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
METRO HEALTH FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 615
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ALLEN PARK, MI481010615
A Employer identification number

38-2100939
B Telephone number (see instructions)

(313) 965-4220
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$8,442,520J 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) 49,115
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 149,648 149,648  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 438,260
b Gross sales price for all assets on line 6a 1,868,879
7 Capital gain net income (from Part IV, line 2)... 438,260
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)....... Click to see attachment 2,222 2,222  
12 Total. Add lines 1 through 11........ 639,245 590,130  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 97,960 19,592   78,368
14 Other employee salaries and wages......        
15 Pension plans, employee benefits....... 20,541 4,108   16,433
16a Legal fees (attach schedule)......... Click to see attachment 20 20   0
b Accounting fees (attach schedule)....... Click to see attachment 18,800 18,800   0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 12,927 2,585   10,342
21 Travel, conferences, and meetings....... 4,043 1,059   2,984
22 Printing and publications.......... 2,451 491   1,961
23 Other expenses (attach schedule)....... Click to see attachment 91,747 46,674   45,073
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 248,489 93,329   155,161
25 Contributions, gifts, grants paid....... 213,578 213,578
26 Total expenses and disbursements. Add lines 24 and 25 462,067 93,329   368,739
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 177,178
b Net investment income (if negative, enter -0-) 496,801
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets 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......... 294,530 475,770 475,770
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..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 3,979,709 Click to see attachment4,294,122 4,294,122
c Investments—corporate bonds (attach schedule)....... 1,954,843 Click to see attachment2,031,607 2,031,607
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 1,573,553 Click to see attachment1,641,021 1,641,021
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) 7,802,635 8,442,520 8,442,520
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 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........... 7,802,635 8,442,520
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 7,802,635 8,442,520
30 Total liabilities and net assets/fund balances (see instructions). 7,802,635 8,442,520
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
7,802,635
2
Enter amount from Part I, line 27a .....................
2
177,178
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
462,707
4
Add lines 1, 2, and 3 ..........................
4
8,442,520
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
8,442,520
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a PUBLICLY TRADED INVESTMENTS P    
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 1,868,879   1,430,619 438,260
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       438,260
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 438,260
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 6,906
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 6,906
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 3,520
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 3,520
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 3,386
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 taxBullet   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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMI
    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 addressbulletMETROHEALTHFDN.ORG
    14
    The books are in care ofbulletRANDY WALAINIS Telephone no.bullet (313) 965-4220

    Located atbulletPO BOX 615ALLEN PARKMI ZIP+4bullet481010615
    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)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    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
    RANDY C WALAINIS CPA PRESIDENT(EXEC DIR TO 8/2021)
    4.00     		45,460 11,050 0
    PO BOX 615
    ALLEN PARK,MI48101
    RUTH KALENIECKI EXECUTIVE DIRECTOR
    40.00     		52,500 3,420 0
    PO BOX 615
    ALLEN PARK,MI48101
    LILLIE M TABOR PRESIDENT EMERITUS
    2.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    CHERYL L CHANDLER VICE-PRESIDENT
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    RAYMOND COCHRAN CPA TREASURER
    2.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    JUDITH A BEAN PHD TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    VALERIE HEROD BELAY TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    LAURA J CHAMPAGNE TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    JEANINE C HATCHER TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    MARK R LEZOTTE TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    MADIHA TARIQ MPH TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    RICHARD TEETS PHD TRUSTEE
    1.00     		0 0 0
    PO BOX 615
    ALLEN PARK,MI48101
    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.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    7,841,866
    b
    Average of monthly cash balances.......................
    1b
    380,643
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    8,222,509
    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
    8,222,509
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    123,338
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    8,099,171
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    404,959
    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
    404,959
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    6,906
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    6,906
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    398,053
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    398,053
    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
    398,053
    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 7 398,053
    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...... 103,699
    b From 2017...... 92,906
    c From 2018...... 104,955
    d From 2019...... 15,723
    e From 2020...... 65,721
    f Total of lines 3a through e ........ 383,004
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 368,739
    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..... 368,739
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021. 29,314 29,314
    (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 5 353,690
    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) ...     		74,385
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		279,305
    10 Analysis of line 9:
    a Excess from 2017.... 92,906
    b Excess from 2018.... 104,955
    c Excess from 2019.... 15,723
    d Excess from 2020.... 65,721
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    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:
    RUTH KALENIECKI EXECUTIVE DIRECTOR
    PO BOX 615
    ALLEN PARK,MI48101
    (313) 965-4220
    bThe form in which applications should be submitted and information and materials they should include:
    ALL FUNDING REQUESTS MUST BE DISCUSSED WITH FOUNDATION STAFF PRIOR TO PREPARATION AND SUBMISSION OF GRANT REQUESTS. FOUNDATION STAFF WILL DETERMINE IF A GRANT REQUEST LETTER OR FULL GRANT APPLICATION IS REQUIRED. THE FOUNDATION HAS SPECIFIC GRANT REQUEST LETTER AND GRANT APPLICATION FORMATS. IN ADDITION TO COMPLETING THE REQUIRED REQUEST DOCUMENT, GRANTSEEKERS WILL BE ASKED TO PROVIDE A COPY OF THEIR CURRENT IRS DETERMINATION LETTER INDICATING IRS 501(C)(3) TAX-EXEMPT STATUS; A LIST OF BOARD OF DIRECTORS, WITH AFFILIATIONS; THE ORGANIZATION'S CURRENT ANNUAL OPERATING BUDGET, INCLUDING EXPENSES AND REVENUE; MOST RECENT ANNUAL FINANCIAL STATEMENT (INDEPENDENTLY AUDITED, IF AVAILABLE; IF NOT AVAILABLE, THEY SHOULD ATTACH A COPY OF THEIR MOST RECENTLY COMPLETED IRS FORM 990); LETTERS OF SUPPORT SHOULD VERIFY PROJECT NEED AND COLLABORATION WITH OTHER ORGANIZATIONS, IF AVAILABLE.
    cAny submission deadlines:
    FEB. 1 & AUG. 1. PLEASE CONTACT FOUNDATION STAFF AS COVID-19 HAS IMPACTED GRANT SUBMISSION SCHEDULE.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    GRANTS ARE MADE TO ORGANIZATIONS WITH PROGRAMS SERVING RESIDENTS OF THE DETROIT, MICHIGAN METROPOLITAN AREA (WAYNE, OAKLAND AND MACOMB COUNTIES). THERE WILL BE NO GRANTS HIGHER THAN $50,000; NO GRANTS WILL BE MADE TO MUNICIPALITIES, OTHER GOVERNMENTAL DEPARTMENTS OR FUNDS (EXCEPT BY SPECIFIC BOARD ACTION). BRICK AND MORTAR GRANTS ARE DISCOURAGED. HOWEVER, MHF WILL CONSIDER REQUESTS FOR INITIATIVES THAT WILL HELP AN ORGANIZATION TO BUILD ITS CAPACITY, INCLUDING SUCH THINGS AS NEW EQUIPMENT, FACILITY RENOVATIONS, TECHNOLOGY, NEW HEALTH CENTER ACCESS POINTS, ETC. MHF WILL NOT PROVIDE LOANS; SUPPORT RELIGIOUS ORGANIZATIONS; INDULGE IN LOBBYING; OR SUPPORT ORGANIZATIONS WHICH DISCRIMINATE BECAUSE OF AGE, RACE, ETHNIC ORIGIN, RELIGION, SEXUAL ORIENTATION, GENDER IDENTITY, DISABILITY OR SEX.
    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
    BRIDGING COMMUNITIES INC
    6900 MCGRAW
    DETROIT,MI48210     		NONE PC - PUBLIC CHARITY TO BUILD INFRASTRUCTURE, PURCHASE EQUIPMENT, AND PROVIDE TECHNICAL ASSISTANCE TO SENIORS IN THE USE OF PERSONAL DEVICES TO ACCESS TELEHEALTH SERVICES. 10,000
    CENTRAL UNITED METH CHURCH OF DETROT CDC
    23 EAST ADAMS
    DETROIT,MI48226     		NONE PC - PUBLIC CHARITY TO SUPPORT ONGOING COSTS OF PROVIDING PREVENTATIVE, BASIC MEDICAL CARE AND FOLLOW-UP FOR DETROIT'S HOMELESS. (3 YEAR STABILITY GRANT) 7,000
    CENTRAL UNITED METH CHURCH OF DETROT CDC
    23 EAST ADAMS
    DETROIT,MI48226     		NONE PC - PUBLIC CHARITY UNRESTRICTED USE (MATCHING GIFTS PROGRAM) 500
    COUNCIL OF MICHIGAN FOUNDATIONS
    ONE SOUTH HARBOR DRIVE SUITE 8
    GRAND HAVEN,MI49417     		NONE PC - PUBLIC CHARITY TO SUPPORT ANNUAL MEMBERSHIP. 2,200
    DETROIT WAYNE COUNTY HEALTH AUTHORITY
    3031 W GRAND BLVD SUITE 600
    DETROIT,MI48202     		NONE PC - PUBLIC CHARITY TO SUPPORT DWCHA'S ALBERT SCHWEITZER FELLOWSHIP PROGRAM. 5,000
    FERNCARE FREE CLINIC INC
    751 E NINE MILE ROAD SUITE 2
    FERNDALE,MI48220     		NONE PC - PUBLIC CHARITY TO SUPPORT OPERATIONS OF THE FREE PHARMACY WITHIN THE CLINIC. (3 YEAR STABILITY GRANT) 6,633
    FERNCARE FREE CLINIC INC
    751 E NINE MILE ROAD SUITE 2
    FERNDALE,MI48220     		NONE PC - PUBLIC CHARITY UNRESTRICTED USE (MATCHING GIFTS PROGRAM) 500
    GRANTMAKERS IN HEALTH
    1100 CONNECTICUT AVENUE NW SUITE
    1100
    WASHINGTON,DC20036     		NONE PC - PUBLIC CHARITY TO SUPPORT ANNUAL MEMBERSHIP. 3,250
    GREATER DETRIOT AREA HEALTH COUNCIL
    30200 TELEGRAPH ROAD SUITE 105
    BINGHAM FARMS,MI48025     		NONE PC - PUBLIC CHARITY TO SUPPORT OPERATIONS OF THE HEALTH COUNCIL 1,000
    HOPE MEDICAL CLINIC INC
    518 HARRIET STREET
    YPSILANTI,MI48197     		NONE PC - PUBLIC CHARITY TO EXPAND THE OFFERINGS OF THE WAYNE CLINIC. (2 YEAR GRANT) 10,525
    MACOMB INTERFAITH VOLUNTEER CAREGIVERS
    25650 KELLY ROAD
    ROSEVILLE,MI48006     		NONE PC - PUBLIC CHARITY TO SUPPORT MEDICAL TRANSPORTATION SERVICES FOR OLDER AND DISABLED ADULTS IN MACOMB AND OAKLAND COUNTIES. (3 YEAR STABILITY GRANT) 7,000
    MICHIGAN ADVOCACY PROGRAM
    15 S WASHINGTON STREET
    YPSILANTI,MI48197     		NONE PC - PUBLIC CHARITY TO SUPPORT THE CREATION OF AN OMBUDSMAN PROGRAM WITHIN THE MICHIGAN ELDER JUSTICE INITIATIVE FOR HOME- AND COMMUNITY-BASED SERVICES. 15,000
    MICHIGAN COMMUNITY HEALTH WORKER ALLIANCE
    901 TOWER DRIVE SUITE 420
    TROY,MI48098     		NONE PC - PUBLIC CHARITY TO EMPLOY COMMUNITY HEALTH WORKERS IN WAYNE COUNTY TO INCREASE COVID-19 VACCINATIONS. 14,700
    MICHIGAN LEAGUE FOR PUBLIC POLICY
    1223 TURNER STREET SUITE G-1
    LANSING,MI48906     		NONE PC - PUBLIC CHARITY TO SUPPORT ANNUAL MEMBERSHIP. 250
    MICHIGAN NONPROFIT ASSOCIATION
    330 MARSHALL STREET
    LANSING,MI48912     		NONE PC - PUBLIC CHARITY TO SUPPORT ANNUAL MEMBERSHIP. 270
    MICHIGAN UNIVERSAL HEALTH CARE ACCESS NETWORK
    35828 SMITHFIELD COURT
    FARMINGTON,MI48335     		NONE PC - PUBLIC CHARITY TO SUPPORT ANNUAL MEMBERSHIP. 250
    MICHIGN PRIMARY CARE ASSOCIATION
    7215 WESTSHIRE DR
    LANSING,MI48917     		NONE PC - PUBLIC CHARITY TO SUPPORT A CAMPAIGN ACROSS SOUTHEAST MICHIGAN TO REENGAGE HEALTH CENTER PATIENTS WHO STOPPED RECEIVING CARE DUE TO THE COVID-19 CRISIS. 15,000
    NEIGHBORHOOD SERVICE ORGANIZATION
    882 OAKMAN BLVD SUITE C
    DETROIT,MI48238     		NONE PC - PUBLIC CHARITY TO SUPPORT CONSTRUCTION OF AND EQUIPMENT FOR THE DETROIT HEALTHY HOUSING CENTER INTEGRATED HEALTHCARE CLINIC. 50,000
    OAKLAND INTEGRATED HEALTHCARE NETWORK
    461 W HURON STREET SUITE 103
    PONTIAC,MI48341     		NONE PC - PUBLIC CHARITY TO PROVIDE START-UP COSTS FOR ENHANCED CARE MANAGEMENT AIMED TO IMPROVE UTILIZATION OF PRIMARY HEALTH CARE SERVICES BY BEHAVIORAL HEALTH PATIENTS. 15,000
    ORDER OF MALTA DENTAL CLINIC
    31698 SOUTHVIEW ST
    BEVERLY HILLS,MI48025     		NONE PC - PUBLIC CHARITY TO SUPPORT FREE DENTAL SERVICES IN THE CITY OF DETROIT. (3 YEAR STABILITY GRANT) 7,000
    PONTIAC COMMUNITY FOUNDATION
    79 OAKLAND AVE
    PONTIAC,MI48342     		NONE PC - PUBLIC CHARITY TO SUPPORT THE DEVELOPMENT OF A CITY-WIDE STRATEGY TO ADDRESS RACIAL HEALTH DISPARITIES, EMPHASIZE THE IMPORTANCE OF PREVENTIVE CARE, AND RESPOND TO THE COVID-19 CRISIS. 12,500
    RUTH ELLIS CENTER
    95 VICTOR STREET
    HIGHLAND PARK,MI48203     		NONE PC - PUBLIC CHARITY UNRESTRICTED USE (MATCHING GIFTS PROGRAM) 500
    THE REGENTS OF THE UNIVERSITY OF MICHIGAN ON BEHALF OF MICHIGAN MEDICINE
    1600 HURON PARKWAY
    ANN ARBOR,MI48109     		NONE PC - PUBLIC CHARITY TO IMPLEMENT TRAILS (TRANSFORMING RESEARCH INTO ACTION TO IMPROVE THE LIVES OF STUDENTS) IN DETROIT PUBLIC SCHOOLS COMMUNITY DISTRICT. (YEAR 3) 12,500
    WORLD MEDICAL RELIEF
    21725 MELROSE
    SOUTHFIELD,MI48075     		NONE PC - PUBLIC CHARITY TO SUPPORT ONGOING COSTS OF PURCHASING GENERIC PRESCRIPTION MEDICATIONS FOR LOW-INCOME RESIDENTS OF SOUTHEAST MICHIGAN. (3 YEAR STABILITY GRANT) 7,000
    Total .................................bullet 3a 203,578
    bApproved for future payment
    DETROIT WAYNE COUNTY HEALTH AUTHORITY
    3031 W GRAND BLVD SUITE 600
    DETROIT,MI48202     		NONE PC - PUBLIC CHARITY TO SUPPORT DWCHA'S ALBERT SCHWEITZER FELLOWSHIP PROGRAM. 10,000
    CENTRAL UNITED METH CHURCH OF DETROT CDC
    23 EAST ADAMS
    DETROIT,MI48226     		NONE PC - PUBLIC CHARITY TO SUPPORT ONGOING COSTS OF PROVIDING PREVENTATIVE, BASIC MEDICAL CARE AND FOLLOW-UP FOR DETROIT'S HOMELESS. (3 YEAR STABILITY GRANT) 7,000
    COVENANT COMMUNITY CARE
    559 W GRAND BLVD
    DETROIT,MI48216     		NONE PC - PUBLIC CHARITY TO PURCHASE DENTAL EQUIPMENT FOR THE NEWLY-BUILT JOY-SOUTHFIELD HEALTH CENTER. 50,000
    FERNCARE FREE CLINIC INC
    751 E NINE MILE ROAD SUITE 2
    FERNDALE,MI48220     		NONE PC - PUBLIC CHARITY TO SUPPORT OPERATIONS OF THE FREE PHARMACY WITHIN THE CLINIC. (3 YEAR STABILITY GRANT) 6,634
    HOPE MEDICAL CLINIC INC
    518 HARRIET STREET
    YPSILANTI,MI48197     		NONE PC - PUBLIC CHARITY TO EXPAND THE OFFERINGS OF THE WAYNE CLINIC. (2 YEAR GRANT) 10,000
    MACOMB INTERFAITH VOLUNTEER CAREGIVERS
    25650 KELLY ROAD
    ROSEVILLE,MI48006     		NONE PC - PUBLIC CHARITY TO SUPPORT MEDICAL TRANSPORTATION SERVICES FOR OLDER AND DISABLED ADULTS IN MACOMB AND OAKLAND COUNTIES. (3 YEAR STABILITY GRANT) 7,000
    MICHIGAN COMMUNITY HEALTH WORKER ALLIANCE
    901 TOWER DRIVE SUITE 420
    TROY,MI48098     		NONE PC - PUBLIC CHARITY TO EMPLOY COMMUNITY HEALTH WORKERS IN WAYNE COUNTY TO INCREASE COVID-19 VACCINATIONS. 14,000
    ORDER OF MALTA DENTAL CLINIC
    31698 SOUTHVIEW ST
    BEVERLY HILLS,MI48025     		NONE PC - PUBLIC CHARITY TO SUPPORT FREE DENTAL SERVICES IN THE CITY OF DETROIT. (3 YEAR STABILITY GRANT) 7,000
    WORLD MEDICAL RELIEF
    21725 MELROSE
    SOUTHFIELD,MI48075     		NONE PC - PUBLIC CHARITY TO SUPPORT ONGOING COSTS OF PURCHASING GENERIC PRESCRIPTION MEDICATIONS FOR LOW-INCOME RESIDENTS OF SOUTHEAST MICHIGAN. (3 YEAR STABILITY GRANT) 7,000
    Total .................................bullet 3b 118,634
    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 ............     		    18 438,260  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 590,130 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    590,130
    (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
    METRO HEALTH FOUNDATION
     
    Employer identification number

    38-2100939
    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
    METRO HEALTH FOUNDATION
          		Employer identification number
    38-2100939
    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
    DORIS M FELL TRUST
     
    370 E MAPLE ROAD 3RD FLOOR
     
    BIRMINGHAM, MI48009

    		$ 49,115


    (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.)
    (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
    METRO HEALTH FOUNDATION
          		Employer identification number

    38-2100939
    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
    METRO HEALTH FOUNDATION
          		Employer identification number

    38-2100939
    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:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 18,800 18,800   0

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Name of Bond End of Year Book Value End of Year Fair Market Value
    AMERICAN EXPRESS COMPANY 76,410 76,410
    AMERICAN HONDA FINANCE 101,470 101,470
    BB&T CORPORATION 75,280 75,280
    BANK OF NEW YORK MELLON 49,999 49,999
    BOEING COMPANY 100,150 100,150
    COMERICA INC 103,988 103,988
    DTE ENERGY CO 99,865 99,865
    EXXON MOBIL CORPORATION 75,003 75,003
    GOLDMAN SACHS GROUP INC 106,020 106,020
    JP MORGAN CHASE 128,415 128,415
    PNC FINANCIAL SERVICES GROUP 101,893 101,893
    SYSCO CORPORATION 101,056 101,056
    UNION PACIFIC CORP 30,117 30,117
    U.S. BANCORP 75,261 75,261
    WELLS FARGO & COMPANY 101,200 101,200
    ZENECA WILMINGTON 88,604 88,604
    MORGAN STANLEY 51,241 51,241
    MITSUBISHI 130,811 130,811
    VERIZON COMMUNIC 99,371 99,371
    CATERPILLAR FINL 78,998 78,998
    NVIDIA CORP 123,853 123,853
    CITIGROUP INC. 132,602 132,602

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Name of Stock End of Year Book Value End of Year Fair Market Value
    A T & T CORP 12,054 12,054
    ABBVIE INC 23,018 23,018
    ALIBABA GROUP HLDG ADR 8,909 8,909
    AMAZON.COM INC 70,021 70,021
    AMEDISYS 20,235 20,235
    AMERICAN EXPRESS COMPANY 65,440 65,440
    AMERISAFE INC 26,377 26,377
    APACHE CORP 75,292 75,292
    APPLE COMPUTER INC 255,701 255,701
    AUTOMATIC DATA PROCESSING 44,384 44,384
    B & G FOODS INC 16,133 16,133
    BALL CORPORATION 18,291 18,291
    BANK OF AMERICA CORP 113,894 113,894
    BLACKROCK 109,867 109,867
    BOEING CO 72,475 72,475
    BORG WARNER 32,901 32,901
    CARLISLE COMPANIES INC 31,015 31,015
    CENTRAL GARDEN & PET 31,581 31,581
    CHURCH & DWIGHT CO INC 19,475 19,475
    CISCO SYSTEMS INC 56,399 56,399
    COSTCO WHSL CORP NEW 102,186 102,186
    CVS HEALTH CORP 67,570 67,570
    DAVITA 25,027 25,027
    DIAMONFBACK ENERGY 31,277 31,277
    DOVER CORPORATION 78,088 78,088
    EAST WEST BANCORP 37,766 37,766
    ESTEE LAUDER CO INC 62,934 62,934
    EVEREST REINSURANCE HLDG 30,131 30,131
    EXLSERVICE HOLDINGS 26,059 26,059
    FIRST AMERICAN FINANCIAL 14,081 14,081
    FIRST FOUNDATION INC 30,081 30,081
    GLOBAL PAYMENTS 33,796 33,796
    HEALTHEQUITY INC 16,590 16,590
    HESKA CORP 22,811 22,811
    HEXCEL CORP. 15,540 15,540
    HOMEDEPOT INC 95,452 95,452
    IAA INC. 26,322 26,322
    IBM CORP 16,708 16,708
    IDEX CORP 20,087 20,087
    ILLINOIS TOOL WORKS INC 71,572 71,572
    J P MORGAN CHASE 105,303 105,303
    JOHNSON & JOHNSON 66,717 66,717
    KADANT 26,505 26,505
    KAR AUCTION SERVICES 22,024 22,024
    KIMBERLY-CLARK CORP 47,164 47,164
    KINDER MORGAN 34,575 34,575
    L3HARRIS TECHNOLOGIES IN 78,899 78,899
    LINDE PLC 103,929 103,929
    LKQ CORPORATION 39,020 39,020
    MARRIOTT VACATION WORLDWIDE 22,812 22,812
    MASTERCARD INC 129,355 129,355
    MICROCHIP TECHNOLOGY INC 40,047 40,047
    MICROSOFT CORP 191,702 191,702
    NEW YORK CMNTY BANCORP 11,355 11,355
    NIKE INC CLASS B 91,669 91,669
    NORDSON CORP 25,527 25,527
    OLD DOMINION FREIGHT 14,335 14,335
    OMNICOM GROUP INC 51,289 51,289
    PALO ALTO NETWORKS 36,189 36,189
    PEPSICO INCORPORATED 52,113 52,113
    PLANET FITNESS INC 26,268 26,268
    POLARIS INDUSTRIES 11,541 11,541
    PROSPERITY BANCSHARES 16,629 16,629
    SITEONE LANDSCAPE SUPPLY 18,171 18,171
    SKYWORKS SOLUTIONS INC. 36,458 36,458
    SS&C TECHNOLOGIES 26,234 26,234
    STANDEX INTERNATIONAL 21,579 21,579
    STARBUCKS CORP 94,746 94,746
    STEEL DYNAMICS 19,242 19,242
    STRYKER CORP 96,271 96,271
    SYNOPSYS INC 42,378 42,378
    TECHTARGET 24,872 24,872
    THERMO FISHER SCIENTIFIC 156,801 156,801
    TRACTOR SUPPLY COMPANY 34,597 34,597
    UNITEDHEALTH GROUP INC 135,578 135,578
    VAIL RESORTS INC. 22,953 22,953
    WALT DISNEY CO 83,641 83,641
    WATERS CORP 16,767 16,767
    WELLS FARGO & CO NEW 45,581 45,581
    WELLS FARGO CONV PFD 14,905 14,905
    ZIONS BANCORPORATION 25,580 25,580
    HILLENBRAND INC 30,154 30,154
    LESLIES INC 29,338 29,338
    MATTERPORT INC 12,590 12,590
    META PLATFORMS INC 33,635 33,635
    OPTION CARE HEALTH INC 13,367 13,367
    REGAL BELOIT CORP 26,378 26,378
    U S PHYSICAL THERAPY 21,499 21,499
    USIO INC 8,415 8,415
    VALERO ENERGY CORP 10,140 10,140
    VERIZON COMMUNICATN 19,745 19,745

    TY 2021 InvestmentsOtherSchedule2
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    FIRST TR DJ INTERNET FD FMV 404,773 404,773
    ISHARES MSCI GRMNY IDX FMV 24,585 24,585
    JP MORGAN EXCH TRADED NT FMV 10,419 10,419
    REALTY INCOME CORP FMV 15,750 15,750
    SPDR BIOTECH FMV 123,156 123,156
    VANGUARD EMERGING MARKET FMV 34,869 34,869
    VANGUARD INTL EQTY INDEX FMV 889,173 889,173
    VANGUARD PACIFIC FMV 42,906 42,906
    GLOBAL X US PREFERRED FMV 9,918 9,918
    SPDR S&P KENSHO CLEAN FMV 36,974 36,974
    VANGUARD SHORT-TERM BOND FMV 48,498 48,498

    TY 2021 LegalFeesSchedule
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 20 20   0


    TY 2021 OtherExpensesSchedule
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK CHARGES 39,048 39,048   0
    OFFICE EQUIPMENT & SUPPLIES 5,554 1,111   4,443
    MISCELLANEOUS 1,272 1,272   0
    INSURANCE 4,280 856   3,424
    TELEPHONE 1,227 245   982
    UTILITIES 798 160   638
    CONTRACT LABOR 39,320 3,932   35,388
    DUES AND SUBSCRIPTIONS 248 50   198


    TY 2021 OtherIncomeSchedule2
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    SETTLEMENT ACTIVITY 169 169 169
    EXCISE TAX 2,053 2,053 2,053


    TY 2021 OtherIncreasesSchedule
    Name:
    METRO HEALTH FOUNDATION
    EIN:
    38-2100939
    Description Amount
    UNREALIZED GAINS ON INVESTMENTS 462,707