Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
HILLSDALE FUND INC
 
Number and street (or P.O. box number if mail is not delivered to street address)CO PIEDMONT TRUST CO PO BOX 20124
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
GREENSBORO, NC27420
A Employer identification number

56-6057433
B Telephone number (see instructions)

(336) 574-8696
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$39,800,724J 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)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 940 940  
4 Dividends and interest from securities... 28,403 531,245  
5a Gross rents............      
b Net rental income or (loss)  
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)... 3,248,933
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 1,060,612 -394  
12 Total. Add lines 1 through 11........ 1,089,955 3,780,724  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages...... 76,600 0   76,600
15 Pension plans, employee benefits....... 2,364 0   2,364
16a Legal fees (attach schedule)......... Click to see attachment 400 0   400
b Accounting fees (attach schedule)....... Click to see attachment 275 275   0
c Other professional fees (attach schedule)....        
17 Interest...............   67,366    
18 Taxes (attach schedule) (see instructions)... Click to see attachment 90,227 27,276   5,843
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 16,744 0   16,744
21 Travel, conferences, and meetings....... 150 0   150
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 170,683 471,348   28,524
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 357,443 566,265   130,625
25 Contributions, gifts, grants paid....... 1,476,736 1,476,736
26 Total expenses and disbursements. Add lines 24 and 25 1,834,179 566,265   1,607,361
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -744,224
b Net investment income (if negative, enter -0-) 3,214,459
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............. 45,864 48,356 48,356
2 Savings and temporary cash investments......... 287,169 565,453 565,453
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).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment27,936,569 Click to see attachment29,666,860 Click to see attachment39,186,915
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 28,269,602 30,280,669 39,800,724
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........ 28,269,602 30,280,669
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 0 0
29 Total net assets or fund balances (see instructions)..... 28,269,602 30,280,669
30 Total liabilities and net assets/fund balances (see instructions). 28,269,602 30,280,669
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
28,269,602
2
Enter amount from Part I, line 27a .....................
2
-744,224
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
3,815,903
4
Add lines 1, 2, and 3 ..........................
4
31,341,281
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
1,060,612
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
30,280,669
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a PAIF LLC-ST LOSS P 2021-01-01 2021-12-31
b PAIF LLC-LT GAIN P 2020-01-01 2021-12-31
c PAIF LLC-SECTION 1231 GAIN P 2020-01-01 2021-12-31
d PAIF LLC-SECTION 1256 LOSS P 2021-01-01 2021-12-31
e PAIF LLC-SECTION 1256 LOSS P 2020-01-01 2021-12-31
(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     241,687 -241,687
b 3,499,490     3,499,490
c 8,944     8,944
d     7,126 -7,126
e     10,688 -10,688
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       -241,687
b       3,499,490
c       8,944
d       -7,126
e       -10,688
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 3,248,933
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 44,681
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 44,681
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 8,008
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 57,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 65,008
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 20,327
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet20,327 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNC
    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 ofbulletPIEDMONT TRUST COMPANY Telephone no.bullet (336) 574-8669

    Located atbullet800 GREEN VALLEY RD STE 203GREENSBORONC ZIP+4bullet27408
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
    No
    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
    GEORGE L DUFOURNIER TRUSTEE
    1.00     		0 0 0
    PO BOX 20124
    GREENSBORO,NC27420
    WILLIAM L R SMITH TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    MARGARET R WHITE TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    EUDORA L RICHARDSON TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    LUNSFORD R SMITH TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    SION A BONEY III TREASURER
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    MARGARET W GALLAGHER TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    LAURINDA L DOUGLAS TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    JOHN PETER GALLAGHER TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    LOUISE B MCCOY PRESIDENT
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    BARBARA R EVANS TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    JAMES L RICHARDSON TRUSTEE
    1.00     		0 0 0
    P O BOX 20124
    GREENSBORO,NC27420
    MARTIN M BONEY TRUSTEE
    1.00     		0 0 0
    PO BOX 20124
    GREENSBORO,NC27420
    CALI C SMITH TRUSTEE
    1.00     		0 0 0
    PO BOX 20124
    GREENSBORO,NC27420
    CAROLINE S PRYOR TRUSTEE
    1.00     		0 0 0
    PO BOX 20124
    GREENSBORO,NC27420
    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
    MARY SCOTT EXEC DIR/SECRETARY
    20.00     		76,600 2,364 0
    PO BOX 20124
    GREENSBORO,NC27420
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    PIEDMONT TRUST COMPANY ACCOUNTING 158,275
    PO BOX 20124
    GREENSBORO,NC27420
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 N/A 0
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 NONE 0
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    38,810,538
    b
    Average of monthly cash balances.......................
    1b
    623,836
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    39,434,374
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    39,434,374
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    591,516
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    38,842,858
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,942,143
    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
    1,942,143
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    44,681
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
    91,331
    c
    Add lines 2a and 2b............................
    2c
    136,012
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,806,131
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,806,131
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    1,806,131
    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 1,806,131
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 1,362,586
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 1,607,361
    a Applied to 2020, but not more than line 2a 1,362,586
    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..... 244,775
    e Remaining amount distributed out of corpus 0
    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 0
    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 ..........     		1,561,356
    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 ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    MARY SCOTT HILLSDALE FUND INC PIEDM
    PO BOX 20124
    GREENSBORO,NC27420
    (336) 274-5471
    bThe form in which applications should be submitted and information and materials they should include:
    COMPLETED APPLICATION WITH A COPY OF INTERNAL REVENUE SERVICE EXEMPTION LETTER
    cAny submission deadlines:
    DEADLINES VARY EACH YEAR, ONE IN SPRING AND ONE IN FALL
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    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
    ALLIANCE MEDICAL MINISTRY INC
    101 DONALD ROSS DR
    RALEIGH,NC27610     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    ANGEL WATCHING OVER ME INC
    3 N FEDERAL HWY
    DANIA BEACH,FL33004     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    ANIMAL PROTECTION SOCIETY-FRIDAY HARBOR
    PO BOX 1355
    FRIDAY HARBOR,WA98250     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    BACKPACK BEGINNINGS
    1852 BANKING ST 9024
    GREENSBORO,NC27408     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 40,000
    BASIC HEALTH INTERNATIONAL
    6425 LIVING PL 2ND FLOOR
    PITTSBURGH,PA15206     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 50,000
    BLUE RIDGE WILDLIFE CENTER
    106 ISLAND FARM LN
    BOYCE,VA22620     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    CENTER FOR CHILD AND FAMILY HEALTH INC
    1121 W CHAPEL HILL ST SUITE 100
    DURHAM,NC27701     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    CHESAPEAKE BAY TRUST
    108 SEVERN AVENUE
    ANNAPOLIS,MD21403     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 40,000
    CLEAN MIAMI BEACH INC
    2395 LAKE PANCOAST DR APT 10
    MIAMI BEACH,FL33140     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    COMMUNITY FOUNDATION FOR NANTUCKET
    PO BOX 204
    NANTUCKET,MA02554     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 2,500
    COMMUNITY FOUNDATION OF HARRISONBURY & ROCKINGHAM COUNTY
    PO BOX 1068
    HARRISONBURG,VA22803     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    CONCORD COMMUNITY CENTER
    645 WALTER GRISSOM RD
    KITTRELL,NC27544     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 13,000
    DENISON UNIVERSITY
    100 W COLLEGE ST
    GRANVILLE,OH43023     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    ELKIN VALLEY TRAILS ASSOCIATION
    PO BOX 91
    ELKIN,NC28621     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 50,000
    FARMER FOODSHARE INC
    902 N MANGUM ST
    DURHAM,NC27701     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    FAUQUIER FREE CLINIC INC
    35 ROCK POINTE LN
    WARRENTON,VA20186     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    FELLOWSHIP HALL INC
    5140 DUNSTAN RD
    GREENSBORO,NC27405     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    FLAGSHIP DETROIT FOUNDATION
    110 MOSBY CT
    SHELBYVILLE,TN37160     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 22,000
    FOOD BANK OF THE ROCKIES
    10700 E 45TH AVE
    DENVER,CO80239     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 40,000
    FOOTHILLS HOUSING CORPORATION
    47 GARRETT STREET 205
    WARRENTON,VA20186     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 2,500
    FOUNDATION MEDICI
    9350 E MARKET ST
    WARREN,OH44484     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    FRIENDS OF THE NC STATE MUSEUM OF NATURAL SCIENCES
    PO BOX 26928
    RALEIGH,NC27611     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 50,000
    GEORGETOWN UNIVERSITY-AMERICAN STUDIES PROGRAM
    DEPARTMENT NUMBER 0734
    WASHINGTON,DC20073     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    GIRLS ROCK AUSTIN
    PO BOX 300897
    AUSTIN,TX78703     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    GREENSBORO URBAN MINISTRY
    305 WEST GATE CITY BLVD
    GREENSBORO,NC27406     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    HABITAT FOR HUMANITY OF GREATER GREENSBORO INC
    1031 SUMMIT AVE SUITE 2W-2
    GREENSBORO,NC27405     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    HAITI OUTREACH MINISTRIES
    PO BOX 71042
    DURHAM,NC27722     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    HEALING TRANSITIONS INTERNATIONAL INC
    1251 GOODE STREET
    RALEIGH,NC27603     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    HELENE FOUNDATION
    13200 STRICKLAND RD SUITE 114-308
    RALEIGH,NC27613     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    HISTORIC PRESERVATION FOUNDATION OF NORTH CAROLINA INC
    PO BOX 27644
    RALEIGH,NC27611     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    HOSPICE OF WAKE COUNTY INC
    250 HOSPICE CIRCLE
    RALEIGH,NC27607     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    HOUSE OF MERCY INC
    PO BOX 808
    BELMONT,NC28012     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,575
    HOUSTON IMMIGRATION LEGAL SERVICES COLLABORATIVE
    515 POST OAK BLVD 1000
    HOUSTON,TX77027     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 35,000
    LOCUST PROJECTS INC
    3852 NORTH MIAMI AVENUE
    MIAMI,FL33127     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    MADE4ME INC
    5540 ATLANTIC SPRINGS RD SUITE 101
    RALEIGH,NC27616     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 7,500
    MAGNOLIA HOUSE FOUNDATION INC
    PO BOX 5817
    GREENSBORO,NC27406     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    MIAMI DIAPER BANK INC
    4770 BISCAYNE BOULEVARD SUITE 980
    MIAMI,FL33137     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    MOC BEAGLES INC
    PO BOX 346
    MIDDLEBURG,VA20118     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 2,500
    MOSES H CONE MEMORIAL HOSPITAL OPERATING CORP
    1200 NORTH ELM ST
    GREENSBORO,NC27401     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 50,000
    NANTUCKET ATHENEUM
    1 INDIA STREET
    NANTUCKET,MA02554     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 2,500
    NANTUCKET CONSERVATION FOUNDATION INC
    PO BOX 13
    NANTUCKET,MA02554     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    NATIONAL TRUST FOR HISTORIC PRESERVATION IN THE UNITED STATES
    2600 VIRGINIA AVENUE NW SUITE 1100
    WASHINGTON,DC20037     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 30,000
    NORTH CAROLINA STATE UNIVERSITY
    NCSU CAMPUS BOX 7406
    RALEIGH,NC276957406     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    NORTH CAROLINA WILDLIFE FEDERATION INC
    1346 SAINT JULIEN PL
    CHARLOTTE,NC28205     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    OCTAGON HOUSE RESTORATION INC
    PO BOX 357
    ENGELHARD,NC27824     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 38,500
    ORCA BEHAVIOR INSTITUTE
    573 WESTCOTT DR
    FRIDAY HARBOR,WA98250     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    OURAY ICE PARK INC
    PO BOX 1058
    OURAY,CO81427     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    PIEDMONT ENVIRONMENTAL COUNCIL
    PO BOX 460
    WARRENTON,VA20188     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    PLAINS COMMUNITY LEAGUE
    PO BOX 432
    THE PLAINS,VA20198     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    REBUILDING TOGETHER OF THE TRIANGLE
    200 TRANS AIR DR SUITE 200
    MORRISVILLE,NC27560     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    REEVES DOWNTOWN SCHOOL OF MUSIC INC
    549 WEST MAIN ST
    ELKIN,NC28621     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    ROCK AND ROLL HALL OF FAME AND MUSEUM INC
    1100 ROCK ROLL BLVD
    CLEVELAND,OH44114     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    ROSIE'S PLACE INC
    899 HARRISON AVENUE
    BOSTON,MA02118     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 2,500
    SAINT MARY'S SCHOOL
    900 HILLSBOROUGH ST
    RALEIGH,NC27603     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    SALEM BAND
    500 SOUTH CHURCH ST
    WINSTONSALEM,NC27101     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 7,000
    SEAL HARBOR VILLAGE IMPRVMT SOCIETY INC
    PO BOX 171
    SEAL HARBOR,ME04675     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    SECOND HARVEST FOOD BANK OF MIDDLE TENNESSEE
    331 GREAT CIRCLE ROAD
    NASHVILLE,TN37228     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    SECOND HARVEST FOOD BANK OF OF NORTHWEST NORTH CAROLINA INC
    3655 REED STREET
    WINSTONSALEM,NC27107     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 50,000
    SOUTHEAST RURAL COMMUNITY ASSISTANCE PROJECT INC
    347 CAMPBELL AVE SW
    ROANOKE,VA24016     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 20,000
    SOUTHERN ENVIRONMENTAL LAW CENTER
    201 WEST MAIN ST SUITE 14
    CHARLOTTESVILLE,VA22902     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    SPECIAL KIDS INC
    2132 E MAIN ST
    MURFREESBORO,TN37130     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 18,661
    SR3-SEA LIFE RESPONSE REHABILITATION & RESEARCH
    2003 SOUTH 216TH ST 98811
    DES MOINES,WA98198     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    SUNDARI FOUNDATION INC
    217 NW 15TH ST
    MIAMI,FL33136     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    SUSTAINABLE AGRICULTURE AND FOOD SYSTEMS FUNDERS
    133 E DE LA GUERRA 306
    SANTA BARBARA,CA93101     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 3,500
    TAMMY LYNN MEMORIAL FOUNDATION
    739 CHAPPELL DR
    RALEIGH,NC27606     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    TRUMBULL NEIGHBORHOOD PARTNERSHIP
    736 MAHONING AVE NW
    WARREN,OH44483     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    UNITED ARTS COUNCIL OF GREENSBORO
    1500 YANCEYVILLE STREET
    GREENSBORO,NC27405     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 5,000
    UNITED WAY OF GREATER GREENSBORO
    1500 YANCEYVILLE STREET
    GREENSBORO,NC27405     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 10,000
    UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
    208 W FRANKLIN ST CAMPUS BOX 6100
    CHAPEL HILL,NC27516     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 25,000
    UNIVERSITY OF WASHINGTON-UW MEDICINE
    850 REPUBLICAN ST
    SEATTLE,WA98109     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 35,000
    VIRGINIA EASTERN SHORE LAND TRUST
    36076 LANKFORD HWY
    BELLE HAVEN,VA23306     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 15,000
    VIRGINIA ORGANIZING INC
    703 CONCORD AVE
    CHARLOTTESVILLE,VA22903     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 1,500
    WOODBERRY FOREST SCHOOL
    117 WOODBERRY STATION
    WOODBERRY FOREST,VA22989     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 80,000
    YMCA OF THE TRIANGLE AREA INC
    801 CORPORATE CENTER DR SUITE 200
    RALEIGH,NC27607     		NONE PC TO ASSIST THE TAX EXEMPT ORGANIZATION TO CARRY OUT ITS EXEMPT PURPOSE. 32,000
    Total .................................bullet 3a 1,476,736
    bApproved for future payment
    Total .................................bullet 3b 0
    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 ...........     		    14 940  
    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 ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 1,089,955 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,089,955
    (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

    TY 2021 AccountingFeesSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK CUSTODY FEES 275 275   0

    TY 2021 LegalFeesSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 400 0   400


    TY 2021 OtherAssetsSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    PIEDMONT ASSOCIATES INVESTMENT FUND LLC 24,555,067 26,285,358 35,849,682
    PIMCO LOW DURATION FUND 3,381,502 3,381,502 3,337,233


    TY 2021 OtherDecreasesSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Description Amount
    PAIF DISTRIBUTIONS 1,060,612


    TY 2021 OtherExpensesSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE SUPPLIES & EQUIPMENT 794 0   794
    COMPUTER SERVICES 6,291 0   6,291
    INSURANCE 4,258 0   4,258
    ACCTG,CHARITABLE & GRANT ADMINISTRATION 158,000 142,200   15,800
    UTILITIES 1,340 0   1,340
    PA LLC-OTHER EXPENSES 0 329,148   0
    PA LLC-CHARITABLE CONTRIBUTIONS 0 0   41


    TY 2021 OtherIncomeSchedule2
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    INVESTMENT FUND DISTRIBUTIONS 1,060,612 0 1,060,612
    PAIF LLC OTHER INCOME   -394  


    TY 2021 OtherIncreasesSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Description Amount
    PAIF LLC K-1 ADJUSTMENTS 3,815,903


    TY 2021 TaxesSchedule
    Name:
    HILLSDALE FUND INC
    EIN:
    56-6057433
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES PAID 0 27,276   0
    STATE INCOME TAXES PAID 5,706 0   0
    PAYROLL TAXES 5,843 0   5,843
    FEDERAL EXCISE AND UNRELATED BUSINESS TAXES 78,678 0   0