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 01-01-2021 , and ending 12-31-2021
Name of foundation
THE MOSAIC FOUNDATION
(Of R & P Heydon)
% PETER N HEYDON
Number and street (or P.O. box number if mail is not delivered to street address)324 East Washington Street
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Ann Arbor, MI48104
A Employer identification number

38-2910797
B Telephone number (see instructions)

(734) 747-7070
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$2,775,003J 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) 100,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 738 738  
4 Dividends and interest from securities... 11,689 11,689  
5a Gross rents............ 4,000 4,000  
b Net rental income or (loss) 4,000
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)...  
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 405,863 405,863  
12 Total. Add lines 1 through 11........ 522,290 422,290  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
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 16,800 8,400 0 8,400
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 6,792     6,508
19 Depreciation (attach schedule) and depletion... Click to see attachment 32,905    
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 34,591 811   33,780
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 91,088 9,211 0 48,688
25 Contributions, gifts, grants paid....... 199,220 199,220
26 Total expenses and disbursements. Add lines 24 and 25 290,308 9,211 0 247,908
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 231,982
b Net investment income (if negative, enter -0-) 413,079
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......... 895,509 1,140,504 1,140,504
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)....... 125,568 Click to see attachment125,568 317,467
c Investments—corporate bonds (attach schedule)....... 91,064 Click to see attachment91,064 96,400
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 bullet1,387,978
Less: accumulated depreciation (attach schedule) bullet256,715 1,142,812 Click to see attachment1,131,263 1,131,263
15 Other assets (describe bullet) Click to see attachment90,833 Click to see attachment89,369 Click to see attachment89,369
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,345,786 2,577,768 2,775,003
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...........    
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........ 2,345,786 2,577,768
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)..... 2,345,786 2,577,768
30 Total liabilities and net assets/fund balances (see instructions). 2,345,786 2,577,768
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
2,345,786
2
Enter amount from Part I, line 27a .....................
2
231,982
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
2,577,768
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
2,577,768
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.)
1a
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
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
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  
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  
3 Add lines 1 and 2........................... 3 5,742
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 5,742
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a  
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 12,000
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 12,000
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  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 6,258
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet6,258 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
     
    No
    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 addressbulletN/A
    14
    The books are in care ofbulletPETER N HEYDON Telephone no.bullet (734) 663-1619

    Located atbullet324 EAST WASHINGTON STREETANN ARBORMI ZIP+4bullet48104
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    PETER N HEYDON DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    Marie R Deveney DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    C Wendell Dunbar DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    Richard Handelman DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    C Allan Heydon DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    Scott N Heydon DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    Sarah Schriber DIRECTOR
    0     		0 0 0
    324 East Washington Street
    Ann Arbor,MI48104
    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
     
    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
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    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
    381,852
    b
    Average of monthly cash balances.......................
    1b
    1,010,908
    c
    Fair market value of all other assets (see instructions)................
    1c
    1,220,632
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,613,392
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    2,613,392
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    39,201
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    2,574,191
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    128,710
    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
    128,710
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    5,742
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    5,742
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    122,968
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    122,968
    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
    122,968
    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 7 122,968
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:2019, 2018, 2017  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 307,253
    b From 2017...... 577,946
    c From 2018...... 558,224
    d From 2019...... 534,126
    e From 2020...... 137,983
    f Total of lines 3a through e ........ 2,115,532
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 269,264
    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..... 122,968
    e Remaining amount distributed out of corpus 146,296
    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 2,261,828
    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 ..........     		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) .......     		100,000
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		207,253
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		1,954,575
    10 Analysis of line 9:
    a Excess from 2017.... 577,946
    b Excess from 2018.... 558,224
    c Excess from 2019.... 534,126
    d Excess from 2020.... 137,983
    e Excess from 2021.... 146,296
    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).)
    NONE
    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.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    Alice Lloyd College
    100 Purpose Road
    Pippa Passes,KY41844     		  PC SUPPORT EDUCATION 1,000
    The Edible Schoolyard Project
    1517 Shattuck Avenue
    Berkeley,CA94709     		  PC SUPPORT EDUCATION 500
    Four Ways Books
    11 Jay Street 4th Floor
    New York,NY10013     		  PC SUPPORT EDUCATION 100
    Girls Group
    2531 Jackson Avenue Ste 188
    Ann Arbor,MI48103     		  PC SUPPORT EDUCATION 250
    Rare Book School University of Virginia
    PO Box 400103
    Charlottesville,VA229044103     		  PC SUPPORT EDUCATION 250
    South Plains College Foundation
    1401 South College Avenue
    Levelland,TX79336     		  PC SUPPORT EDUCATION 1,875
    United Negro College Fund Inc
    1805 7th Street NW
    Washington,DC20001     		  PC SUPPORT EDUCATION 1,500
    University of Michigan William L Clements Library
    990 South University Avenue
    Ann Arbor,MI48109     		  PC SUPPORT EDUCATION 1,000
    University of Michigan Telling It Program
    701 East University Avenue
    East Quad Ste 1801
    Ann Arbor,MI481091245     		  PC SUPPORT EDUCATION 1,000
    Princeton University Annual Giving
    330 Alexander Street
    Princeton,NJ08540     		  PC SUPPORT EDUCATION 10,000
    Pinceton University Class of '62 Scholarship Fund
    100 Overlook Center Ste 300
    c/o Office of the Recording Secreta
    Princeton,NJ08540     		  PC SUPPORT EDUCATION 1,000
    African Wildlife Foundation
    1100 New Jersey Avenue SE Ste 900
    Washington,DC20003     		  PC SUPPORT ANIMAL WELFARE 1,000
    Aussie Rescue and Placement Helpline
    PO Box 911654
    Saint George,UT84791     		  PC SUPPORT ANIMAL WELFARE 250
    Cornell Lab of Ornithology
    159 Sapsucker Woods Road
    Ithaca,NY14850     		  PC SUPPORT ANIMAL WELFARE 120
    Equine Voices
    PO Box 9597
    Pueblo,CO810086077     		  PC SUPPORT ANIMAL WELFARE 500
    Happy Cat
    PO Box 7013
    Merrifield,VA221167013     		  PC SUPPORT ANIMAL WELFARE 100
    LIFE
    1720 South Ocean Blvd
    Manalapan,FL33462     		  PC SUPPORT ANIMAL WELFARE 1,000
    Magic Marble Foundation
    1789 Cedar Lane
    Ann Arbor,MI48105     		  PC SUPPORT ANIMAL WELFARE 1,000
    Palm Beach Island Cats
    PO Box 173
    Palm Beach,FL33480     		  PC SUPPORT ANIMAL WELFARE 500
    Peggy Adams Animal Rescue League
    3200 North Military Trail
    West Palm Beach,FL33409     		  PC SUPPORT ANIMAL WELFARE 1,000
    AARP Foundation
    601 East Street NW
    Washington,DC20049     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 100
    Americans United for Separation of Church & State
    1310 L Street NW Ste 200
    Washington,DC20005     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 250
    Amnesty International USA
    311 West 43rd St 7th Floor
    New York,NY10036     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 500
    Church of Saint Mary the Virgin
    Church Road
    Great Milton,Oxfordshire, OX 4  
    UK     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 1,500
    Detroit Horse Power
    8425 West McNichols Rd
    Detroit,MI48221     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 1,000
    Feed the Children
    333 North Meridian Avenue
    Oklahoma City,OK731076507     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 500
    The Food Gatherers Inc
    1 Carrot Way
    PO Box 131037
    Ann Arbor,MI48113     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 2,500
    Habitat for Humanity of Huron Valley
    2805 South Industrial Hwy Ste 100
    Ann Arbor,MI48104     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 100
    Hightower Lowdown
    PO Box 3109
    Langhorne,PA190479830     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 250
    International Rescue Committee
    122 East 42nd Street
    New York,NY101681289     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 1,000
    League of Michigan Bicyclists
    410 South Cedar Street Ste A
    Lansing,MI48912     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 200
    Paws for Purple Hearts
    PO Box 1209
    Merrifield,VA221161209     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 500
    Peace Neighborhood Center
    1111 North Maple Road
    Ann Arbor,MI48103     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 6,000
    Saint Louis Center
    16195 Old US Hwy 12
    Chelsea,MI481189646     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 250
    Shelter Association of Washtenaw County
    312 West Huron Street
    Ann Arbor,MI48103     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 1,000
    SOS Community Services
    101 South Huron Street
    Ypsilanti,MI48197     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 2,000
    Southern Poverty Law Center
    400 Washington Avenue
    Montgomery,AL36104     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 1,000
    Washtenaw Camp Placement
    3135 South State Street Ste 350D
    Ann Arbor,MI48108     		  PC SUPPORT ADVANCEMENT OF SOCIAL JUSTICE 1,000
    Friends of WLRN Inc
    PO Box 19731
    Miami,FL331019731     		  PC SUPPORT PUBLIC BROADCASTING 2,000
    Interlochen Public Radio
    PO Box Office 199
    Interlochen,MI49643     		  PC SUPPORT PUBLIC BROADCASTING 1,000
    Michigan State University WKAR FM
    404 Wilson Road Room 212
    283 Communication Arts Science Bl
    East Lansing,MI488246421     		  PC SUPPORT PUBLIC BROADCASTING 2,000
    StoryCorps
    80 Hanson Place 2nd Floor
    Brooklyn,NY11217     		  PC SUPPORT PUBLIC BROADCASTING 500
    University of Michigan WUOM Public Radio
    535 West William Street Ste 110
    Ann Arbor,MI481034978     		  PC SUPPORT PUBLIC BROADCASTING 1,000
    WGTE Toledo Public Radio
    1270 South Detroit Avenue
    PO Box 30
    Toledo,OH43614     		  PC SUPPORT PUBLIC BROADCASTING 500
    WQCS Public Radio in Fort Pierce
    3209 Virginia Avenue
    Fort Pierce,FL34981     		  PC SUPPORT PUBLIC BROADCASTING 1,000
    WRCJ Detroit Schools Public Radio
    1 Clover Court
    Riley Broadcast Center
    Wixom,MI48393     		  PC SUPPORT PUBLIC BROADCASTING 1,000
    Eastern Michigan University WEMU Public Radio
    PO Box 980350
    Ypsilanti,MI481980350     		  PC SUPPORT PUBLIC BROADCASTING 10,500
    Classic Car Club of America Museum
    6865 West Hickory Road
    Hickory Corners,MI49060     		  PC SUPPORT AUTOMOBILE CHARITIES 2,500
    The Henry Ford
    20900 Oakwood Blvd
    Dearborn,MI481245029     		  PC SUPPORT AUTOMOBILE CHARITIES 5,000
    Model A Ford Foundation
    PO Box 28
    Peotone,IL604680028     		  PC SUPPORT AUTOMOBILE CHARITIES 250
    National Packard Museum
    1899 Mahoning Avenue NW
    Warren,OH44483     		  PC SUPPORT AUTOMOBILE CHARITIES 200
    Pebble Beach Company Foundation
    PO Box Office 1767
    Pebble Beach,CA93953     		  PC SUPPORT AUTOMOBILE CHARITIES 2,500
    Dawn Farm
    502 West Huron
    Ann Arbor,MI48103     		  PC SUPPORT HEALTH BETTERMENT 1,000
    Doctors Without Borders USA
    40 Rector Street 16th Floor
    New York,NY10006     		  PC SUPPORT HEALTH BETTERMENT 1,500
    Mary Obolensky Leukemia Foundation
    1400 Alabama Avenue Ste 9
    West Palm Beach,FL33401     		  PC SUPPORT HEALTH BETTERMENT 2,000
    Oxfam America
    226 Causeway Street 5th Floor
    Boston,MA021142206     		  PC SUPPORT HEALTH BETTERMENT 1,000
    Packard Health
    5200 Venture Drive
    Ann Arbor,MI48108     		  PC SUPPORT HEALTH BETTERMENT 6,000
    Partners in Health
    800 Boylston Street Ste 300
    Boston,MA02199     		  PC SUPPORT HEALTH BETTERMENT 1,000
    Planned Parenthood of Michigan
    PO Box 3673
    Ann Arbor,MI48106     		  PC SUPPORT HEALTH BETTERMENT 2,500
    Huron Waterloo Pathways Initiative
    1480 East Old US 12
    Chelsea,MI48118     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 500
    Land Trust Alliance
    1250 H Street NW Ste 600
    Washington,DC20005     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 250
    Legacy Land Conservancy
    6276 Jackson Road Ste G
    Ann Arbor,MI48103     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 1,000
    Library Green Conservancy
    1405 Lutz Avenue
    c/o Frank Wilhelme Treasurer
    Ann Arbor,MI48103     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 3,000
    Michigan Environmental Council
    602 West Ionia Street
    Lansing,MI48933     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 250
    Michigan Historic Preservation Network
    313 East Cesar E Chavez Avenue
    Lansing,MI48906     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 7,500
    National Trust for Historic Preservation
    2600 Virginia Avenue NW Ste 1100
    Washington,DC20037     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 100
    The Nature Conservancy Michigan
    101 East Cesar E Chavez Avenue
    Lansing,MI48906     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 1,000
    Preservation Foundation of Palm Beach
    311 Peruvian Avenue
    Palm Beach,FL33480     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 31,000
    Thousand Friends of Florida
    PO Box 5498
    Tallahassee,FL323145948     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 1,000
    Treeline Conservancy
    525 West William Street
    Ann Arbor,MI48103     		  PC SUPPORT HISTORIC AND LAND PRESERVATION 1,000
    Ann Arbor Film Festival
    PO Box 8232
    Ann Arbor,MI48107     		  PC SUPPORT CULTURAL ENRICHMENT 1,000
    Ann Arbor Grail Singers
    1401 Maywood Avenue
    Ann Arbor,MI48103     		  PC SUPPORT CULTURAL ENRICHMENT 1,000
    Caprock Cultural Association
    109 North Avenue N
    PO Box 37
    Post,TX79356     		  PC SUPPORT CULTURAL ENRICHMENT 1,250
    Cultural Council for Palm Beach County
    601 Lake Avenue
    Lake Worth,FL33460     		  PC SUPPORT CULTURAL ENRICHMENT 150
    Kerrytown Concert House
    415 North 4th Avenue
    Ann Arbor,MI48104     		  PC SUPPORT CULTURAL ENRICHMENT 1,000
    The Lotos Foundation
    5 East 66th Street
    New York,NY10065     		  PC SUPPORT CULTURAL ENRICHMENT 1,000
    The Palm Beach Civic Association
    139 North County Road Ste 33
    Palm Beach,FL334809932     		  PC SUPPORT CULTURAL ENRICHMENT 1,500
    The Palm Beach Symphony
    400 Hibiscus Street Ste 100
    West Palm Beach,FL33401     		  PC SUPPORT CULTURAL ENRICHMENT 1,000
    The Stecher and Horowitz Foundation
    119 West 57th Street Ste 1401
    New York,NY10019     		  PC SUPPORT CULTURAL ENRICHMENT 1,000
    United States Equestrian Team Foundation
    1040 Pottersville Road
    PO Box 355
    Gladstone,NJ07934     		  PC SUPPORT CULTURAL ENRICHMENT 2,500
    University of Michigan University Musical Society
    881 North University Avenue
    Burton Memorial Tower
    Ann Arbor,MI481099912     		  PC SUPPORT CULTURAL ENRICHMENT 5,000
    Wallace Theatre
    823 Houston Street
    Levelland,TX79336     		  PC SUPPORT CULTURAL ENRICHMENT 1,875
    Williamston Theatre
    122 South Putnam Street
    Williamston,MI48895     		  PC SUPPORT CULTURAL ENRICHMENT 500
    American Friends of Musee D'Orsay
    62 Rue De Lille
    Paris,Cedex 0775343
    FR     		  PC SUPPORT MUSEUMS 7,000
    American Trust for the British Library
    562 Saint Marks Avenue
    Brooklyn,NY112163514     		  PC SUPPORT MUSEUMS 5,000
    American Fund for Westminster Abbey
    111 East 56th Street Ste 211
    New York,NY10022     		  PC SUPPORT MUSEUMS 1,000
    Century Association Archives Foundation
    7 West 43rd Street
    New York,NY10036     		  PC SUPPORT MUSEUMS 2,000
    The Folger Shakespeare Library
    201 East Capital Street SE
    Washington,DC200031004     		  PC SUPPORT MUSEUMS 11,000
    The Frick Collection
    1 East 70th Street
    New York,NY10021     		  PC SUPPORT MUSEUMS 1,000
    Garza County Historical Museum
    119 North Avenue N
    CW Post Historical Center
    Post,TX79356     		  PC SUPPORT MUSEUMS 2,000
    The Grolier Club NYC
    47 East 60th Street
    New York,NY10022     		  PC SUPPORT MUSEUMS 500
    Hillwood Estate Museum and Gardens
    4155 Linnean Avenue NW
    Washington,DC20008     		  PC SUPPORT MUSEUMS 3,800
    King Barn Dairy Mooseum
    18028 Central Park Circle
    PO Box 76
    Boyds,MD208410076     		  PC SUPPORT MUSEUMS 500
    National Museum of African American History & Cult
    PO Box 98097
    Washington,DC200908097     		  PC SUPPORT MUSEUMS 1,000
    Shiawassee Arts Center
    206 Curwood Castle Drive
    Owosso,MI48867     		  PC SUPPORT MUSEUMS 250
    The Society of the Four Arts
    100 Four Arts Plaza
    Palm Beach,FL33480     		  PC SUPPORT MUSEUMS 10,000
    Tuskegee Airmen National Historical Museum
    PO Box 1808
    Merrifield,VA221168008     		  PC SUPPORT MUSEUMS 250
    Total .................................bullet 3a 199,220
    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 ...........     		    14 738  
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....     16 4,000  
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    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) ..   422,290  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    422,290
    (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
    THE MOSAIC FOUNDATION
    (Of R & P Heydon)
    Employer identification number

    38-2910797
    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
    THE MOSAIC FOUNDATION
    (Of R & P Heydon)         		Employer identification number
    38-2910797
    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
    Peter N Heydon
    324 East Washington Street
     
    Ann Arbor, MI48104

    		$ 100,000


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

    		$  


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

    		$  


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

    		$  


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

    		$  


    (Complete Part II for noncash contributions.)
    (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
    THE MOSAIC FOUNDATION
    (Of R & P Heydon)         		Employer identification number

    38-2910797
    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
    THE MOSAIC FOUNDATION
    (Of R & P Heydon)         		Employer identification number

    38-2910797
    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:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX & ACCOUNTING FEES 16,800 8,400   8,400

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2021 DepreciationSchedule
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    FURNITURE & EQUIPM 2000-12-31 4,802 4,802 M7          
    FURNITURE & EQUIPM 2001-12-31 1,994 1,994 M7          
    FURNITURE & EQUIPM 2002-12-31 831 831 M7          
    FURNITURE & EQUIPM 2005-12-31 4,928 4,928 M7          
    FURNITURE & EQUIPM 2006-12-31 249 249 M7          
    FURNITURE & EQUIPM 2010-06-30 9,870 9,870 M7          
    BUILDING 1528 PONT 2007-01-01 153,397 53,689 SL 40 3,835      
    BUILDING IMPROVEME 2007-01-01 4,190 1,468 SL 40 105      
    BUILDING IMPROVEME 2008-01-01 34,870 11,334 SL 40 872      
    BUILDING IMPROVEME 2009-01-01 43,391 13,019 SL 40 1,085      
    BUILDING IMPROVEME 2010-01-01 20,425 5,619 SL 40 511      
    BUILDING IMPROVEME 2011-01-01 4,170 1,041 SL 40 104      
    BUILDING IMPROVEME 2012-01-01 9,888 2,224 SL 40 247      
    BUILDING IMPROVEME 2013-01-01 67,275 13,456 SL 40 1,682      
    BUILDING IMPROVEME 2014-01-01 10,175 1,778 SL 40 254      
    BUILDING IMPROVEME 2015-12-31 91,941 11,495 SL 40 2,299      
    ELECTRIC METER 2016-01-06 4,994 1,940 M7   223      
    BUILDING 1528 PONT 2016-12-31 4,490 448 SL 40 112      
    ELEVATOR 2017-12-31 40,000 40,000 M15          
    BUILDING IMPROVEME 2017-12-31 180,733 13,554 SL 40 4,518      
    BUILDING IMPROVEME 2018-12-31 341,426 17,072 SL 40 8,536      
    BUILDING IMPROVEME 2019-12-31 324,771 8,119 SL 40 8,119      
    BUILDING IMPROVEME 2020-12-31 5,429   SL 40 136      
    TREES & SHRUBS 2020-12-31 2,383 2,383 M15          
    BUILDING IMPROVEME 2021-07-01 21,356   SL 40 267      

    TY 2021 GeneralExplanationAttachment
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Identifier Return Reference Explanation
    Statement for Conduit Foundation Form 990-PF, Part XII, Line 7 IRC CODE SEC. 170(B)(1)(F)(II) A PRIVATE FOUNDATION THAT, NOT LATER THAN THE 15TH DAY OF THE THIRD MONTH AFTER THE END OF ITS TAX YEAR IN WHICH CONTRIBUTIONS ARE RECEIVED, MAKES QUALIFYING DISTRIBUTIONS EQUAL TO 100% OF CONTRIBUTIONS RECEIVED QUALIFIES AS A 60% CHARITY. QUALIFYING DISTRIBUTIONS DURING THE TAX YEAR: $269,264 LESS INCOME DISTRIBUTABLE AMOUNT: $122,968 REMAINING AMOUNT OUT OF CORPUS (PART XII, LINE 4E): $146,296 CONTRIBUTIONS RECEIVED (PART I, LINE 1): $100,000 AMOUNT TREATED AS DISTRIBUTIONS OUT OF CORPUS: $100,000 SINCE THE FOUNDATION MADE QUALIFYING DISTRIBUTIONS, NET OF APPLICABLE UNDISTRIBUTED INCOME FOR THE CURRENT AND PRIOR YEAR, OF MORE THAN $100,000 NOT LATER THAN THE 15TH DAY OF THE THIRD MONTH AFTER THE END OF ITS TAX YEAR, IT THEREFORE QUALIFIES AS A CONDUIT FOUNDATION 60% CHARITY. BASED ON THE ABOVE, THE MOSAIC FOUNDATION (OF R. & P. HEYDON) IS A CONDUIT FOUNDATION UNDER IRC CODE SEC. 170(B)(1)(F)(II) FOR ITS TAX YEAR ENDED 12/31/2021.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Name of Bond End of Year Book Value End of Year Fair Market Value
    TIAA-CREF HIGH YIELD BOND 91,064 96,400

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Name of Stock End of Year Book Value End of Year Fair Market Value
    GRIEF BROS CORP 7,375 29,890
    LEDYARD NB 92,450 184,125
    AGILYSYS 22,680 88,920
    NATIONAL RESEARCH 3,063 14,532

    TY 2021 LandEtcSchedule2
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    FURNITURE & EQUIPM 4,802 4,802    
    FURNITURE & EQUIPM 1,994 1,994    
    FURNITURE & EQUIPM 831 831    
    FURNITURE & EQUIPM 4,928 4,928    
    FURNITURE & EQUIPM 249 249    
    FURNITURE & EQUIPM 9,870 9,870    
    BUILDING 1528 PONT 153,397 57,524 95,873  
    BUILDING IMPROVEME 4,190 1,573 2,617  
    BUILDING IMPROVEME 34,870 12,206 22,664  
    BUILDING IMPROVEME 43,391 14,104 29,287  
    BUILDING IMPROVEME 20,425 6,130 14,295  
    BUILDING IMPROVEME 4,170 1,145 3,025  
    BUILDING IMPROVEME 9,888 2,471 7,417  
    BUILDING IMPROVEME 67,275 15,138 52,137  
    BUILDING IMPROVEME 10,175 2,032 8,143  
    BUILDING IMPROVEME 91,941 13,794 78,147  
    ELECTRIC METER 4,994 4,660 334  
    BUILDING 1528 PONT 4,490 560 3,930  
    ELEVATOR 40,000 40,000    
    BUILDING IMPROVEME 180,733 18,072 162,661  
    BUILDING IMPROVEME 341,426 25,608 315,818  
    BUILDING IMPROVEME 324,771 16,238 308,533  
    BUILDING IMPROVEME 5,429 136 5,293  
    TREES & SHRUBS 2,383 2,383    
    BUILDING IMPROVEME 21,356 267 21,089  


    TY 2021 OtherAssetsSchedule
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    INT ON JOINT ACCT OPERATIONS 90,833 89,369 89,369


    TY 2021 OtherExpensesSchedule
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    STATE FILING FEE 20     20
    UTILITIES 4,342     4,342
    Insurance 7,180     7,180
    REPAIRS & MAINTENANCE 2,361     2,361
    LEGAL FEES 19,777     19,777
    INVESTMENTS FEES 811 811    
    BANK FEES 100     100


    TY 2021 OtherIncomeSchedule2
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    ROYALTY INCOME 404,423 404,423  
    OCCIDENTAL ENERGY 188 188  
    SUNOCO 335 335  
    APACHE CORP 510 510  
    UNITEX OIL & GAS 407 407  


    TY 2021 TaxesSchedule
    Name:
    THE MOSAIC FOUNDATION
     
    (Of R & P Heydon)
    EIN:
    38-2910797
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PROPERTY TAXES 6,508     6,508
    IRS PENALTY & INTEREST 284