TY 2021 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
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Go 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
JOHN LARSEN FOUNDATION MNG AGY (PLG)

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 0634
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
MILWAUKEE, WI532010634

A Employer identification number

41-1715465

B Telephone number (see instructions)

(612) 377-9010

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$9,170,766J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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)


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...	124,862		122,758
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		317,999
b	Gross sales price for all assets on line 6a 1,403,859
7	Capital gain net income (from Part IV, line 2)...			317,999
8	Net short-term capital gain.........				0
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....
11	Other income (attach schedule).......
12	Total. Add lines 1 through 11........	442,861		440,757
13	Compensation of officers, directors, trustees, etc.
14	Other employee salaries and wages......			0	0	0
15	Pension plans, employee benefits.......			0	0
16a	Legal fees (attach schedule).........					0
b	Accounting fees (attach schedule).......		1,850	0	0	1,850
c	Other professional fees (attach schedule)....		63,306	56,976		6,331
17	Interest...............					0
18	Taxes (attach schedule) (see instructions)...		6,965	849		0
19	Depreciation (attach schedule) and depletion...		0	0
20	Occupancy..............
21	Travel, conferences, and meetings.......			0	0
22	Printing and publications..........			0	0
23	Other expenses (attach schedule).......		1,434	2		1,432
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	73,555		57,827	0	9,613
25	Contributions, gifts, grants paid.......	365,000				365,000
26	Total expenses and disbursements. Add lines 24 and 25	438,555		57,827	0	374,613
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	4,306
b	Net investment income (if negative, enter -0-)			382,930
c	Adjusted net income (if negative, enter -0-)...				0

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2021)

Form 990-PF (2021)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	229	46	46
	2	Savings and temporary cash investments.........	277,482	184,165	184,165
	3	Accounts receivable
		Less: allowance for doubtful accounts		0	0
	4	Pledges receivable
		Less: allowance for doubtful accounts
	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)
		Less: allowance for doubtful accounts 0
	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).......	4,323,878	4,583,961	7,927,343
	c	Investments—corporate bonds (attach schedule).......	1,174,827	821,957	858,966
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........		200,000	200,000
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )	272	246	246
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	5,776,688	5,790,375	9,170,766
	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 )
	23	Total liabilities (add lines 17 through 22).........		0
		Foundations that follow FASB ASC 958, check here
		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
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	5,776,688	5,790,375
	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).....	5,776,688	5,790,375
	30	Total liabilities and net assets/fund balances (see instructions).	5,776,688	5,790,375

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

5,776,688

Enter amount from Part I, line 27a .....................

4,306

Other increases not included in line 2 (itemize) bullet

10,000

Add lines 1, 2, and 3 ..........................

5,790,994

Decreases not included in line 2 (itemize) bullet

619

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

5,790,375

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	15. CMC MATLS INC		2020-07-09	2021-01-06
b	21. CERENCE INC		2020-07-09	2021-01-06
c	47. MAXLINEAR INC CLASS A			2021-01-06
d	19. QUANTERIX CORP		2020-07-09	2021-01-06
e	40. REXFORD INDUSTRIAL REALTY IN		2020-07-09	2021-01-07
	92. ALIBABA GROUP HOLDING LTD A D R		2020-07-09	2021-01-08
	51. PLUG POWER INC		2020-08-13	2021-01-12
	73. ESPERION THERAPEUTICS INC		2020-07-09	2021-01-13
	41. ALTRA INDUSTRIAL MOTION CORP		2020-08-10	2021-01-14
	37. PLUG POWER INC		2020-08-13	2021-01-14
	6. INTUITIVE SURGICAL INC NEW		2020-09-17	2021-01-15
	200000. BP CAPITAL MARKETS 3.062% 3/17/22		2019-03-06	2021-01-22
	42. ELECTRONIC ARTS COM		2019-11-04	2021-01-26
	92. FORTIVE CORP WI			2021-01-26
	6. ROPER INDS INC		2020-07-09	2021-01-26
	111. GENPACT LIMITED		2020-07-09	2021-01-26
	14. PLUG POWER INC		2020-08-13	2021-01-27
	87. SUNPOWER CORP			2021-01-27
	17. HEALTHEQUITY INC			2021-01-29
	29. ELECTRONIC ARTS COM		2019-11-04	2021-02-02
	13. MICROSOFT CORP		2020-07-09	2021-02-02
	13. PAYPAL HOLDINGS INC		2017-02-24	2021-02-02
	10. ROPER INDS INC		2020-07-09	2021-02-02
	498. FORTIVE CORP WI		2020-07-09	2021-02-08
	17.00096 HEXCEL CORP NEW		2020-12-03	2021-02-17
	55.99904 HEXCEL CORP NEW			2021-02-17
	72. GENPACT LIMITED		2020-07-09	2021-02-17
	59. MAGNITE INC COM		2021-01-25	2021-02-19
	402. MARTEN TRANSPORTATION LTD		2020-07-09	2021-02-19
	82. GENPACT LIMITED		2020-07-09	2021-02-23
	120. GENPACT LIMITED		2020-07-09	2021-02-23
	92. ALLETE INC		2020-07-09	2021-02-24
	120. IOVANCE BIOTHERAPEUTICS INC			2021-02-25
	12. KARUNA THERAPEUTICS INC		2020-07-09	2021-02-25
	42. MAXLINEAR INC CLASS A		2020-07-09	2021-02-25
	41. SPROUT SOCIAL INC CLASS A			2021-02-25
	57. WSFS FINL CORP		2020-07-09	2021-02-25
	95. ESSENT GROUP LTD		2020-07-09	2021-02-25
	417. KAR AUCTION SERVICES INC		2020-08-07	2021-02-26
	79. GENPACT LIMITED		2020-07-09	2021-02-26
	175. APPLIED MATLS INC COM		2019-02-26	2021-03-01
	279. REALPAGE INC		2020-12-08	2021-03-01
	111. TJX COS INC NEW COM		2013-03-12	2021-03-01
	70. WSFS FINL CORP		2020-07-09	2021-03-01
	34. QUANTERIX CORP		2020-07-09	2021-03-02
	104. ROMEO POWER INC			2021-03-02
	113. WORKHORSE GROUP INC			2021-03-02
	108. GENPACT LIMITED		2020-07-09	2021-03-03
	20. BANDWIDTH INC CLASS A		2020-07-09	2021-03-04
	38. MAGNITE INC COM		2021-01-25	2021-03-04
	14. NAVAVAX INC		2020-09-14	2021-03-04
	86. PLUG POWER INC		2020-08-13	2021-03-04
	45. QUANTERIX CORP		2020-07-09	2021-03-04
	32. RENEWABLE ENERGY GROUP INC			2021-03-04
	152. REXFORD INDUSTRIAL REALTY IN		2020-07-09	2021-03-04
	29. EMERGENT BIOSOLUTIONS INC			2021-03-08
	58. MSC INDL DIRECT CO INC CL A		2020-07-09	2021-03-10
	69. WSFS FINL CORP		2020-07-09	2021-03-11
	161. SOUTH JERSEY INDUSTRIES		2020-07-09	2021-03-12
	47. TRIUMPH BANCORP INC		2020-07-09	2021-03-12
	14. HELEN OF TROY LTD			2021-03-26
	14. HELEN OF TROY LTD			2021-03-26
	56. VISTEON CORP			2021-03-30
	80. VELODYNE LIDAR INC		2020-12-16	2021-03-31
	23. BIOXCEL THERAPEUTICS INC		2020-07-09	2021-04-05
	69. FRONTDOOR INC		2020-07-09	2021-04-05
	66. FIBROGEN INC		2020-07-09	2021-04-07
	29. NKARTA INC			2021-04-08
	19. VISTEON CORP			2021-04-08
	117. VERTEX INC CL A			2021-04-12
	27. CONMED CORP			2021-04-15
	13. BROOKS AUTOMATION INC		2020-07-09	2021-04-19
	2. ALPHABET INC CL C		2013-03-12	2021-04-20
	17. BROOKS AUTOMATION INC		2020-07-09	2021-04-21
	5. SYNAPTICS INC		2020-07-11	2021-04-21
	36. HEXCEL CORP NEW			2021-04-22
	37. WINTRUST FINANCIAL CORP		2019-11-20	2021-04-23
	35. TRIUMPH BANCORP INC		2020-07-09	2021-04-27
	10. MICROSOFT CORP		2020-07-09	2021-04-29
	17. SHERWIN WILLIAMS CO.		2020-07-09	2021-04-29
	19. ZOETIS INC		2020-07-09	2021-05-03
	28. BLACKLINE INC		2020-07-09	2021-05-04
	23. BROOKS AUTOMATION INC		2020-07-09	2021-05-04
	14. CHART INDUSTRIES INC		2020-11-18	2021-05-04
	56. FOX FACTORY HOLDING CORP			2021-05-04
	179. LOUISIANA PAC CORP		2020-07-09	2021-05-04
	14. SILICON LABORATORIES INC		2020-07-09	2021-05-04
	14. LITHIA MOTORS INC CL A			2021-05-05
	45. CHEMOCENTRYX INC			2021-05-07
	72. DECIPHERA PHARMACEUTICALS IN		2020-07-09	2021-05-07
	7. DECKERS OUTDOOR CORP		2020-07-09	2021-05-07
	23. NATERA INC			2021-05-07
	152. VERTEX INC CL A		2020-09-16	2021-05-07
	40. ZYMEWORKS INC		2020-07-09	2021-05-07
	71. ESSENT GROUP LTD		2020-07-09	2021-05-07
	92. DANIMER SCIENTIFIC INC			2021-05-12
	11. DECKERS OUTDOOR CORP		2020-07-09	2021-05-12
	85. DESKTOP METAL INC COM CL A		2020-12-24	2021-05-12
	12. SBA COMMUNICATIONS CORP		2020-07-09	2021-05-13
	10. THERMO ELECTRON CORP COM		2020-07-09	2021-05-13
	13. EVERCORE PARTNERS INC			2021-05-17
	26. STIFEL FINANCIAL CORP		2020-07-09	2021-05-17
	39. CENTRAL GARDEN & PET CO		2021-05-07	2021-05-18
	110. ARRAY TECHNOLOGIES INC			2021-05-19
	62. LOUISIANA PAC CORP		2020-07-09	2021-05-19
	21. SITEONE LANDSCAPE SUPPLY INC			2021-05-24
	49. MALIBU BOATS INC			2021-05-26
	49. MARRIOTT VACATIONS WORLD		2020-07-09	2021-05-26
	25. ZOETIS INC		2020-07-09	2021-05-26
	38. BROOKS AUTOMATION INC		2020-07-09	2021-05-28
	25. NATERA INC			2021-05-28
	16. NAVAVAX INC			2021-05-28
	31. SITEONE LANDSCAPE SUPPLY INC			2021-05-28
	31. ULTRAGENYX PHARMACEUTICAL IN		2020-07-09	2021-05-28
	220. BLOOM ENERGY CORP A			2021-06-02
	105. CENTRAL GARDEN & PET CO		2021-05-07	2021-06-02
	57. LOUISIANA PAC CORP		2020-07-09	2021-06-02
	20. DANAHER CORP COM		2020-07-09	2021-06-03
	190. QTS REALTY TRUST INC CL A			2021-06-07
	210. STIFEL FINANCIAL CORP		2020-07-09	2021-06-07
	42. XILINX INC COM		2013-03-12	2021-06-10
	58. E S C O TECHNOLOGIES INC		2020-07-09	2021-06-11
	46. RENEWABLE ENERGY GROUP INC			2021-06-14
	51. WINTRUST FINANCIAL CORP			2021-06-14
	84. DANAHER CORP COM		2020-07-09	2021-06-15
	69. WSFS FINL CORP		2020-07-09	2021-06-15
	8. INTUIT INC COMMON STOCK		2020-07-09	2021-06-17
	23. HEALTHEQUITY INC		2018-12-13	2021-06-22
	11. NATERA INC		2020-09-24	2021-06-22
	50. STIFEL FINANCIAL CORP		2020-07-09	2021-06-22
	32. STIFEL FINANCIAL CORP		2020-07-09	2021-06-22
	27. HEALTHEQUITY INC			2021-06-24
	16. NATERA INC			2021-06-24
	30. STIFEL FINANCIAL CORP		2020-07-09	2021-06-24
	57. NATERA INC		2020-07-09	2021-06-25
	11. KARUNA THERAPEUTICS INC		2020-07-09	2021-06-30
	26. RENEWABLE ENERGY GROUP INC			2021-07-01
	16. SYNAPTICS INC			2021-07-01
	26. CERENCE INC		2020-07-09	2021-07-06
	159. KENNAMETAL INC			2021-07-07
	72. SWITCH INC A		2021-06-07	2021-07-08
	23. BROWN FORMAN CORP CL B		2020-07-09	2021-07-09
	18. DANAHER CORP COM		2020-07-09	2021-07-09
	32. ELECTRONIC ARTS COM		2019-11-04	2021-07-09
	22. WALKER & DUNLOP INC		2020-07-09	2021-07-09
	29. WINTRUST FINANCIAL CORP		2021-02-24	2021-07-09
	129. SWITCH INC A		2020-07-09	2021-07-12
	53. WINTRUST FINANCIAL CORP			2021-07-12
	21. CRYPORT INC		2020-12-03	2021-07-15
	40. COMFORT SYS USA INC		2020-07-09	2021-07-16
	63. FRONTDOOR INC		2020-07-09	2021-07-16
	111. MERIDIAN BIOSCIENCE INC		2020-07-09	2021-07-22
	56. MERIDIAN BIOSCIENCE INC		2020-08-05	2021-07-22
	52. TPI COMPOSITES INC		2020-07-15	2021-07-23
	148. TCR2 THERAPEUTICS INC		2020-10-20	2021-07-26
	40. HEALTHEQUITY INC			2021-07-29
	38. BROWN FORMAN CORP CL B		2020-07-09	2021-07-30
	33. DANAHER CORP COM		2020-07-09	2021-07-30
	7. DEXCOM INC		2020-07-09	2021-07-30
	22. ELECTRONIC ARTS COM		2020-07-10	2021-07-30
	24. LANCASTER COLONY CORP		2020-07-09	2021-07-30
	18. SHERWIN WILLIAMS CO.		2020-07-09	2021-07-30
	12. ZOETIS INC		2020-07-09	2021-07-30
	24. IGM BIOSCIENCES INC			2021-08-02
	85. TG THERAPEUTICS INC			2021-08-03
	21. LHC GROUP INC			2021-08-13
	75000. WESTPAC BANKING 2.000% 8/19/21		2016-10-11	2021-08-19
	75000. BANK NY MELLON MTN 3.550% 9/23/21		2016-11-28	2021-08-23
	16. MASTERCARD INC		2020-07-09	2021-08-25
	3. ALPHABET INC CL C		2020-07-09	2021-08-26
	33. APPLIED MATLS INC COM		2019-02-26	2021-08-31
	15. ELECTRONIC ARTS COM			2021-08-31
	6. MASTERCARD INC		2020-07-09	2021-08-31
	27. MALIBU BOATS INC		2020-07-09	2021-09-01
	53. TPI COMPOSITES INC		2020-07-15	2021-09-01
	2. AMAZON COM INC COM		2020-07-09	2021-09-02
	10. DEXCOM INC		2020-07-09	2021-09-02
	57. DICERNA PHARMACEUTICALS INC		2020-07-09	2021-09-09
	131. HEXCEL CORP NEW			2021-09-10
	14. POWER INTEGRATIONS INC		2020-07-09	2021-09-10
	64. SWITCH INC A		2020-07-09	2021-09-10
	56. DICERNA PHARMACEUTICALS INC		2020-07-09	2021-09-14
	42. SPROUT SOCIAL INC CLASS A		2020-07-21	2021-09-14
	75. ELECTRONIC ARTS COM			2021-09-16
	57. ENERSYS			2021-09-16
	62. K B HOME			2021-09-16
	32. NEOGENOMICS INC			2021-09-16
	119. WOLVERINE WORLD WIDE INC			2021-09-16
	57. DANAHER CORP COM		2020-07-09	2021-09-20
	72. ELECTRONIC ARTS COM		2019-05-15	2021-09-20
	127. ELECTRONIC ARTS COM			2021-09-22
	74. SYNOPSYS INC COM		2013-03-12	2021-09-22
	7. LHC GROUP INC		2021-06-07	2021-09-23
	32. BICYCLE THERAPEUTICS LTD A D R		2020-10-20	2021-09-24
	99. GREEN PLAINS INC.			2021-09-24
	44. OLLIES BARGAIN OUTLET HOLDI		2021-05-07	2021-09-24
	20. VISTEON CORP		2021-05-28	2021-09-24
	7. VISTEON CORP		2020-07-09	2021-09-24
	28. OLLIES BARGAIN OUTLET HOLDI			2021-09-29
	48. XILINX INC COM		2013-03-12	2021-09-30
	78. ESSENT GROUP LTD		2020-07-09	2021-09-30
	213. PGT INC		2021-05-04	2021-10-01
	25. BICYCLE THERAPEUTICS LTD A D R		2020-10-20	2021-10-07
	56. EDITAS MEDICINE INC		2021-07-01	2021-10-07
	51. FOCUS FINANCIAL PARTNERS A		2020-08-06	2021-10-07
	11. WALKER & DUNLOP INC		2020-07-09	2021-10-07
	212. JETBLUE AIRWAYS CORP COM			2021-10-19
	30. MICROSOFT CORP		2020-07-09	2021-10-19
	19. CHART INDUSTRIES INC		2020-08-21	2021-10-20
	.6356 CABOT OIL & GAS CORP CL A		2018-01-26	2021-10-21
	60. OLLIES BARGAIN OUTLET HOLDI			2021-10-21
	6. INTUITIVE SURGICAL INC NEW		2020-09-17	2021-10-26
	13. COHEN STEERS INC		2021-06-07	2021-10-28
	9. WALKER & DUNLOP INC		2020-07-09	2021-10-28
	135. CAREDX INC			2021-11-01
	23. MAXLINEAR INC CLASS A		2020-07-09	2021-11-02
	4. SILICON LABORATORIES INC		2020-07-09	2021-11-02
	13. BROOKS AUTOMATION INC			2021-11-03
	14. CRYPORT INC			2021-11-03
	.5989 REGAL BELOIT CORP		2020-11-10	2021-11-03
	20. REGAL BELOIT CORP			2021-11-03
	45. LIVE PERSON INC			2021-11-04
	133. MACERICH CO			2021-11-04
	25. MAXLINEAR INC CLASS A		2020-07-09	2021-11-04
	17. CRYPORT INC		2020-11-23	2021-11-05
	20. IGM BIOSCIENCES INC			2021-11-24
	34. VERICEL CORP		2021-07-09	2021-11-24
	30. PUBMATIC INC COM CL A		2021-05-07	2021-12-01
	10. ADOBE SYS INC		2020-12-03	2021-12-07
	19. AUTODESK INC			2021-12-07
	28. CRYPORT INC		2020-11-23	2021-12-07
	9. INTUIT INC COMMON STOCK		2020-07-09	2021-12-07
	182. INVITAE CORP		2020-07-09	2021-12-07
	33. PUBMATIC INC COM CL A		2021-05-07	2021-12-07
	13. SPROUT SOCIAL INC CLASS A		2020-07-21	2021-12-07
	14. THERMO ELECTRON CORP COM		2020-07-09	2021-12-07
	36. BICYCLE THERAPEUTICS LTD A D R		2020-10-20	2021-12-08
	8. SILICON LABORATORIES INC		2020-07-09	2021-12-08
	6. SITIME CORP		2021-11-12	2021-12-08
	290. UNION PACIFIC CORPORATION			2021-12-08
	72. MALIBU BOATS INC			2021-12-09
	26. REGAL BELOIT CORP			2021-12-09
	12. SILICON LABORATORIES INC		2020-07-09	2021-12-10
	160. SUNPOWER CORP		2020-10-07	2021-12-21
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	2,214	2,030	184
b	2,180	848	1,332
c	1,697	1,318	379
d	888	528	360
e	1,859	1,669	190
	21,230	24,001	-2,771
	3,247	582	2,665
	1,962	3,740	-1,778
	2,477	1,714	763
	2,485	422	2,063
	4,772	4,062	710
	206,332	200,223	6,109
	6,134	4,127	2,007
	6,235	6,011	224
	2,513	2,372	141
	4,534	3,889	645
	909	160	749
	4,530	1,645	2,885
	1,423	1,169	254
	4,270	2,849	1,421
	3,133	2,783	350
	3,182	555	2,627
	3,923	3,953	-30
	34,307	28,792	5,515
	884	935	-51
	2,910	3,113	-203
	2,929	2,523	406
	3,447	2,306	1,141
	6,614	6,915	-301
	3,277	2,873	404
	4,840	4,204	636
	5,801	5,186	615
	4,341	3,916	425
	1,446	1,179	267
	1,762	1,055	707
	2,983	1,386	1,597
	3,130	1,426	1,704
	3,917	2,996	921
	5,819	7,314	-1,495
	3,232	2,768	464
	21,064	6,930	14,134
	24,290	19,433	4,857
	7,418	2,478	4,940
	3,682	1,751	1,931
	2,593	944	1,649
	1,327	2,848	-1,521
	1,809	1,733	76
	4,462	3,784	678
	2,636	2,809	-173
	1,594	1,485	109
	2,548	1,477	1,071
	3,604	982	2,622
	2,891	1,250	1,641
	2,354	1,396	958
	7,071	6,341	730
	2,513	2,959	-446
	5,176	3,734	1,442
	3,592	1,726	1,866
	4,505	3,637	868
	3,750	1,005	2,745
	2,865	1,302	1,563
	2,865	2,833	32
	6,739	6,636	103
	908	1,615	-707
	857	1,176	-319
	3,756	3,043	713
	1,400	2,750	-1,350
	918	1,987	-1,069
	2,246	1,539	707
	2,336	2,889	-553
	3,532	2,318	1,214
	1,314	589	725
	4,601	821	3,780
	1,645	770	875
	658	487	171
	2,057	2,223	-166
	2,854	2,458	396
	3,112	749	2,363
	2,522	2,141	381
	4,652	3,287	1,365
	3,338	2,608	730
	3,072	2,447	625
	2,154	1,041	1,113
	2,088	1,358	730
	8,401	5,724	2,677
	12,263	4,590	7,673
	1,881	1,432	449
	5,303	5,283	20
	492	2,490	-1,998
	2,531	3,928	-1,397
	2,403	1,326	1,077
	2,372	1,643	729
	2,694	3,477	-783
	1,216	1,418	-202
	3,542	2,239	1,303
	1,452	4,244	-2,792
	3,553	2,084	1,469
	1,033	1,653	-620
	3,406	3,675	-269
	4,549	3,882	667
	1,902	1,634	268
	1,798	782	1,016
	2,020	2,085	-65
	1,604	4,650	-3,046
	4,036	1,590	2,446
	3,710	2,523	1,187
	3,704	3,711	-7
	8,360	3,927	4,433
	4,375	3,432	943
	3,854	1,720	2,134
	2,352	1,703	649
	2,451	1,559	892
	5,313	3,403	1,910
	3,225	2,730	495
	5,392	6,294	-902
	5,308	5,613	-305
	3,707	1,461	2,246
	4,789	3,714	1,075
	14,819	12,373	2,446
	13,778	6,316	7,462
	5,409	1,606	3,803
	5,192	4,676	516
	3,175	2,838	337
	4,001	2,275	1,726
	20,589	15,597	4,992
	3,570	1,726	1,844
	3,783	2,461	1,322
	1,837	1,526	311
	1,194	714	480
	3,052	1,504	1,548
	1,993	962	1,031
	2,236	1,565	671
	1,915	805	1,110
	1,951	902	1,049
	6,604	2,811	3,793
	1,222	1,080	142
	1,641	1,518	123
	2,456	1,464	992
	3,230	1,049	2,181
	5,510	5,865	-355
	1,520	1,511	9
	1,704	1,457	247
	4,976	3,342	1,634
	4,486	3,144	1,342
	2,190	1,011	1,179
	2,153	2,153
	2,714	2,408	306
	3,920	2,163	1,757
	1,143	1,033	110
	2,935	1,508	1,427
	2,919	2,778	141
	2,092	2,789	-697
	1,055	1,484	-429
	1,944	1,363	581
	1,876	2,899	-1,023
	3,034	2,251	783
	2,710	2,408	302
	9,865	6,127	3,738
	3,534	3,106	428
	3,183	3,055	128
	4,727	3,682	1,045
	5,232	3,480	1,752
	2,433	1,647	786
	1,662	2,394	-732
	2,196	2,432	-236
	3,820	4,229	-409
	75,000	74,658	342
	75,000	75,000
	5,783	4,713	1,070
	8,558	4,534	4,024
	4,412	1,307	3,105
	2,195	1,514	681
	2,094	1,767	327
	1,945	1,331	614
	1,915	1,389	526
	6,934	6,356	578
	5,430	4,438	992
	1,259	1,445	-186
	7,071	6,895	176
	1,522	871	651
	1,663	1,191	472
	1,195	1,419	-224
	5,231	1,234	3,997
	10,311	7,259	3,052
	4,291	2,588	1,703
	2,572	1,856	716
	1,501	1,133	368
	3,913	4,398	-485
	18,390	10,584	7,806
	9,391	6,955	2,436
	16,100	11,838	4,262
	23,648	2,607	21,041
	1,147	1,392	-245
	1,372	611	761
	3,147	2,650	497
	2,780	3,851	-1,071
	1,996	2,425	-429
	699	469	230
	1,848	2,437	-589
	7,342	1,836	5,506
	3,487	2,460	1,027
	4,078	5,873	-1,795
	1,002	477	525
	2,237	3,135	-898
	2,850	2,038	812
	1,338	506	832
	3,167	4,415	-1,248
	9,241	6,423	2,818
	3,422	1,387	2,035
	13	19	-6
	3,989	5,077	-1,088
	2,067	1,354	713
	1,204	971	233
	1,156	414	742
	6,932	11,825	-4,893
	1,509	578	931
	786	409	377
	1,561	1,413	148
	1,080	663	417
	96	52	44
	3,207	1,726	1,481
	2,300	2,638	-338
	2,931	2,407	524
	1,726	628	1,098
	1,335	788	547
	1,100	1,867	-767
	1,356	1,845	-489
	1,221	1,338	-117
	6,491	4,836	1,655
	5,226	5,458	-232
	1,948	1,297	651
	6,052	2,769	3,283
	3,003	6,257	-3,254
	1,210	1,471	-261
	1,314	382	932
	8,755	5,435	3,320
	1,886	687	1,199
	1,607	818	789
	1,904	1,553	351
	71,352	24,230	47,122
	4,869	3,574	1,295
	4,240	2,128	2,112
	2,422	1,227	1,195
	3,224	2,762	462
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
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			27,913
			27,913
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			27,913
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			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913
			27,913

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			184
b			1,332
c			379
d			360
e			190
			-2,771
			2,665
			-1,778
			763
			2,063
			710
			6,109
			2,007
			224
			141
			645
			749
			2,885
			254
			1,421
			350
			2,627
			-30
			5,515
			-51
			-203
			406
			1,141
			-301
			404
			636
			615
			425
			267
			707
			1,597
			1,704
			921
			-1,495
			464
			14,134
			4,857
			4,940
			1,931
			1,649
			-1,521
			76
			678
			-173
			109
			1,071
			2,622
			1,641
			958
			730
			-446
			1,442
			1,866
			868
			2,745
			1,563
			32
			103
			-707
			-319
			713
			-1,350
			-1,069
			707
			-553
			1,214
			725
			3,780
			875
			171
			-166
			396
			2,363
			381
			1,365
			730
			625
			1,113
			730
			2,677
			7,673
			449
			20
			-1,998
			-1,397
			1,077
			729
			-783
			-202
			1,303
			-2,792
			1,469
			-620
			-269
			667
			268
			1,016
			-65
			-3,046
			2,446
			1,187
			-7
			4,433
			943
			2,134
			649
			892
			1,910
			495
			-902
			-305
			2,246
			1,075
			2,446
			7,462
			3,803
			516
			337
			1,726
			4,992
			1,844
			1,322
			311
			480
			1,548
			1,031
			671
			1,110
			1,049
			3,793
			142
			123
			992
			2,181
			-355
			9
			247
			1,634
			1,342
			1,179

			306
			1,757
			110
			1,427
			141
			-697
			-429
			581
			-1,023
			783
			302
			3,738
			428
			128
			1,045
			1,752
			786
			-732
			-236
			-409
			342

			1,070
			4,024
			3,105
			681
			327
			614
			526
			578
			992
			-186
			176
			651
			472
			-224
			3,997
			3,052
			1,703
			716
			368
			-485
			7,806
			2,436
			4,262
			21,041
			-245
			761
			497
			-1,071
			-429
			230
			-589
			5,506
			1,027
			-1,795
			525
			-898
			812
			832
			-1,248
			2,818
			2,035
			-6
			-1,088
			713
			233
			742
			-4,893
			931
			377
			148
			417
			44
			1,481
			-338
			524
			1,098
			547
			-767
			-489
			-117
			1,655
			-232
			651
			3,283
			-3,254
			-261
			932
			3,320
			1,199
			789
			351
			47,122
			1,295
			2,112
			1,195
			462

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	317,999
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 ...................		3

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 and enter “N/A" on line 1.
	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	5,323
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	5,323
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	8,352
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

7	Total credits and payments. Add lines 6a through 6d..............		7	8,352
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.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	3,029
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax3,029	Refunded	11	0

Part VI-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?.........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2021)

Page 5

Part VI-A

Statements Regarding Activities (continued)

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

JOHNLARSENFOUNDATION.ORG

The books are in care of bullet

JOHN E LARSEN, C/O US BANK NATL ASS Telephone no. bullet

(855) 452-4091

Located at bullet

101 E 5TH STREETST PAULMN ZIP+4 bullet

551640713

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

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

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)

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? ..............................

1a(2)

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........

1a(3)

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............

1a(4)

(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)

(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)

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 ..........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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? .............

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)):

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?....................

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year? ..............................

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.) .....................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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? ..

Form 990-PF (2021)

Page 6

Part VI-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........

5a(1)

(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)

(3) Provide a grant to an individual for travel, study, or other similar purposes? .............

5a(3)

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions ........................

5a(4)

(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)

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 ........

Organizations relying on a current notice regarding disaster assistance check here ......... bullet

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? .................

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? .............................

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....

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? .........................

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
JOHN A LARSEN	TREASURER 2	0
2015 SUMMIT AVENUE ST PAUL,MN55105	TREASURER 2	0
KAREN R LARSEN	DIRECTOR 3	0
2015 SUMMIT AVE ST PAUL,MN55105	DIRECTOR 3	0
KRISTEN L ROSE	DIRECTOR 1	0
1825 STANFORD AVENUE ST PAUL,MN55105	DIRECTOR 1	0
JOHN E LARSEN	PRESIDENT 5	0
2002 W LAKE OF THE ISLE PARKWAY MINNEAPOLIS,MN55405	PRESIDENT 5	0

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...................				0

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
US BANK	INVESTMENT MGMT	63,306
PO BOX 0634 MILWAUKEE,WI53201	INVESTMENT MGMT	63,306

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	LOAN TO PROPEL NONPROFITS	100,000
2	LOAN TO METROPOLITAN CONSORTIUM OF COMMUNITY DEVELOPMENT	100,000
All other program-related investments. See instructions.
3

Total. Add lines 1 through 3......................... bullet

200,000

Form 990-PF (2021)

Page 8

Part IX

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

8,327,325

Average of monthly cash balances.......................

379,304

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

8,706,629

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

8,706,629

Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see

instructions) .............................

130,599

Net value of noncharitable-use assets. Subtract line 4 from line 3. .......

8,576,030

Minimum investment return. Enter 5% (0.05) of line 5................

428,802

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.)

Minimum investment return from Part IX, line 6..................

428,802

Tax on investment income for 2021 from Part V, line 5.......

5,323

Income tax for 2021. (This does not include the tax from Part V.) ...

Add lines 2a and 2b............................

5,323

Distributable amount before adjustments. Subtract line 2c from line 1............

423,479

Recoveries of amounts treated as qualifying distributions................

10,000

Add lines 3 and 4............................

433,479

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...

433,479

Part XI

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

Program-related investments—total from Part VIII-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.

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					433,479
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......	0
b From 2017......	0
c From 2018......	0
d From 2019......	13,939
e From 2020......	0
f Total of lines 3a through e ........		13,939
4Qualifying distributions for 2021 from Part
XI, line 4: $ 574,613
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.....					433,479
e Remaining amount distributed out of corpus		141,134
5 Excess distributions carryover applied to 2021.		0			0
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5		155,073
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) ...		0
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......		155,073
10 Analysis of line 9:
a Excess from 2017....	0
b Excess from 2018....	0
c Excess from 2019....	13,939
d Excess from 2020....	0
e Excess from 2021....	141,134

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 4942(j)(3) or4942(j)(5)

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	(e) Total

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

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions

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)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
BREAKING FREE PO BOX 4366 ST PAUL,MN55104	NONE	PC	GENERAL OPERATING	2,500
FRASER 240 W 64TH ST MINNEAPOLIS,MN55423	NONE	PC	GENERAL OPERATING	5,000
THE SIERRA CLUB FOUNDATION 2327 E FRANKLIN AVE MINNEAPOLIS,MN55406	NONE	PC	GENERAL OPERATING	10,000
SPCO ANNUAL FUND 408 SAINT PETER STREET STE 300 SAINT PAUL,MN55102	NONE	PC	GENERAL OPERATING	5,000
FRIENDS OF THE SPCO 408 ST PETER STREET STE 300 ST PAUL,MN55102	NONE	PC	GENERAL OPERATION	6,000
NORTHSIDE ACHIEVEMENT ZONE 2123 WEST BROADWAY AVENUE 100 MINNEAPOLIS,MN55411	NONE	PC	GENERAL OPERATING	3,000
WHITEFISH AREA PROPERTY OWNERS ASSN P O BOX 342 CROSSLAKE,MN56442	NONE	PC	GENERAL OPERATING	4,000
MN CENTER FOR ENVIRONMENTAL ADVOCACY 26 EXCHANGE STREET SUITE 206 SAINT PAUL,MN55101	NONE	PC	GENERAL OPERATING	15,000
GIVEMN 101 FIFTH STREET EAST STE 2400 ST PAUL,MN55101	NONE	PC	GENERAL OPERATING	15,000
CLIMATE GENERATION A WILL STEGER -- 2801 - 21ST AVENUE S SUITE 110 MINNEAPOLIS,MN55407	NONE	PC	GENERAL OPERATING	3,000
NATURE CONSERVANCY 1101 W RIVER PKWY 200 MINNEAPOLIS,MN55415	NONE	PC	GENERAL OPERATING	5,000
OUTFRONT MINNESOTA 310 38TH STREET EAST 204 MINNEAPOLIS,MN55409	NONE	PC	GENERAL OPERATING	20,000
NATIONAL WILDLIFE TURKEY FEDERATION 13075 LINNET ST NW COON RAPIDS,MN55448	NONE	PC	GENERAL OPERATING	10,000
AVENUES FOR HOMELESS YOUTH 1708 OAK PARK AVENUE N MINNEAPOLIS,MN55411	NONE	PC	GENERAL OPERATING	12,500
SAINT PAUL ACADEMY AND SUMMIT SCHOOL 1712 RANDOLPH AVE SAINT PAUL,MN55105	NONE	PC	GENERAL OPERATING	10,000
PLANNED PARENTHOOD OF MN SD ND 671 VANDALIA ST STE 323 ST PAUL,MN55114	NONE	PC	GENERAL OPERATING	15,000
PARK SQUARE THEATER 408 ST PETER ST STE 110 ST PAUL,MN55102	NONE	PC	GENERAL OPERATING	5,000
FRESH ENERGY 408 ST PETER STREET STE 220 ST PAUL,MN55102	NONE	PC	GENERAL OPERATING	20,000
METROPOLITAN CONSORTIUM OF COMM DEV 3137 CHICAGO AVE Minneapolis,MN55407	NONE	PC	GENERAL OPERATING	10,000
CONSERVATION MINNESOTA 1101 W RIVER PKWY STE 250 MINNEAPOLIS,MN55415	NONE	PC	GENERAL OPERATING	90,000
LAKES AREA RESTORATIVE JUSTICE 424 NW 3RD ST BRAINERD,MN56401	NONE	PC	GENERAL OPERATING	35,000
RESTORATIVE JUSTICE COMMUNITY ACTION 101 EAST GRANT STREET MINNEAPOLIS,MN55403	NONE	PC	GENERAL OPERATING	7,500
PEASE COMMUNITY FOUNDATION 601 13TH AVE SE Minneapolis,MN55414	NONE	PC	GENERAL OPERATING	3,500
NAMI MN 1919 UNIVERSITY AVE W 400 St Paul,MN55104	NONE	PC	GENERAL OPERATING	3,000
ADVOCATES FOR REPRODUCTIVE EDUCATION PO BOX 1086 BRAINERD,MN56401	NONE	PC	GENERAL OPERATING	20,000
PROPEL NONPROFITS 1 SE MAIN ST SUITE 600 Minneapolis,MN55414	NONE	PC	GENERAL OPERATING	10,000
AMAZE WORKS INC 475 CLEVELAND AVE N STE 322 ST PAUL,MN55104	NONE	PC	GENERAL OPERATING	20,000
Total ................................. 3a				365,000

bApproved for future payment

Total ................................. 3b

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	(e) Related or exempt function income (See instructions.)
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	317,999
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: aOTHER INCOME			1
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..				442,861

13Total. Add line 12, columns (b), (d), and (e)..................

442,861

(See worksheet in line 13 instructions to verify calculations.)

Part XV-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	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)

Page 13

Part XVI

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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? ...........Yes No

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.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name				Firm's EIN
	Firm's address				Phone no.

Form 990-PF (2021)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
TAX PREPARATION FEE (NON-ALLOC	1,850			1,850

Name of Bond	End of Year Book Value	End of Year Fair Market Value
075887BA6 BECTON DICKINSON
961214DA8 WESTPAC BANKING
166764AH3 CHEVRON CORP	75,586	77,222
87612EAV8 TARGET CORP
46625HJE1 JPMORGAN CHASE CO	50,310	51,003
06406HBY4 BANK NY MELLON MTN
17275RAH5 CISCO SYSTEMS
913017BR9 UNITED TECH CORP
949746SH5 WELLS FARGO COMPANY	71,734	78,794
89236TDR3 TOYOTA MOTOR MTN	75,273	80,449
91324PBV3 UNITEDHEALTH GRP	98,899	100,197
92826CAD4 VISA INC	75,307	80,025
037833AS9 APPLE INC	76,072	79,321
14912L5Q0 CATERPILLAR FIN MTN	96,855	102,171
78013XW20 ROYAL BANK MTN	201,921	209,784
05565QCZ9 BP CAPITAL MARKETS

- TIN:

TY 2021 InvestmentsCorpStockSchedule

Name:

JOHN LARSEN FOUNDATION MNG AGY (PLG)

EIN:

41-1715465

Name of Stock	End of Year Book Value	End of Year Fair Market Value
231021106 CUMMINS INC	10,472	19,414
860630102 STIFEL FINANCIAL COR	11,667	27,464
361448103 G A T X CORP	8,759	18,337
833034101 SNAP ON INC	8,325	21,969
81211K100 SEALED AIR CORP	13,008	29,889
00507V109 ACTIVISION BLIZZARD	12,007	21,023
548661107 LOWES CO INC	27,062	141,389
194162103 COLGATE PALMOLIVE CO	31,705	40,451
743315103 PROGRESSIVE CORP	7,455	30,795
980745103 WOODWARD INC	8,800	20,469
50540R409 LABORATORY CRP OF AM	9,050	24,194
49338L103 KEYSIGHT TECHNOLOGIE	7,827	48,530
00971T101 AKAMAI TECHNOLOGIES	13,370	22,589
052769106 AUTODESK INC	52,211	58,769
212015101 CONTINENTAL RESOURCE	17,973	28,915
H1467J104 CHUBB LTD	27,226	51,807
46625H100 J P MORGAN CHASE CO	26,283	75,058
G1151C101 ACCENTURE PLC CL A	23,695	126,438
31620M106 FIDELITY NATIONAL IN	18,832	53,265
70450Y103 PAYPAL HOLDINGS INC	13,590	50,539
493267108 KEYCORP	13,990	26,160
090572207 BIO RAD LABS INC CL	5,425	33,245
871607107 SYNOPSYS INC	3,100	32,428
29275Y102 ENERSYS
759351604 REINSURANCE GROUP AM	6,486	14,343
126408103 CSX CORP	5,368	25,944
983919101 XILINX INC	5,470	30,320
369550108 GENERAL DYNAMICS COR	9,842	22,098
478160104 JOHNSON JOHNSON	59,460	87,246
G7496G103 RENAISSANCE RE HOLDI	15,109	21,844
23331A109 D R HORTON INC	10,425	47,826
872540109 TJX COMPANIES INC	5,336	18,145
92939U106 WEC ENERGY GROUP INC	10,495	20,385
65339F101 NEXTERA ENERGY INC	17,319	88,879
12504L109 CBRE GROUP INC	10,450	45,249
461202103 INTUIT INC	39,075	81,689
37940X102 GLOBAL PAYMENTS INC	3,977	22,440
539830109 LOCKHEED MARTIN CORP	41,745	57,221
G5960L103 MEDTRONIC PLC	38,127	50,484
037833100 APPLE INC	6,405	166,206
03662Q105 A N S Y S INC	8,273	41,716
171798101 CIMAREX ENERGY CO
810186106 THE SCOTTS MIRACLE G	5,215	17,710
760759100 REPUBLIC SVCS INC	9,863	43,787
695156109 PACKAGING CORP AMERI	31,599	66,986
254687106 DISNEY WALT CO	38,917	53,437
907818108 UNION PACIFIC CORP
166764100 CHEVRON CORPORATION	34,356	50,226
91324P102 UNITED HEALTH GROUP	24,641	122,522
718546104 PHILLIPS 66	36,151	35,578
149498107 CAUSEWAY EMERGING MA	133,919	134,367
97650W108 WINTRUST FINANCIAL C	5,088	9,445
754730109 RAYMOND JAMES FINL I	5,445	29,216
17275R102 CISCO SYSTEMS INC	44,791	81,874
00206R102 ATT INC	46,980	40,073
594918104 MICROSOFT CORP	74,429	304,033
713448108 PEPSICO INC	34,897	63,578
277432100 EASTMAN CHEM CO	11,902	19,708
24906P109 DENTSPLY SIRONA INC	17,212	19,694
260003108 DOVER CORP	9,139	24,698
574599106 MASCO CORP	7,638	30,405
45866F104 INTERCONTINENTAL EXC	9,289	40,074
438516106 HONEYWELL INTERNATIO	17,927	49,000
02079K107 ALPHABET INC CL C	37,225	83,914
00846U101 AGILENT TECHNOLOGIES	8,178	35,283
101121101 BOSTON PPTYS INC	19,063	22,575
237194105 DARDEN RESTAURANTS I	12,388	35,702
03073E105 AMERISOURCEBERGEN CO	6,619	18,073
28176E108 EDWARDS LIFESCIENCES	58,804	169,840
42226A107 HEALTHEQUITY INC
012653101 ALBEMARLE CORP	13,956	33,663
00912X302 AIR LEASE CORP	19,813	21,673
444097109 HUDSON PACIFIC PROPE	14,161	12,726
G4388N106 HELEN OF TROY LTD
29977A105 EVERCORE PARTNERS IN	11,845	14,944
042735100 ARROW ELECTRONICS IN	16,366	27,525
858912108 STERICYCLE INC COMMO	17,545	18,966
87166B102 SYNEOS HEALTH INC	8,819	25,670
G5494J103 LINDE PLC	40,539	84,182
12572Q105 CME GROUP INC	27,052	37,696
23283R100 CYRUSONE INC	34,849	57,690
20030N101 COMCAST CORP CL A	49,119	64,875
718172109 PHILIP MORRIS INTL	55,443	57,570
09215C105 BLACK KNIGHT INC	10,739	22,629
00191U102 ASGN INC	4,646	9,255
441593100 HOULIHAN LOKEY INC	13,398	26,708
76169B102 REXNORD CORP
882508104 TEXAS INSTRUMENTS IN	42,117	79,346
922908769 VANGUARD TOTAL STOCK	678,462	1,086,480
459506101 INTL FLAVORS FRAGRA	36,823	39,621
038222105 APPLIED MATERIALS IN	7,682	30,528
G8060N102 SENSATA TECHNOLOGIES	24,538	30,783
025816109 AMERICAN EXPRESS CO	48,061	63,968
03064D108 AMERICOLD REALTY TRU	22,458	24,658
83088M102 SKYWORKS SOLUTIONS I	22,604	35,372
64049M209 NEOGENOMICS INC	1,581	2,661
285512109 ELECTRONIC ARTS INC
693475105 P N C FINANCIAL SERV	38,228	63,364
428291108 HEXCEL CORP NEW
573075108 MARTEN TRANSPORTATIO
57667L107 MATCH GROUP INC NEW	40,607	46,817
553530106 MSC INDL DIRECT CO I
053484101 AVALONBAY COMMUNITIE	33,486	38,899
57776J100 MAXLINEAR INC CLASS	2,436	7,313
87266J104 TPI COMPOSITES INC
235851102 DANAHER CORP
838518108 SOUTH JERSEY INDUSTR	3,230	3,735
197236102 COLUMBIA BKG SYS INC	14,726	13,415
776153108 ROMEO POWER INC
739276103 POWER INTEGRATIONS I	10,244	13,283
16115Q308 CHART INDUSTRIES INC	4,168	8,612
02208R106 ALTRA INDUSTRIAL MOT	8,891	11,913
48238T109 KAR AUCTION SERVICES
12571T100 CMC MATLS INC	32,912	45,239
22160K105 COSTCO WHSL CORP	28,766	49,958
172908105 CINTAS CORP	34,993	58,055
26969P108 EAGLE MATERIALS INC	4,807	11,486
85209W109 SPROUT SOCIAL INC CL	911	2,811
35138V102 FOX FACTORY HOLDING	4,098	8,505
05464T104 AXSOME THERAPEUTICS	3,920	1,813
98985W102 ZYMEWORKS INC
513847103 LANCASTER COLONY COR	4,819	4,802
75972A301 RENEWABLE ENERGY GRO	2,388	2,674
670002401 NAVAVAX INC
92538J106 VERTEX INC CL A
824348106 SHERWIN WILLIAMS CO	33,257	60,572
867652406 SUNPOWER CORP
199908104 COMFORT SYS USA INC	4,292	7,322
207410101 CONMED CORP	6,775	9,640
90400D108 ULTRAGENYX PHARMACEU
45780R101 INSTALLED BLDG PRODS	6,788	9,082
45687V106 INGERSOLL RAND INC	5,844	20,603
00724F101 ADOBE SYS INC	43,212	52,737
950755108 WERNER ENTERPRISES I	8,539	9,341
35905A109 FRONTDOOR INC	3,351	2,785
88322Q108 TG THERAPEUTICS INC
74758T303 QUALYS INC	3,941	4,940
04271T100 ARRAY TECHNOLOGIES I
82509L107 SHOPIFY INC A	41,339	57,850
018522300 ALLETE INC
546347105 LOUISIANA PACIFIC CO
538146101 LIVE PERSON INC	7,417	5,787
46120E602 INTUITIVE SURGICAL I	42,868	79,765
G8994E103 TRANE TECHNOLOGIES P	20,042	76,367
50187A107 LHC GROUP INC	8,502	6,313
59064R109 MESA LABS INC	10,167	15,092
76169C100 REXFORD INDUSTRIAL R
229050307 CRYPORT INC	4,989	6,509
252131107 DEXCOM INC	46,801	58,528
75606N109 REALPAGE INC
09075P105 BIOXCEL THERAPEUTICS
156727109 CERENCE INC	2,180	4,139
057665200 BALCHEM CORP	5,407	9,947
023135106 AMAZON.COM INC	50,846	53,349
19247A100 COHEN STEERS INC	16,722	22,295
G3922B107 GENPACT LIMITED
05988J103 BANDWIDTH INC CLASS	12,014	6,745
87808K106 TCR2 THERAPEUTICS IN
98978V103 ZOETIS INC	37,060	65,888
98138J206 WORKHORSE GROUP INC
78410G104 SBA COMMUNICATIONS C	65,318	89,086
816850101 SEMTECH CORP COM	6,627	10,227
46185L103 INVITAE CORP
81762P102 SERVICENOW INC	72,216	83,735
82982L103 SITEONE LANDSCAPE SU
48666K109 K B HOME	3,801	5,815
296315104 E S C O TECHNOLOGIES
11373M107 BROOKLINE BANCORP IN	4,506	8,160
09239B109 BLACKLINE INC	4,574	5,488
05550J101 BJS WHOLESALE CLUB H	6,397	10,916
56117J100 MALIBU BOATS INC
31572Q808 FIBROGEN INC
012348108 ALBANY INTL CORP CL	5,388	8,580
G3198U102 ESSENT GROUP LTD
89679E300 TRIUMPH BANCORP INC	1,818	10,122
93148P102 WALKER & DUNLOP INC	5,057	16,597
57164Y107 MARRIOTT VACATIONS W
65487U108 NKARTA INC
29664W105 ESPERION THERAPEUTIC
34417P100 FOCUS FINANCIAL PART	16,604	25,202
589584101 MERIDIAN BIOSCIENCE
88146M101 TERRENO REALTY CORP	8,553	13,305
462260100 IOVANCE BIOTHERAPEUT
088786108 BICYCLE THERAPEUTICS
871829107 SYSCO CORP	13,388	20,030
243537107 DECKERS OUTDOOR CORP
N6596X109 NXP SEMICONDUCTORS N	38,056	66,967
776696106 ROPER INDS INC	35,972	44,759
550021109 LULULEMON ATHLETICA	29,325	36,405
74766Q101 QUANTERIX CORP
00287Y109 ABBVIE INC	15,875	25,726
632307104 NATERA INC
826919102 SILICON LABORATORIES	3,988	8,050
72919P202 PLUG POWER INC
978097103 WOLVERINE WORLD WIDE	11,107	10,026
74736A103 QTS REALTY TRUST INC
34959J108 FORTIVE CORP WI
87105L104 SWITCH INC A	19,804	25,432
115637209 BROWN FORMAN CORP CL	27,181	31,257
453836108 INDEPENDENT BK CORP	13,512	16,958
829073105 SIMPSON MFG CO INC	6,947	9,457
883556102 THERMO FISHER SCIENT	45,027	74,731
87157D109 SYNAPTICS INC	1,103	4,053
114340102 BROOKS AUTOMATION IN	9,682	10,620
57636Q104 MASTERCARD INC	50,319	60,006
253031108 DICERNA PHARMACEUTIC
449585108 IGM BIOSCIENCES INC
502431109 L3HARRIS TECHNOLOGIE	30,494	39,876
518439104 LAUDER ESTEE COS INC	31,530	61,823
922280102 VARONIS SYSTEMS INC	3,630	4,976
48576A100 KARUNA THERAPEUTICS
92839U206 VISTEON CORP	4,803	6,335
16383L106 CHEMOCENTRYX INC
01609W102 ALIBABA GROUP HOLDIN
25058X105 DESKTOP METAL INC CO
92259F101 VELODYNE LIDAR INC
929328102 WSFS FINL CORP
24344T101 DECIPHERA PHARMACEUT
808513105 SCHWAB CHARLES CORP	43,319	75,522
489170100 KENNAMETAL INC	4,184	5,458
29089Q105 EMERGENT BIOSOLUTION
421298100 HAYWARD HLDGS INC	8,238	8,761
971378104 WILLSCOT MOBIL MINI	7,935	10,128
75524B104 RBC BEARINGS INC	7,891	7,877
127097103 CABOT OIL GAS CORP C	20,746	29,431
674215207 OASIS PETROLEUM INC	11,486	15,119
25401T108 DIGITALBRIDGE GROUP	3,937	4,023
477143101 JETBLUE AIRWAYS CORP	10,108	8,202
848574109 SPIRIT AEROSYSTEMS H	13,642	12,884
05478C105 AZEK CO INC CL A	12,525	14,936
256746108 DOLLAR TREE INC	33,962	46,372
16679L109 CHEWY INC CLASS A	47,634	34,026
527064109 LESLIES INC	9,388	8,328
55405Y100 MA COM TECH SOLUTION	8,855	11,354
89377M109 TRANSMEDICS GROUP IN	7,308	4,349
98139A105 WORKIVA INC	9,849	9,787
72352L106 PINTEREST INC CLASS	49,482	28,099
11133T103 BROADRIDGE FINANCIAL	23,654	23,767
353514102 FRANKLIN ELEC INC	8,113	8,889
404030108 H E EQUIPMENT SERVI	10,067	11,377
165167735 CHESAPEAKE ENERGY CO	13,965	14,130
554382101 MACERICH CO	5,436	5,270
07373V105 BEAM THERAPEUTICS IN	3,059	2,231
91688F104 UPWORK INC	2,341	1,469
43283X105 HILTON GRAND VACATIO	8,953	10,318
04335A105 ARVINAS INC	7,468	9,200
127203107 CACTUS INC CLASS A	9,953	9,685
27627N105 EASTERN BANKSHARES I	5,916	5,769
45826J105 INTELLIA THERAPEUTIC	2,593	4,020
74467Q103 PUBMATIC INC COM CL	10,995	11,202
043436104 ASBURY AUTOMOTIVE GR	13,113	11,400
45167R104 IDEX CORP	33,995	41,592
393222104 GREEN PLAINS INC.	3,101	4,171
09062W204 BIOLIFE SOLUTIONS IN	11,112	8,945
44267D107 HOWARD HUGHES CORP/T	5,933	6,310
02553E106 AMERICAN EAGLE OUTFI	12,568	10,381
98983L108 ZURN WATER SOLUTIONS	3,595	7,608
690370101 OVERSTOCK COM INC DE	7,641	4,839
23282W605 CYTOKINETICS INC	3,134	4,923
86614U100 SUMMIT MATERIALS INC	8,790	13,888
880779103 TEREX CORP	8,060	7,735
922475108 VEEVA SYSTEMS INC-CL	53,956	48,541
22266L106 COUPA SOFTWARE INC	35,458	24,656
12508E101 CDK GLOBAL INC	28,312	22,999
553368101 MP MATLS CORP	6,097	7,585
87874R100 TECHTARGET INC	8,024	10,618

Borrower's Name	Original Amount of Loan	Date of Note	Maturity Date	Interest Rate
CITY OF LAKES COMMUNITY LAND TRUST	200,000	2016-10	2016-04	4.000 %
CITY OF LAKES COMMUNITY LAND TRUST	100,000	2016-06	2018-04	3.000 %
CITY OF LAKES COMMUNITY LAND TRUST	100,000	2016-04	2019-04	4.000 %

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
994120ZM8 PROPEL NONPROFITS 1.	AT COST	100,000	100,000
994120ZN6 MCCD 1.0% 06/01/2026	AT COST	100,000	100,000

Description	Amount
ROC ADJUSTMENT	36
COST BASIS ADJUSTMENT	380
WASH SALE ADJUSTMENT	203

Description	Revenue and Expenses per Books	Net Investment Income	Disbursements for Charitable Purposes
OTHER MISC EXPENSES	1,407	0	1,407
STATE FILING FEE/TAX	25	0	25
ADR FEES	2	2	0

Category	Amount	Net Investment Income
FOREIGN TAXES	746	746
FEDERAL ESTIMATES - PRINCIPAL	6,116	0
FOREIGN TAXES ON NONQUALIFIED	103	103