    Curit Sally
    10 Powder Mill Road
    Camden,ME04843     		None I Groceries 1,500
    Davis Robert
    17 Mountain Street
    Camden,ME04843     		None I Groceries 500
    Derby Thomas
    PO Box 1095
    Camden,ME04843     		None I Heating oil 1,000
    Derby Thomas
    PO Box 1095
    Camden,ME04843     		None I Groceries 1,500
    Diprete Maura
    143 Martin Corner Road
    Lincolnville,ME04849     		None I Real estate taxes 1,000
    Dyer Mary
    10 Highland Ave Apt 5
    Camden,ME04843     		None I Groceries 1,500
    Eaton Cathy
    121 Slab City Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Eaton Cathy
    121 Slab City Road
    Lincolnville,ME04849     		None I Real estate taxes 233
    Engstrom Reginald
    503 Beach Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Engstrom Reginald
    503 Beach Road
    Lincolnville,ME04849     		None I Real estate taxes 457
    Erskine Leroy Donna
    297 Youngtown Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Fogg Charles
    487 West Street
    Rockport,ME04856     		None I Groceries 1,500
    Gerry Cecil Elaine
    44 Tucker Brook Rd
    Lincolnville,ME04849     		None I Firewood 1,060
    Gerry Cecil Elaine
    44 Tucker Brook Rd
    Luncolnville,ME04849     		None I Real estate taxes 987
    Gerry Cecil Elaine
    44 Tucker Brook Rd
    Lincolnville,ME04849     		None I Groceries 1,500
    Gregory Bradford
    1025 Commercial Street
    Rockport,ME04856     		None I Groceries 1,500
    Grotton Phyllis
    2343 Belfast Road
    Lincolnville,ME04849     		None I Real estate taxes 896
    Grotton Phyllis
    2343 Belfast Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Hallowell Jocelyn
    61 Kimberly Drive
    Rockport,ME04856     		None I Real estate taxes 1,000
    Hallowell Jocelyn
    61 Kimberly Drive
    Rockport,ME04856     		None I Groceries 1,500
    Hannan Muriel
    291 Melvin Heights Road
    Camden,ME04843     		None I Groceries 1,000
    Harwood Janice
    263 Main Street
    Lincolnville,ME04849     		None I Heating oil 1,500
    Harwood Janice
    263 Main Street
    Lincolnville,ME04849     		None I Groceries 1,500
    Heald Nancy
    915 Beach Road
    Lincolnville,ME04849     		None I Real estate taxes 1,000
    Heald Nancy
    915 Beach Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Hendrick Kathleen
    150 Park Street
    Rockport,ME04856     		None I Groceries 1,500
    Herrick Tina
    2159 Belfast Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Hodgkins Amzy
    17 Keller Drive
    Rockport,ME04856     		None I Groceries 1,500
    Hofer Janice
    31 Knowlton Street
    Camden,ME04843     		None I Heating oil 1,000
    Hofer Janice
    31 Knowlton Street
    Camden,ME04843     		None I Groceries 1,500
    Holbrook Patricia
    10 Pearse Road
    Hope,ME04847     		None I Groceries 1,500
    Holbrook Patricia
    10 Pearse Road
    Hope,ME04847     		None I Real estate taxes 1,000
    Hunt Howard
    43 Molyneaux Road
    Camden,ME04843     		None I Real estate taxes 1,000
    Hunt Howard
    43 Molyneaux Road
    Camden,ME04843     		None I Groceries 1,500
    Ives William Eleanor
    58 Mistic Ave
    Rockport,ME04856     		None I Real estate taxes 1,000
    Jacobs Henry
    513 Buzzell Hill Road
    Hope,ME04847     		None I Real estate taxes 1,000
    Jacobs Henry
    513 Buzzell Hill Road
    Hope,ME04847     		None I Groceries 1,500
    Kane Maren
    37 Camden Road
    Lincolnville Center,ME04850     		None I Groceries 1,500
    Knight Keryn
    5 Belmont Avenue
    Camden,ME04843     		None I Real estate taxes 1,000
    Knight Keryn
    5 Belmont Avenue
    Camden,ME04843     		None I Groceries 1,000
    Lawson Raymond
    588 West Street
    Rockport,ME04856     		None I Real estate taxes 500
    Lawson Raymond
    588 West Street
    Rockport,ME04856     		None I Groceries 1,000
    Leland Faye
    685 Rockland Street
    Rockport,ME04856     		None I Groceries 1,500
    Long Cedric Pauline
    62 Pearl Street
    Camden,ME04843     		None I Groceries 1,000
    Ludwick Frances
    355 Commercial Street
    Rockport,ME04856     		None I Groceries 1,000
    Ludwig Barbara
    164 Ludwig Road
    Hope,ME04847     		None I Groceries 1,500
    Ludwig Alex Peggy
    903 Camden Road
    Hope,ME04847     		None I Groceries 1,500
    Ludwig Alex Peggy
    903 Camden Road
    Hope,ME04847     		None I Real estate taxes 1,000
    Main Shirley
    36 Riverside Drive
    Camden,ME04846     		None I Real estate taxes 1,000
    Main Shirley
    36 Riverside Drive
    Camden,ME04843     		None I Groceries 1,500
    Making Community Happen
    46 Summer Street
    Rockland,ME04841     		None PC Annual campaign 10,000
    Marston Amber
    50 Cobb Road
    Camden,ME04843     		None I Real estate taxes 500
    Marston Amber
    50 Cobb Road
    Camden,ME04843     		None I Groceries 1,500
    McGovern Susan
    Coleman Pond Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Meservey Marion
    373 Main Street
    Hope,ME04843     		None I Groceries 500
    Moholland Jacqueline
    PO Box 864
    Rockport,ME04856     		None I Groceries 1,500
    Nash Charles
    73 Pearl Street
    Camden,ME04843     		None I Groceries 1,500
    Overlock Patrick
    54 Lincolnville Road
    Hope,ME04856     		None I Real estate taxes 1,000
    Packard Doris
    243 Camden Road
    Lincolnville,ME04849     		None I Groceries 500
    Packard Doris
    243 Camden Road
    Linconville,ME04849     		None I Real estate taxes 1,000
    Pearse Rita
    PO Box 2022
    Hope,ME04847     		None I Real estate taxes 1,000
    Pearse Rita
    PO Box 2022
    Hope,ME04847     		None I Groceries 1,500
    Pearse Rita
    PO Box 2022
    Hope,ME04847     		None I Heating oil 1,000
    Pendleton Estelle
    2685 Belfast Road
    Lincolnville,ME04849     		None I Groceries 500
    Pendleton Warren
    105 Searsmont Rd
    Lincolnville,ME04849     		None I Groceries 500
    Pendleton Wayne
    118 Mechanic Street
    Camden,ME04843     		None I Biobricks 399
    Pendleton Wayne
    118 Mechanic Street
    Camden,ME04843     		None I Groceries 1,500
    Perry Ingrid
    220 West Street Ext
    Rockport,ME04856     		None I Groceries 1,500
    Pierce Marie
    687 Beach Road
    Lincolnville,ME04849     		None I Real estate taxes 1,000
    Pierce Marie
    687 Beach Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Pottle Lianne
    79 Union Street Apt 1
    Camden,ME04843     		None I Groceries 1,500
    Rankin Robert
    2284 Atlantic Highway
    Lincolnville,ME04849     		None I Groceries 1,500
    Recht Jacqueline
    12 Highland Park Drive Apt 21
    Camden,ME04843     		None I Groceries 1,500
    Rego Shirley
    2612 Belfast Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Robinson Marjorie
    1 Country Way
    Camden,ME04843     		None I Groceries 500
    Riley Jean
    39 Megunticook St Apt 32
    Camden,ME04843     		None I Rent 1,785
    Russell Carolyn
    154 Robbins Road
    Hope,ME04847     		None I Heating oil 500
    Russell Carolyn
    154 Robbins Road
    Hope,ME04847     		None I Groceries 1,500
    Robbins Emmi
    11 Beechwood Lane
    Lincolnville,ME04849     		None I Heating oil 1,000
    Roderick Sharon
    277 Camden Rd
    Hope,ME04847     		None I Groceries 1,500
    Senn Corelyn
    152 South Cobbtown Road
    Lincolnville,ME04849     		None I Real estate taxes 500
    Senn Corelyn
    152 South Cobbtown Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Shanahan Sylvia
    85 Pearl Street
    Camden,ME04843     		None I Groceries 1,500
    Prosser Gwen
    79 Union Street 3
    Camden,ME04843     		None I Groceries 1,500
    Smith Lorraine
    Highland Avenue
    Camden,ME04843     		None I Groceries 1,500
    Stanley Pat
    42 Mountainside Park
    Camden,ME04843     		None I Groceries 1,500
    Staples Sonja
    89 Marriner Drive
    Lincolnville,ME04849     		None I Groceries 1,500
    Sullivan Patricia
    128 Washington Street
    Camden,ME04843     		None I Real estate taxes 1,000
    Sullivan Patricia
    128 Washington Street
    Camden,ME04843     		None I Groceries 1,500
    Tetreault Patricia
    18 Sunset View Lane
    Hope,ME04847     		None I Heating oil 500
    Tetreault Patricia
    18 Sunset View Lane
    Hope,ME04847     		None I Groceries 1,500
    Thompson Peter
    33 Fogler Road
    Hope,ME04847     		None I Real estate taxes 1,651
    Thompson Peter
    33 Fogler Road
    Hope,ME04847     		None I Heating oil 1,000
    Thompson Peter
    33 Fogler Road
    Hope,ME04847     		None I Home improvement 1,200
    Trisdale Fritz Catherine
    11 Millertown Drive
    Lincolnville,ME04849     		None I Real estate taxes 1,000
    Trisdale Fritz Catherine
    11 Millertown Drive
    Lincolnville,ME04849     		None I Groceries 1,000
    Upton Rosanne
    217 Green Acre Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Upton Rosanne
    217 Green Acre Road
    Lincolnville,ME04849     		None I Heating oil 1,000
    Vose Joan
    12 Lupine Lane
    Camden,ME04843     		None I Heating oil 1,000
    Vose Joan
    12 Lupine Lane
    Camden,ME04843     		None I Groceries 1,500
    Wade Thomas Teresa Jo
    44 Upham Road
    Rockport,ME04856     		None I Real estate taxes 1,000
    Wade Thomas Teresa Jo
    44 Upham Road
    Rockport,ME04856     		None I Groceries 1,500
    Wade Thomas Teresa Jo
    44 Upham Rd
    Rockport,ME04856     		None I Heating oil 1,000
    Walker Jeffrey
    40 Church Street
    Hope,ME04847     		None I Real estate taxes 840
    Watmough Harold Carole
    100 Mt Pleasant St
    Rockport,ME04856     		None I Real estate taxes 1,974
    Webb Margery
    PO Box 1416
    Camden,ME04843     		None I Groceries 1,500
    Wells Vance Marie
    159 Green Acre Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Whitaker Paul Deborah
    79 Union St Apt 30
    Camden,ME04843     		None I Groceries 1,500
    Winslow William
    34 West Street Extension
    Rockport,ME04856     		None I Real estate taxes 679
    Winslow William
    34 West Street Extension
    Rockport,ME04856     		None I Groceries 1,500
    Barrows Darlene
    391 High Street
    Lincolnville,ME04849     		none   Heating OIl 500
    Botley Eva
    2391 Belfast Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Boulette Tamblyn
    10 Faith Lane
    Hope,ME04847     		None I Heating Oil 1,000
    Boulette Tamblyn
    10 Faith Lane
    Hope,ME04847     		None I Groceries 1,500
    Brown Glenn Thompson Amy
    402 Hope Road
    Lincolnville,ME04849     		None I Real Estate Taxes 1,000
    Crowley Edgar
    277 Camden Road
    Hope,ME04847     		None I Real Estate Taxes 1,000
    Downing Robert Jr Teresa
    74 Seacoast Road
    Hope,ME04847     		None I Groceries 1,500
    Dyer Barbara
    11 Highland Avenue
    Camden,ME04843     		None I Groceries 500
    Dyer Barbara
    11 Highland Avenue
    Camden,ME04843     		None 1 Heating Oil 1,000
    Dyer Daniel
    29 Dyer Drive
    Lincolnville,ME04849     		None I Groceries 1,500
    Dyer Daniel
    29 Dyer Drive
    Camden,ME04843     		None I Real Estate Taxes 1,000
    French Dolores
    82 Hosmer Pond Road
    Camden,ME04843     		None I Groceries 1,500
    Gott Carl Mary
    Cobb Road
    Camden,ME04843     		None I Groceries 1,500
    Gott Carl Mary
    Cobb Road
    Camden,ME04843     		None I Heating Oil 1,000
    Hall Margaret
    496 Hope Road
    Lincolnville,ME04849     		None I Real Estate Taxes 394
    Hopkins Richard Paula
    151 Chestnut Street
    Camden,ME04843     		None I Groceries 1,500
    Hopkins Richard Paula
    151 Chestnut Street
    Camden,ME04843     		None I Real Estate Taxes 1,000
    Kangas Eric
    1 Country Way
    Camden,ME04843     		None I Real Estate Taxes 500
    Kierstead Linda
    14 Spring Street
    Camden,ME04843     		None I Groceries 1,500
    Kierstead Linda
    14 Spring Street
    Camden,ME04843     		None I Real Estate Taxes 1,000
    Knight Charles Barbara
    76 Main Street
    Rockport,ME04856     		None I Real Estate Taxes 3,058
    Legasse Paul
    139 Robbins Road
    Hope,ME04847     		None I Groceries 1,500
    Libby Julia
    486 Camden Road
    Lincolnville,ME04856     		None I Real Estate Taxes 500
    Littlefield Ernest Jane
    68 Camden Road
    Lincolnville,ME04849     		None I Real Estate Taxes 500
    Marriner Clifton Ann
    PO Box 156
    Lincolnville Center,ME04850     		None I Groceries 1,500
    Marriner Clifton Ann
    PO Box 156
    Lincolnville Center,ME04850     		None I Real Estate Taxes 1,000
    Miller Pamela
    11 Viewpoint Drive
    Hope,ME04847     		None I Groceries 1,500
    Miller Pamela
    11 Viewpoint Drive
    Hope,ME04847     		None I Heating oil 1,000
    Smith Jeannine
    PO Box 195
    Camden,ME04843     		None I Groceries 500
    Snowdeal Sherrill
    24 Mountain Side Park
    Camden,ME04843     		None I Rent 1,860
    Stevens Christine
    26 Morton Road
    Lincolnville,ME04849     		None I Groceries 1,500
    Timmer Stacy
    34 Camden Street
    Rockport,ME04856     		None I Real Estate Taxes 500
    Urquhart Darlene
    5 Virginia Avenue
    Camden,ME04843     		None I Groceries 1,500
    Urquhart Darlene
    5 Virginia Avenue
    Camden,ME04843     		None I Heating oil 500
    Wadsworth Charlotte
    73 Pearl Street
    Camden,ME04843     		None I Groceries 1,500
    Winchenbach Elizabeth
    18 Start Road
    Camden,ME04843     		None I Groceries 1,000
    Winchenbach Elizabeth
    18 Start Road
    Camden,ME04843     		None I Heating oil 1,000
    Beattie Gretchen
    20 Highland Avenue Apt 15
    Camden,ME04843     		None I Groceries 200
    Beherrell Herbert
    274 Camden Road
    Lincolnville,ME04849     		None I Real estate taxes 969
    Belknap Debbie
    25 John Street
    Camden,ME04843     		None I Groceries 1,000
    Bloniasz Joseph
    166 Beech Hill Road
    Rockport,ME04856     		None I Real estate taxes 1,230
    Curran Mary Ann
    37 Cobb Road
    Camden,ME04843     		None I Groceries 900
    Curran Mary Ann
    37 Cobb Road
    Camden,ME04843     		None I Heating oil 500
    Erskine Leroy Donna
    297 Youngtown Road
    Lincolnville,ME04849     		None I Real estate taxes 500
    Fischer Amy
    Annis Road
    Camden,ME04843     		None I Groceries 500
    Meals on WheelsMaking Community Hap
    46 Summer Street
    Rockland,ME04841     		none PC Annual campaign 500
    Ludwig Keith
    118 Ludwig Road
    Hope,ME04847     		NOne I Real estate taxes 1,273
    Powell Jane
    16 Belmont Avenue Apt D
    Camden,ME04843     		None I Groceries 1,404
    Timmer Stacy
    34 Camden Street
    Rockport,ME04856     		None I Utilities 822
    Total .................................bullet 3a 239,271
    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 ...........     		    14 16  
    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 ............     		    18 637,737  
    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) ..   750,657  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    750,657
    (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: 21013475
    Software Version: 2021v4.0


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting fees 2,175 1,088 0 1,087

    TY 2021 CashDeemedCharitableExplnStmt
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Explanation:
    In accordance with the organization's bylaws, expenditures are to be used for the provision and maintenance of services for local senior citizens in the furtherance of the goal of assisting them to live in their private homes and residences. Cash deemed held for charitable activities approximate the annual obligations of the organization.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Name of Bond End of Year Book Value End of Year Fair Market Value
    Held by Ameriprise 477,489 439,512

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
    Held by Ameriprise 1,166,327 2,699,039

    TY 2021 InvestmentsGovtObligationsSch
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    US Government Securities - End of Year Book Value:

    431,006
    US Government Securities - End of Year Fair Market Value:

    349,927
    State & Local Government Securities - End of Year Book Value:


     
    State & Local Government Securities - End of Year Fair Market Value:


     


    TY 2021 OtherExpensesSchedule
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Insurance 698     698
    Office expense 544     544


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment management fees 5,339 5,339 0 0


    TY 2021 TaxesSchedule
    Name:
    Camden Area Senior Assistance
    EIN:
    01-0248064
    Software ID:
    21013475
    Software Version:
    2021v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Federal income tax 2,310     2,310
    Foreign taxes 84 84