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
FOCUS FOR HEALTH FKA FOCUS AUTISM INC
 
Number and street (or P.O. box number if mail is not delivered to street address)67 MOUNTAIN BLVD 201
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WARREN, NJ07059
A Employer identification number

27-3400299
B Telephone number (see instructions)

(908) 279-7881
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$35,174,944J 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) 1,893,286
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 81,779 81,779  
5a Gross rents............ 1,584,432 1,584,432  
b Net rental income or (loss) 876,537
6a Net gain or (loss) from sale of assets not on line 10 1,122,176
b Gross sales price for all assets on line 6a 4,928,736
7 Capital gain net income (from Part IV, line 2)... 1,122,176
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 4,681,673 2,788,387  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages...... 370,506 0   370,506
15 Pension plans, employee benefits....... 66,117 0   66,117
16a Legal fees (attach schedule)......... Click to see attachment 1,950 0   1,950
b Accounting fees (attach schedule)....... Click to see attachment 9,500 4,750   4,750
c Other professional fees (attach schedule).... Click to see attachment 254,601 0   254,601
17 Interest............... 195,159 193,905   14,027
18 Taxes (attach schedule) (see instructions)... Click to see attachment 288,391 251,304   37,087
19 Depreciation (attach schedule) and depletion... 231,117 231,117  
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 263,184 102,342   153,342
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 1,680,525 783,418   902,380
25 Contributions, gifts, grants paid....... 2,116,284 2,116,284
26 Total expenses and disbursements. Add lines 24 and 25 3,796,809 783,418   3,018,664
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 884,864
b Net investment income (if negative, enter -0-) 2,004,969
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............. 717,964 248,396 248,396
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet975
Less: allowance for doubtful accounts bullet   975 975 975
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)....... 6,826,319 Click to see attachment7,565,716 9,806,746
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet10,906,930
Less: accumulated depreciation (attach schedule) bullet2,407,024 8,731,022 8,499,906 25,000,000
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 attachment176,289 Click to see attachment118,827 Click to see attachment118,827
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 16,452,569 16,433,820 35,174,944
Liabilities 17 Accounts payable and accrued expenses.......... 96,284 104,012
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)...... 4,647,201 4,539,128
22 Other liabilities (describe bullet) Click to see attachment206,274 Click to see attachment223,616
23 Total liabilities (add lines 17 through 22)......... 4,949,759 4,866,756
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........ 0 0
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 11,502,810 11,567,064
29 Total net assets or fund balances (see instructions)..... 11,502,810 11,567,064
30 Total liabilities and net assets/fund balances (see instructions). 16,452,569 16,433,820
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
11,502,810
2
Enter amount from Part I, line 27a .....................
2
884,864
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
12,387,674
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
820,610
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
11,567,064
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 WELLS FARGO - 9007   2021-01-01 2021-12-31
b TD   2021-01-01 2021-12-31
c TD   2021-01-01 2021-12-31
d E-TRADE   2021-01-01 2021-12-31
e UBS   2021-01-01 2021-12-31
UBS   2021-01-01 2021-12-31
RAYMOND JAMES - J723   2021-01-01 2021-12-31
UBS - 5177   2021-01-01 2021-12-31
CAPITAL GAINS DIVIDENDS P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 1,748,469   1,666,621 81,848
b       291,643
c 407,376   241,338 166,038
d       -54,799
e 2,063,202   1,916,003 147,199
401,290   295,519 105,771
308,309   294,426 13,883
      370,503
90     90
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       81,848
b       291,643
c       166,038
d       -54,799
e       147,199
      105,771
      13,883
      370,503
      90
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 1,122,176
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 27,869
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 27,869
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 39,538
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 39,538
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 11,669
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet11,669 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
     
    No
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNJ
    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
     
    No
    Website addressbulletWWW.FOCUSFORHEALTH.ORG
    14
    The books are in care ofbulletBARRY SEGAL Telephone no.bullet (908) 279-7881

    Located atbullet67 MOUNTAIN BLVD STE 201WARRENNJ ZIP+4bullet07059
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    MARTIN SEGAL VICE PRESIDENT
    3.00     		0 0 0
    67 MOUNTAIN BLVD 201
    WARREN,NJ07059
    BARRY SEGAL PRESIDENT
    5.00     		0 0 0
    67 MOUNTAIN BLVD 201
    WARREN,NJ07059
    ROBERT KRAKOW TRUSTEE
    0.50     		0 0 0
    67 MOUNTAIN BLVD 201
    WARREN,NJ07059
    BEA PUDELKO TRUSTEE
    0.50     		0 0 0
    67 MOUNTAIN BLVD 201
    WARREN,NJ07059
    RICHARD SEGAL TRUSTEE
    0.50     		0 0 0
    67 MOUNTAIN BLVD 201
    WARREN,NJ07059
    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
    JENNIFER SHORE EXECUTIVE DIRECTOR
    40.00     		191,475 0 0
    67 MOUNTAIN BLVD
    WARREN,NJ07059
    LAURA RAWLINS ASSOCIATE
    40.00     		60,900 0 0
    67 MOUNTAIN BLVD
    WARREN,NJ07059
    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
    STEVE KRAHLING SPEAKER, RESEARCH 68,000
    C/O 67 MOUNTAIN BLVD
    WARREN,NJ07059
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    9,568,399
    b
    Average of monthly cash balances.......................
    1b
    40,265
    c
    Fair market value of all other assets (see instructions)................
    1c
    20,708,338
    d
    Total (add lines 1a, b, and c).........................
    1d
    30,317,002
    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
    30,317,002
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    454,755
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    29,862,247
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,493,112
    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
    1,493,112
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    27,869
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
    8,366
    c
    Add lines 2a and 2b............................
    2c
    36,235
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,456,877
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,456,877
    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
    1,456,877
    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 1,456,877
    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...... 1,374,623
    b From 2017...... 1,611,530
    c From 2018...... 1,322,559
    d From 2019...... 1,778,574
    e From 2020...... 1,636,750
    f Total of lines 3a through e ........ 7,724,036
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 3,018,664
    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..... 1,456,877
    e Remaining amount distributed out of corpus 1,561,787
    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 9,285,823
    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) ...     		1,374,623
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		7,911,200
    10 Analysis of line 9:
    a Excess from 2017.... 1,611,530
    b Excess from 2018.... 1,322,559
    c Excess from 2019.... 1,778,574
    d Excess from 2020.... 1,636,750
    e Excess from 2021.... 1,561,787
    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).)
    BARRY SEGAL
    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.
    BARRY SEGAL
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    3D GIRLS INC
    PO BOX 10924
    ATLANTA,GA30310     		NONE N/A CHARITABLE PURPOSE 14,000
    A PARTNERSHIP FOR CHANGE
    PO BOX 523
    ORADELL,NJ07649     		NONE N/A CHARITABLE PURPOSE 20,000
    AKHIL AUTISM FOUNDATION
    ATTN MANISHA LAD 46 HARMON RD
    EDISON,NJ08837     		NONE N/A CHARITABLE PURPOSE 18,750
    ALLIANCE FOR NATURAL HEALTH USA
    1011 E JEFFERSON ST 204
    CHARLOTTESVILLE,VA22902     		NONE N/A CHARITABLE PURPOSE 60,000
    ALLIANCE OF FAMILIES FOR JUSTICE
    8 W 126TH ST 3RD FLOOR
    NEW YORK,NY10027     		NONE N/A CHARITABLE PURPOSE 35,000
    AMERICAN EXPRESS
    PO BOX 1270
    NEWARK,NJ07101     		NONE N/A CHARITABLE PURPOSE 1,659
    AMERICA'S BIG SISTERS
    21411 BRITTANY DR
    FRANKFORT,IL60423     		NONE N/A CHARITABLE PURPOSE 20,000
    AUTISM HEALTHCARE COLLABORATIVE
    16 MT BETHEL RD BOX 321
    WARREN,NJ07059     		NONE N/A CHARITABLE PURPOSE 10,000
    AUTISM SUPPORT CENTER KENYA
    SPECIAL NEEDS AFRICA 2419 SMALLMAN
    ST
    PITTSBURGH,PA15222     		NONE N/A CHARITABLE PURPOSE 6,250
    BEYOND CELIAC
    PO BOX 544
    AMBLER,PA19002     		NONE N/A CHARITABLE PURPOSE 35,000
    BLACK WOMEN'S BLUEPRINT INC
    PO BOX 24713
    BROOKLYN,NY11202     		NONE N/A CHARITABLE PURPOSE 35,000
    BLACKFEM INC
    599 MARYLAND AVE
    LEXINGTON,KY40508     		NONE N/A CHARITABLE PURPOSE 30,500
    CHIP INTERNATIONAL INC
    4024 AMBOY AVENUE
    STATEN ISLAND,NY10308     		NONE N/A CHARITABLE PURPOSE 38,000
    EDJA FOUNDATION (NYAKA)
    NYAKA AIDS ORPHANS PROJECT PO BOX
    339
    EAST LANSING,MI48826     		NONE N/A CHARITABLE PURPOSE 25,000
    ELS FOR AUTISM FOUNDATION
    KERRY KRUCKEL 3900 MILITARY TRAIL
    STE 200
    JUPITER,FL33458     		NONE N/A CHARITABLE PURPOSE 60,000
    FATHERS UPLIFT INC
    12 SOUTHERN AVE
    DORCHESTER,MA02124     		NONE N/A CHARITABLE PURPOSE 35,000
    FIRECRACKER FOUNDATION
    2450 DELHI COMMERCE DR STE 9
    HOLT,MI48842     		NONE N/A CHARITABLE PURPOSE 25,000
    FLORIDA ALLIANCE TO END HUMAN TRAFFICKING
    1400 VILLAGE SQUARE BLVD SUITE
    3-110
    TALLAHASSEE,FL32312     		NONE N/A CHARITABLE PURPOSE 50,000
    HOLLA
    10-41 115TH ST APT 3B
    COLLEGE POINT,NY11356     		NONE N/A CHARITABLE PURPOSE 50,000
    HELLOBABY CHICAGO
    14 N PEORIA ST STE 2E
    CHICAGO,IL60607     		NONE N/A CHARITABLE PURPOSE 10,000
    HELP A COMMUNITY TRUST
    N/A
    NA    
    MI     		NONE N/A CHARITABLE PURPOSE 6,250
    IMAGE IMPACT INTERNATIONAL
    86 CLIFFORD AVE
    PELHAM,NY10803     		NONE N/A CHARITABLE PURPOSE 5,000
    JOYFUL MOTHERHOOD
    N/A
    NA    
    MI     		NONE N/A CHARITABLE PURPOSE 9,375
    JUSTICE TEAMS NETWORK
    PO BOX 399389
    SAN FRANCISCO,CA94139     		NONE N/A CHARITABLE PURPOSE 15,000
    KIDS ARE SACRED
    PO BOX 23805
    OVERLAND PARK,KS66223     		NONE N/A CHARITABLE PURPOSE 20,000
    KIDSAFE FOUNDATION
    20283 STATE ROAD 7 STE 102
    BOCA RATON,FL33498     		NONE N/A CHARITABLE PURPOSE 20,000
    MENTEE GLOBAL
    1320 DARTFORD CT
    NAPERVILLE,IL60540     		NONE N/A CHARITABLE PURPOSE 10,000
    MIDDLE PROJECT INC
    50 EAST 7TH STREET
    NEW YORK,NY10003     		NONE N/A CHARITABLE PURPOSE 90,000
    MIRROR MEMOIRS
    1000 N ALAMEDA ST STE 240
    LOS ANGELES,CA90012     		NONE N/A CHARITABLE PURPOSE 25,000
    MOMS HELPING MOMS FOUNDATION
    1118 NORTH AVE
    PLAINFIELD,NJ07062     		NONE N/A CHARITABLE PURPOSE 5,000
    MORTAR CINCINNATI
    1329 VINE ST
    CINCINNATI,OH45202     		NONE N/A CHARITABLE PURPOSE 20,000
    MY LIFE MY CHOICE
    989 COMMONWEALTH AVE
    BOSTON,MA02215     		NONE N/A CHARITABLE PURPOSE 25,000
    MYGOAL INC - AUTISM
    PO BOX 531
    MONMOUTH JUNCTION,NJ08852     		NONE N/A CHARITABLE PURPOSE 70,000
    NASSAN'S PLACE
    NADINE WRIGHT-ARBUBAKRR PO BOX 833
    EAST ORANGE,NJ07019     		NONE N/A CHARITABLE PURPOSE 22,000
    NATIONAL BLACK WOMEN'S JUSTICE INSTITUTE
    2703 7TH ST MAILBOX 109
    BERKELEY,CA94710     		NONE N/A CHARITABLE PURPOSE 40,000
    NATIONAL HEALTH FREEDOM COALITION
    1043 GRAND AVE 137
    ST PAUL,MN55105     		NONE N/A CHARITABLE PURPOSE 35,000
    OASIS TLC
    1 MORGAN RD
    MIDDLETOWN,NJ07748     		NONE N/A CHARITABLE PURPOSE 10,000
    ONE CHILD NETWORK & SUPPORT
    8 LAGANI AVE RICHMOND HILL
    NA,ONTARIOL4B 3EI
    CA     		NONE N/A CHARITABLE PURPOSE 40,000
    PEACEWORKS INC (AXAYACATL)
    1125 WOOLLEY AVE UNION
    UNION,NJ07083     		NONE N/A CHARITABLE PURPOSE 6,250
    PENNSYLVANIA HORTICULTURAL SOCIETY
    100 N 20TH ST 5TH FLOOR
    PHILADELPHIA,PA19103     		NONE N/A CHARITABLE PURPOSE 10,000
    POAC (PARENTS OF AUTISTIC CHILDREN)
    1989 ROUTE 88
    BRICK,NJ08724     		NONE N/A CHARITABLE PURPOSE 50,000
    PROJECT HOOD
    6330 S KING DR
    CHICAGO,IL60637     		NONE N/A CHARITABLE PURPOSE 10,000
    REVIVE A CHILD UGANDA
    PLOT 1763 BLOCK 220 BEN KAMULEGEYA
    ROAD
    NA   16499
    UG     		NONE N/A CHARITABLE PURPOSE 12,500
    RISE COLORADO
    1595 ELMIRA ST STE 201
    AURORA,CO80010     		NONE N/A CHARITABLE PURPOSE 25,000
    ROAR AS ONE
    1223 WILSHIRE BLVD STE 834
    SANTA MONICA,CA90403     		NONE N/A CHARITABLE PURPOSE 35,000
    SACRED SPACES INC
    5915 BEACON ST
    PITTSBURGH,PA15217     		NONE N/A CHARITABLE PURPOSE 35,000
    SAFE HARBOR CHILD ACCESS CENTERS
    171 MAIN ST 2ND FLOOR
    FLEMINGTON,NJ08822     		NONE N/A CHARITABLE PURPOSE 20,000
    SMILE MUMS (FRM NENO) NENO WORLD VISION ALUMNI FOUNDATION
    PO BOX 9716
    FEDERAL WAY,WA98063     		NONE N/A CHARITABLE PURPOSE 12,000
    SOCIAL CHANGE
    23 E 26TH ST APT 2
    CHICAGO,IL60616     		NONE N/A CHARITABLE PURPOSE 40,000
    THE BLACK FEMINIST PROJECT
    725 FOX STREET APT 1B
    BRONX,NY10455     		NONE N/A CHARITABLE PURPOSE 30,000
    THE CONFESS PROJECT
    701 W 7TH ST STE 204
    LITTLE ROCK,AR72201     		NONE N/A CHARITABLE PURPOSE 30,000
    THE MAMA BEAR EFFECT
    11 DENNIS DR
    BURLINGTON,MA01803     		NONE N/A CHARITABLE PURPOSE 15,000
    THE MIDLAND FOUNDATION
    PO BOX 5026
    NORTH BRANCH,NJ08876     		NONE N/A CHARITABLE PURPOSE 2,500
    UNCHAINED AT LAST
    208 LENOX AVE 189
    WESTFIELD,NJ07090     		NONE N/A CHARITABLE PURPOSE 40,000
    UNIVERSITY OF ILLINOIS FOUNDATION
    CASH DESK 1305 W GREEN ST
    URBANA,IL61801     		NONE N/A CHARITABLE PURPOSE 50,000
    VILLAGE OF WISDOM
    WILLIAM JACKSON 600 E UMSTEAD ST
    DURHAM,NC27701     		NONE N/A CHARITABLE PURPOSE 50,000
    VITAMIN ANGELS
    PO BOX 4490
    SANTA BARBARA,CA93140     		NONE N/A CHARITABLE PURPOSE 6,500
    WOMEN'S HOPE FOR CHANGE
    PO BOX 175
    NA,MCHINJI  
    MI     		NONE N/A CHARITABLE PURPOSE 6,250
    YES 4 MINNEAPOLIS
    231 MARIA AVE
    SAINT PAUL,MN55106     		NONE N/A CHARITABLE PURPOSE 15,000
    WEST SIDE JUSTICE CENTER
    601 SOUTH CALIFORNIA AVE
    CHICAGO,IL60612     		NONE N/A CHARITABLE PURPOSE 10,000
    BLACK MOTHERS BREASTFEEDING ASSOCIATES
    19750 BURT RD
    DETROIT,MI48219     		NONE N/A CHARITABLE PURPOSE 2,500
    BLACK VILLAGE FOUNDATION
    20640 MICHIGAN ISLAND CT
    FRANKFORT,IL60423     		NONE N/A CHARITABLE PURPOSE 25,000
    CHICAGO CHANGE
    220 NE 38TH ST UNIT 12 FT
    LAUDERDALE,FL33334     		NONE N/A CHARITABLE PURPOSE 25,000
    CHICAGO APPLESEED CENTER
    750 N LAKE SHORE DRIVE FOURTH FLOOR
    CHICAGO,IL60611     		NONE N/A CHARITABLE PURPOSE 15,000
    CHICAGO TORTURE JUSTICE CENTER
    641 W 63RD ST
    CHICAGO,IL60621     		NONE N/A CHARITABLE PURPOSE 25,000
    SUSTAINABLE SOUTH BRONX
    ONE SMITH ST 4TH FLOOR
    BROOKLYN,NY11201     		NONE N/A CHARITABLE PURPOSE 80,000
    CHAINLESS CHANGE TOTAL
    220 NE 38TH ST UNIT 12 FT
    LAUDERDALE,FL33334     		NONE N/A CHARITABLE PURPOSE 25,000
    CONNECT AUTISM TANZANIA
    PO BOX 7791 MOSHI TANZANIA
    BROOKLYN,NY11201     		NONE N/A CHARITABLE PURPOSE 25,000
    CONTEXTOS
    2240 SOUTH MICHIGAN AVE
    CHICAGO,IL60621     		NONE N/A CHARITABLE PURPOSE 5,000
    CORAZON CONTENTO GRANADA
    1000 2ND AVE 34TH FLOOR
    SEATTLE,WA98104     		NONE N/A CHARITABLE PURPOSE 5,000
    URBAN TREE CONNECTION
    1445 N 52ND STREET
    PHILADELPHIA,PA19131     		NONE N/A CHARITABLE PURPOSE 10,000
    TOGETHER FOR GIRLS INC
    1889F NW SUITE 350
    WASHINGTON,DC07090     		NONE N/A CHARITABLE PURPOSE 10,000
    SERVICE WOMEN'S ACTION NETWORK
    441 4TH ST NW STE 707N
    WASHINGTON,DC07090     		NONE N/A CHARITABLE PURPOSE 15,000
    OUT OF JUSTICE
    PO BOX 10924
    BALTIMORE,MD21218     		NONE N/A CHARITABLE PURPOSE 15,500
    MISSISSPPI RISING COALITION
    5 CHANDELUR COVE
    OCEAN SPRINGS,MS39564     		NONE N/A CHARITABLE PURPOSE 15,000
    MEN STOPPING VIOLENCE
    2785 LAWRENCE HWY STE 112
    DECATUR,GA60540     		NONE N/A CHARITABLE PURPOSE 25,000
    HACKENSACK UMC FOUNDATION
    160 ESSEX ST
    LODI,NJ07644     		NONE N/A CHARITABLE PURPOSE 25,000
    GRACE
    4026 WARDS RD
    LYNCHBURG,VA24502     		NONE N/A CHARITABLE PURPOSE 20,000
    FFLIC
    1307 ORETHA CASTLE HALEY BLVD
    NEW ORLEANS,LA70113     		NONE N/A CHARITABLE PURPOSE 15,000
    EQUITY AND TRANSFORMATION
    10 W 35TH ST
    CHICAGO,IL60616     		NONE N/A CHARITABLE PURPOSE 25,000
    STOP IT NOW
    351 PLEASANY ST
    NORTHHAMPTON,MA01060     		NONE N/A CHARITABLE PURPOSE 15,000
    HOOD COLLEGE
    401 ROSEMONT AVE
    FREDERICK,MD21701     		NONE N/A CHARITABLE PURPOSE 5,000
    NJ COALITION AGAINST HUMAN TRAFFICKING
    30 CHATHAM RD
    SHORT HILLS,NJ07078     		NONE N/A CHARITABLE PURPOSE 15,000
    PREVENTHUMAN TRAFFICKING
    4410 MASSACHUSETTS AVE
    WASHINGTON,DC20016     		NONE N/A CHARITABLE PURPOSE 10,000
    JUSTICE FOR GEORGIA
    1040 W MARIETTA ST
    ATLANTA,GA30350     		NONE N/A CHARITABLE PURPOSE 10,000
    JARED HEARTS OF SUCCESS
    8343 ROSWELL RD STE 126
    ATLANTA,GA30350     		NONE N/A CHARITABLE PURPOSE 5,000
    IMPACTDMV
    11010 PELICAN DR
    UPPER MARLBORO,MD20772     		NONE N/A CHARITABLE PURPOSE 5,000
    RISE HEALTH
    3420 TORINGTON WAY
    CHARLOTTE,NC28277     		NONE N/A CHARITABLE PURPOSE 10,500
    ROOTS OF HEALTH
    455 MAIN STREET APT 14E
    NEW YORK,NY10044     		NONE N/A CHARITABLE PURPOSE 10,000
    SMALL TALKS CHILDREN
    3400 PINT TREE RD STE 106
    LANSING,MI48911     		NONE N/A CHARITABLE PURPOSE 10,000
    SWEM KIDS
    216 MARSHALLS LN SE
    ATLANTA,GA30316     		NONE N/A CHARITABLE PURPOSE 5,000
    THE NEXT GEN COME UP
    25 BRADFORD AVE
    WEST ORANGE,NJ07052     		NONE N/A CHARITABLE PURPOSE 5,000
    TINKS GOLDEN GIRLS
    224 HILCREST AVE
    SOMERSET,NJ08873     		NONE N/A CHARITABLE PURPOSE 5,000
    UNITED WAY OF HUNTERDON COUNTY
    4 WALTER E FORAN BLVD SUITE 401
    FLEMINGTON,NJ08822     		NONE N/A CHARITABLE PURPOSE 5,000
    THE FUNDERS NETWORK
    6705 SW 5TH AVE
    CORAL GABLES,FL33143     		NONE N/A CHARITABLE PURPOSE 10,000
    REBALANCED LIFE WELLNESS ASSOCAITION
    584 GRAND CANYON DRIVE
    MADISON,WI53718     		NONE N/A CHARITABLE PURPOSE 10,000
    THE MAMA BEAR EFFECT
    11 DENNIS DR
    BURLINGTON,MA01803     		NONE N/A CHARITABLE PURPOSE 15,000
    Total .................................bullet 3a 2,116,284
    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 ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....         876,537
    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 1,122,176  
    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 1,203,955 876,537
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    2,080,492
    (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.)
    5B RENTAL INCOME IS GENERATED FROM THE FOUNDATION'S OWNERSHIP OF REAL ESTATE. THIS INCOME IS UTILIZED TO PROMOTE THE FOUNDATION'S MISSION.
    8 RENTAL INCOME IS GENERATED FROM THE FOUNDATION'S OWNERSHIP OF REAL ESTATE. THIS INCOME & GAINS FROM THE SALE OF THE REAL ESTATE IS UTILIZED TO PROMOTE THE FOUNDATION'S MISSION.
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
     
    Employer identification number

    27-3400299
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
          		Employer identification number
    27-3400299
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    BARRY SEGAL
    67 MOUNTAIN BLVD STE 201
     
    WARREN, NJ07059

    		$ 383,968


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    BARRY SEGAL
    67 MOUNTAIN BLVD STE 201
     
    WARREN, NJ07059

    		$ 13,546


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
    BARRY SEGAL
    67 MOUNTAIN BLVD STE 201
     
    WARREN, NJ07059

    		$ 600,920


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    4
    BARRY SEGAL
    67 MOUNTAIN BLVD STE 201
     
    WARREN, NJ07059

    		$ 92,027


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    5
    BARRY SEGAL
    67 MOUNTAIN BLVD STE 201
     
    WARREN, NJ07059

    		$ 802,825


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

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
          		Employer identification number

    27-3400299
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    1
    		 800 SHS - ADBE $ 383,968 2021-02-02
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    2
    		 100 SHS - APPL $ 13,546 2021-02-02
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    3
    		 4,000 SHS - PNC $ 600,920 2021-02-02
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    4
    		 1,334 SHS - RTX $ 92,027 2021-02-02
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    5
    		 5,000 SHS - UPS $ 802,825 2021-02-02
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
          		Employer identification number

    27-3400299
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 9,500 4,750   4,750

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Name of Stock End of Year Book Value End of Year Fair Market Value
    TD AMERITRADE - SECURITIES 1,009,474 1,029,984
    UBS FINANCIAL - (SECURITIES) 1491 4,107,516 6,174,450
    E-TRADE - SECURITIES 744,351 744,351
    UBS FINANCIAL - (SECURITIES) 5177 1,704,375 1,857,961

    TY 2021 LegalFeesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 1,950 0   1,950


    TY 2021 OtherAssetsSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    INVESTMENT IN BAI BRANDS LLC 10,593    
    UTILITY DEPOSITS 2,670 2,670 2,670
    OTHER CURRENT ASSETS 61,103    
    LOAN CLOSING COSTS 101,923 116,157 116,157


    TY 2021 OtherDecreasesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Description Amount
    RETURN OF CAPITAL/UNREALIZED GAIN/LOSS/BOOK/TAX DIFFERENCE ON CONTRIBUTIONS 820,610


    TY 2021 OtherExpensesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADP PROCESSING FEE 2,378 0   2,378
    OPERATIONS EXPENSE 35,702 0   35,702
    OTHER EXPENSE 1,760 0   1,760
    TRAVEL 97,889 0   97,889
    MARKETING EXPENSE 20,518 0   13,018
    BOOKS & PERIODICALS 619 0   619
    INSURANCE 1,976 0   1,976
    INVESTMENT FEES 58,000 58,000   0
    INSURANCE EXPENSE 1,208 1,208   0
    INSURANCE EXPENSE 1,022 1,022   0
    INSURANCE EXPENSE 1,824 1,824   0
    INSURANCE EXPENSE 2,985 2,985   0
    REPAIRS & MAINTENANCE 0 0   0
    INSURANCE 13,066 13,066   0
    UBTI INCLUDED ON 990T 0 0   0
    REPAIRS & MAINTENANCE 0 0   0
    INSURANCE 12,131 12,131   0
    UBTI INCLUDED ON 990T 0 0   0
    INSURANCE 1,645 1,645   0
    AMORTIZATION 10,461 10,461   0


    TY 2021 OtherLiabilitiesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Description Beginning of Year - Book Value End of Year - Book Value
    SECURITY DEPOSITS 93,053 93,053
    PREPAID RENT 101,276 126,896
    OTHER LIABILITIES 11,945 3,667


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CONSULTING FEES 185,996 0   185,996
    PROFESSIONAL FEES 68,605 0   68,605


    TY 2021 TaxesSchedule
    Name:
    FOCUS FOR HEALTH FKA FOCUS AUTISM INC
    EIN:
    27-3400299
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PAYROLL TAXES 27,087 0   27,087
    FEDERAL TAXES 10,000 0   10,000
    REAL ESTATE TAXES 61,209 61,209   0
    REAL ESTATE TAXES 32,606 32,606   0
    REAL ESTATE TAXES 33,347 33,347   0
    REAL ESTATE TAXES 10,380 10,380   0
    REAL ESTATE TAXES 20,008 20,008   0
    REAL ESTATE TAXES 43,005 43,005   0
    REAL ESTATE TAXES 50,749 50,749   0