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
NORTHWEST CHARITABLE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)100 LIBERTY STREET
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WARREN, PA16365
A Employer identification number

27-1403629
B Telephone number (see instructions)

(814) 728-7260
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$19,026,972J 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 15 15  
4 Dividends and interest from securities... 1,016,455 1,016,455  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 241
b Gross sales price for all assets on line 6a 101,585
7 Capital gain net income (from Part IV, line 2)... 241
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........ 1,016,711 1,016,711  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 1,646 1,646    
c Other professional fees (attach schedule).... Click to see attachment 18,301 18,301    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 17,197      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 37,144 19,947   0
25 Contributions, gifts, grants paid....... 985,987 985,987
26 Total expenses and disbursements. Add lines 24 and 25 1,023,131 19,947   985,987
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -6,420
b Net investment income (if negative, enter -0-) 996,764
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 15,551 40,736 40,736
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)....... 12,775,650 Click to see attachment12,775,650 18,090,320
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).......... 923,873 Click to see attachment892,268 895,916
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 13,715,074 13,708,654 19,026,972
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
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........... 13,715,074 13,708,654
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 13,715,074 13,708,654
30 Total liabilities and net assets/fund balances (see instructions). 13,715,074 13,708,654
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
13,715,074
2
Enter amount from Part I, line 27a .....................
2
-6,420
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
13,708,654
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
13,708,654
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 2,711.497 SHARES OF FEDERATED HERMES P   2021-03-15
b FEDERATED HERMES GOVERNMENT P   2021-03-31
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 25,000   24,759 241
b 76,585   76,585  
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       241
b        
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 241
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 13,855
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 13,855
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 14,000
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 14,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 20
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 10 125
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet125 RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    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)
    bulletPA
    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 ofbulletT KAY EADIE Telephone no.bullet (814) 728-7260

    Located atbullet100 LIBERTY STREETWARRENPA ZIP+4bullet16365
    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
     
     
    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
    RONALD J SEIFFERT PRESIDENT
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    JOHN GOLDING VICE-PRESIDE
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    WILLIAM W HARVEY JR TREASURER
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    T KAY EADIE SECRETARY
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    JOHN P MEEGAN DIRECTOR
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    SONIA M PROBST DIRECTOR
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    TIM FANNIN DIRECTOR
    000.00     		0 0 0
    100 LIBERTY STREET
    WARREN,PA16365
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    18,241,118
    b
    Average of monthly cash balances.......................
    1b
    171,343
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    18,412,461
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    18,412,461
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    276,187
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    18,136,274
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    906,814
    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
    906,814
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    13,855
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    13,855
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    892,959
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    892,959
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    892,959
    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 7 892,959
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017...... 125,978
    c From 2018...... 109,603
    d From 2019...... 62,265
    e From 2020...... 399,601
    f Total of lines 3a through e ........ 697,447
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 985,987
    a Applied to 2020, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount..... 892,959
    e Remaining amount distributed out of corpus 93,028
    5 Excess distributions carryover applied to 2021.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 790,475
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		790,475
    10 Analysis of line 9:
    a Excess from 2017.... 125,978
    b Excess from 2018.... 109,603
    c Excess from 2019.... 62,265
    d Excess from 2020.... 399,601
    e Excess from 2021.... 93,028
    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 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
    10000 FRIENDS OF PENNSYLVANIA
    240 N 3RD ST
    HARRISBURG,PA17101     		  PC 2022 COMMONWEALTH AWARD CEREMONY SPO 3,700
    4-H CLUBS OF GREENE COUNTY
    4503 WEST STATE ROAD
    BLOOMFIELD,IN47424     		  PC POSITIVE YOUTH DEVELOPMENT PROGRAM F 1,000
    A BETTER WAY SERVICES INC
    PO BOX 734
    MUNCIE,IN47308     		  PC SPARKLE AND SHINE EVENT SPONSORSHIP 2,500
    ACES
    1001 STATE ST
    ERIE,PA16501     		  PC PROGRAM FUNDING 1,000
    ACTIVE AGING INC
    1034 PARK AVE
    MEADVILLE,PA16335     		  PC CAPITAL CAMPAIGN - LEGACY SPONSORSHI 5,000
    ADAM BLAKEY HOLIDAY FOUNDATION
    2109 MORGAN CREEK DRIVE
    FORT WAYNE,IN46808     		  PC PROGRAM FUNDING 750
    ADMIRAL PEARY CAREER FOUNDATION
    948 BEN FRANKLIN HWY
    EBENSBURG,PA15931     		  PC LIGHTHOUSE PROGRAM SUPPORT 5,000
    AFRICAN AMERICAN CHAMBER OF COMMERC
    KOPPERS BUILDING
    PITTSBURGH,PA15219     		  PC CORPORATE SPONSOR MEMBERSHIP 3,000
    ALL STAR CHARITIES CLASSIC
    PO BOX 82
    BRADFORD,PA16701     		  PC BIG 30 GAME JERSEY SPONSORSHIP 3,000
    ALLEGHENY HEALTH NETWORK
    4818 LIBERTY AVENUE
    PITTSBURGH,PA15224     		  PC COURTESY CORNER PROGRAM FUNDING 10,000
    AMERICAN CANCER SOCIETY
    206 WALKER AVENUE
    WARREN,PA16365     		  PC WARREN ANNUAL MEN'S GOLF OUTING SPON 1,500
    AMERICAN CANCER SOCIETY
    10501 EUCLID AVE
    CLEVELAND,OH44106     		  PC 2022 LIFE SAVERS BALL SPONSORSHIP 2,000
    AWAKEN INC - MARCC FUND
    PO BOX 515
    YORKTOWN,IN47396     		  PC AFGHAN REFUGEE SUPPORT 10,900
    BEI
    44 N STATE STREET
    WARREN,PA16365     		  PC CAPITAL CAMPAIGN 2 OF 3 20,000
    BELLEFONTE LACROSSE ASSOCIATION
    84 LANDON DRIVE
    BELLEFONTE,PA16823     		  PC PROGRAM SUPPORT 1,500
    BELMOUNT HOUSING FINANCIAL EDUCATIO
    2393 MAIN ST
    BUFFALO,NY14214     		  PC JEFFERSON STREET PROJECT (1 OF 5) IN 16,500
    BELMONT HOUSING FINANCIAL EDUCATION
    2393 MAIN ST
    BUFFALO,NY14214     		  PC JEFFFERSON STREET PROJECT (1 OF 5) I 1,500
    BEVERLY GRAY BUSINESS EXCHANGE CENT
    334 E UTICA ST
    BUFFALO,NY14208     		  PC MENTORSHIP AND COACHING INITIATIVE 2,500
    BIG BROTHERS BIG SISTERS NE INDIANA
    1005 W RUDISILL BLVD
    FORT WAYNE,IN46807     		  PC MENTORING PROGRAM FUNDING 500
    BISHOP SHEEN HOUSING FOUNDATION IN
    150 FRENCH ROAD
    ROCHESTER,NY14618     		  PC PROGRAM FUNDING 1,675
    BISON FUND
    284 DELAWARE AVE
    BUFFALO,NY14202     		  PC ANNUAL CELEBRATIN LUNCHEON SPONSORSH 2,500
    BLACK ACHIEVERS INC
    395 E FERRY ST 1
    BUFFALO,NY14208     		  PC ANNUAL AWARDS SPONSORSHIP 5,000
    BLESSING HOUSE
    5440 GROVE AVE
    LORAIN,OH44055     		  PC PROGRAM FUNDING 7,000
    BLUE JACKET INC
    2826 S CALHOUN ST
    FORT WAYNE,IN46807     		  PC SKILLS TRAINING AND EDUCATION FUNDIN 750
    BOYS AND GIRLS CLUB BUFFALO
    282 BABCOCK STREET
    BUFFALO,NY14210     		  PC PROGRAM FUNDING 5,000
    BOYS AND GIRLS CLUB OF FORT WAYNE
    2301 FAIRFIELD AVE
    FORT WAYNE,IN46807     		  PC PROGRAM FUNDING 4,000
    BRADFORD CREATIVE AND PERFORMING AR
    PO BOX 153
    BRADFORD,PA16701     		  PC FALL MUSIC AND ARTS FEST 1,500
    BRADFORD EDUCATIONAL FOUNDATION
    300 CAMPUS DRIVE
    BRADFORD,PA16701     		  PC THE DEAN EVANS LEGACY FUND 5,000
    BRADFORD FAMILY YMCA
    1020 REED ST
    OLEAN,NY14760     		  PC 2021 ANNUAL CAMPAIGN SPONSORSHIP 1,500
    BROTHERS OF MERCY FACILITIES FOUNDA
    4520 RANSOM RD
    CLARENCE,NY14031     		  PC SENIOR APARTMENTS PROJECT FUNDING 5 7,500
    BUFFALO NIAGARA PARTNERSHIP
    257 WEST GENESEE ST
    BUFFALO,NY14203     		  PC MEMBERSHIP AND SPONSORSHIP FUNDING 7,500
    BUFFALO PREP
    18 ACHESON ANNEX
    BUFFALO,NY14214     		  PC PROGRAM FUNDING 2,500
    CAMERON COUNTY COMMUNITY CHEST
    PO BOX 135
    EMPORIUM,PA15834     		  PC ANNUAL CAMPAIGN CONTRIBUTION 2,500
    CAREY SERVICES INC
    2724 S CAREY ST
    MARION,IN46953     		  PC EXPRESSIONS VENUE/REFRESHMENT SPONSO 1,500
    CENTRE COUNTY FIRE COMPANY
    207 N PENNSYLVANIA AVE
    CENTRE HALL,PA16828     		  PC OPERATING EXPENSES 1 OF 3 4,000
    CHAUTAUQUA OPPORTUNITIES
    17 W COURTNEY ST
    DUNKIRK,NY14048     		  PC PROGRAM FUNDING 5,000
    CHILDREN'S ADVOCACY CENER OF RANDOL
    122 S MERIDIAN STREET
    WINCHESTER,IN47394     		  PC PROGRAM FUNDING 2,500
    CHRIST CHILD SOCIETY OF SOUTH BEND
    2366 MIRACLE LANE
    MISHAWAKA,IN46545     		  PC WINTER COAT PROGRAM FUNDING 2,000
    CITY OF FRANKLIN
    191 HOWARD ST
    FRANKLIN,PA16323     		  PC SMALL BUSINESS JUMPSTART FUNDING 1,000
    CLARION COUNTY HOSPITAL
    1 HOSPITAL DR
    CLARION,PA16214     		  PC MAMMOGRAPHY CAMP 2 OF 2 5,000
    COMMONWEALTH CHARITABLE MANAGEMENT
    270 LAKE AVE
    MONTROSE,PA18801     		  PC EVER-FI - ENGAGE 36,270
    COMMONWEALTH CHARITABLE MANAGEMENT
    270 LAKE AVE
    MONTROSE,PA18801     		  PC ENGAGE - INDIANA (1 OF 3) 18,710
    COMMUNITY BLOOD BANK
    2646 PEACH ST
    ERIE,PA16508     		  PC DONOR APPRECIATION DAY SPONSORSHIP 2,000
    COMMUNITY DEV CORP OF BUTLER COUNTY
    120 HOLLYWOOD DR
    BUTLER,PA16001     		  PC 2021 MEMBER INVESTMENT PLEDGE 500
    COMMUNITY FIRST FUND
    51 S DUKE ST
    LANCASTER,PA17608     		  PC PROGRAM FUNDING 1,000
    COMMUNITY FOUNDATION OF GREATER BUF
    726 EXCHANGE STREET
    BUFFALO,NY14210     		  PC EAST SIDE CORRIDOR ECONOMIC DEVELOPM 20,000
    COMMUNITY FOUNDATION OF LORAIN COUN
    9080 LEAVITT RD
    ELYRIA,OH44035     		  PC CONNECT TO A CAUSE SPONSORSHIP 1,000
    COMMUNITY FOUNDATION OF WARREN COUN
    310 2ND AVE
    WARREN,PA16365     		  PC 2021 WARREN GIVES 5,000
    CORNERSTONE OF HOPE INC
    5905 BRECKSVILLE RD
    INDEPENDENCE,OH44131     		  PC PROGRAM FUNDING 10,000
    COURAGEOUS HEALING
    2103 S ANTHONY BLVD
    FORT WAYNE,IN46803     		  PC PROGRAM FUNDING 750
    CRAWFORD COUNTY MENTAL HEALTH AWARE
    944 LIBERTY ST
    MEADVILLE,PA16335     		  PC HOUSING SOLUTIONS PROGRAM FUNDING 20,000
    CROSSROADS FOUNDATION
    6901 LYNN WAY
    PITTSBURGH,PA15208     		  PC PROGRAM FUNDING 1,000
    CROSSROADS UNITED WAY
    601 CR 17
    ELKHART,IN46515     		  PC PROGRAM FUNDING 1,675
    CURWENSVILLE AREA SCHOOL DISTRICT
    650 BEECH STREET
    CURWENSVILLE,PA16833     		  PC YOUTH DEV PROGRAM FUNDING (2 OF 5) 4,055
    DICKINSON CENTER INC
    43 SERVIDEA DR
    RIDGWAY,PA15853     		  PC ST. MARYS CAPITAL CAMPAIGN 2 OF 5 20,000
    DIVAS
    79 FRENCH ST
    BUFFALO,NY14211     		  PC YOUTH TRIP SPONSORSHP 1,000
    ECONOMIC PROGRESS ALLIANCE
    789 BESSEMER ST
    MEADVILLE,PA16335     		  PC FRENCH CREEK DISTRICT INITIATIVE 2 O 10,000
    ECOREHAB OF MUNCIE
    405 S WALNUT ST
    MUNCIE,IN47305     		  PC STEP PROGRAM FUNDING 5,000
    EL CENTRO
    2800 PEARL AVENUE
    LORAIN,OH44055     		  PC 2021 ANNUAL GALA FUNDING 5,000
    ELIZA JENNINGS
    2376 JOHN ROAD
    OLMSTED TOWNSHIP,OH44138     		  PC HONORING OUR LEGACY/GROWING TO SERVE 5,000
    ERIE DAWN
    2816 ELMWOOD AVE
    ERIE,PA16508     		  PC PROGRAM SPONSORSHIP 2,500
    ERIE LIONS CLUB
    2545 W 26TH ST
    ERIE,PA16505     		  PC SAVE AN EYE CHARITY FOOTBALL GAME SP 2,500
    ERIE REG CHAMBER & GROWTH PARTNERSH
    208 E BAYFRONT PKWY
    ERIE,PA16507     		  PC ERIE FORWARD 2 OF 5 20,000
    ERIN'S PURPOSE
    550 WEST SPRING ST
    BLOOMFIELD,IN47424     		  PC PROGRAM FUNDING 1,000
    FLOWER CITY HABITAT FOR HUMANITY
    755 CULVER RD
    ROCHESTER,NY14609     		  PC PROGRAM FUNDING 3,000
    FOXDALE VILLAGE CORPORATION
    500 EAST MARYLN AVE
    STATE COLLEGE,PA16801     		  PC ANNUAL APPEAL CAMPAIGN SUPPORT 1,249
    FULTON THEATRE
    12 N PRINCE ST
    LANCASTER,PA17608     		  PC BREAK OUT PERFORMANCE CAMPAIGN 3 OF 6,163
    GENESIS HOUSE
    3575 ELYRIA AVE
    LORAIN,OH44055     		  PC PROGRAM FUNDING 5,000
    GIGI'S PLAYHOUSE
    6081 N CLINTON ST
    FORT WAYNE,IN46805     		  PC PROGRAM FUNDING 750
    GIRLS ON THE RUN MICHIANA
    51160 BITTERSWEET
    GRANGER,IN46530     		  PC PROGRAM FUNDING 1,000
    GREATER ERIE COMM ACTION COMM (GECA
    18 WEST 9TH ST
    ERIE,PA16501     		  PC PROGRAM FUNDING 2,500
    GREATER ERIE AREA HABITAT FOR HUMAN
    4922 PITTSBURG AVE
    PITTSBURGH,PA16509     		  PC PROGRAM FUNDING 2,500
    GREATER ERIE AREA HABITAT FOR HUMAN
    4922 PITTSBURG AVE
    PITTSBURGH,PA16509     		  PC HOMEBUILDING PROGRAM FUNDING 1,500
    GREATER LYCOMING HABITAT FOR HUMANI
    335 ROSE ST
    WILLIAMSPORT,PA17701     		  PC HOMEBUILDING PROGRAM FUNDING 1,675
    GREATER MUNCIE HABITAT FOR HUMANITY
    1923 S HOYT AVE
    MUNCIE,IN47302     		  PC HOMEBUILDING PROGRAM FUNDING 10,000
    GREENE COUNTY FOUNDATION
    4513 W STATE ROAD
    BLOOMFIELD,IN47424     		  PC CEO PROGRAM SPONSORSHIP (3 OF 3) 1,000
    GUARDIAN ANGEL CENTER INC
    616 SUNSET RD
    ST MARYS,PA15857     		  PC EXPANSION PROJECT FUNDING 3 OF 3 5,000
    HABITAT FOR HUMANITY GREATER CENTRE
    1155 ZION RD
    BELLEFONTE,PA16823     		  PC HOME BUILDING SPONSORSHIP 10,000
    HABITAT FOR HUMANITY GREATER PITTSB
    6435 FRANKSTOWN AVE
    PITTSBURGH,PA15206     		  PC HOMEBUILDING PROGRAM FUNDING 1,500
    HABITAT FOR HUMANITY OF CLEARFIELD
    PO BOX 463
    DUBOIS,PA15801     		  PC HOMEBUILDING PROGRAM FUNDING 12,000
    HABITAT FOR HUMANITY OF GRANT COUNT
    215 S ADAMS
    MARION,IN46952     		  PC AFFORDABLE HOMEOWNERSHIP PROGRAM FUN 2,000
    HANNAH'S HOUSE OF MICHIANA
    518 W 4TH AVE
    MISHAWAKA,IN46544     		  PC PROGRAM FUNDING 1,000
    HARGER UTILITIES CHARITIES INC
    108 WEST CLINTON STREET
    LOCK HAVEN,PA17745     		  PC VETERAN'S PARK REVITALIZATION PROJEC 5,000
    HEADWATERS CHARITABLE TRUST
    434 STATE STREET SUITE 1
    CURWENSVILLE,PA16833     		  PC GREEN JOB CREATION PROGRAM 3 OF 3 5,000
    HILL CDC
    2015-2017 CENTRE AVE
    PITTSBURGH,PA15219     		  PC HOMEOWNERSHIP PROGRAM SUPPORT 5,000
    HILLCROFT ABA CLINIC
    4105 N WALNUT ST
    MUNCIE,IN47303     		  PC SUMMER CAMP SPONSORSHIP 1,600
    HOME
    1542 MAIN STREET
    BUFFALO,NY14209     		  PC PROGRAM FUNDING 3,000
    HOPE INITATIVE CDC INC
    506 W BROAD ST
    ROCHESTER,NY14608     		  PC PROGRAM FUNDING 3,000
    HOUSING ALLIANCE OF PA
    309 FLORENCE AVENUE SUIT
    JENKINTOWN,PA17044     		  PC 2020 HOMES WITHIN REACH CONFERENCE S 2,500
    HOUSING TRANSITIONS INC
    217 EAST NITTANY AVENUE
    STATE COLLEGE,PA16801     		  PC OVERNIGHT SUPERVISOR SHELTER FUNDING 2,000
    HUDSON COMMUNITY FOUNDATION
    49 EAST MAIN STREET
    HUDSON,OH44236     		  PC PROGRAM FUNDING 1,675
    HUNTINGDON AREA HABITAT FOR HUMANIT
    1623 MOORE ST
    HUNTINGDON,PA16652     		  PC PROGRAM FUNDING 5,000
    IN A PINCH INC
    114 W 4TH ST
    MARION,IN46952     		  PC WAREHOUSE SPACE FUNDING 1,000
    JAMESTOWN AREA YMCA
    727 E 2ND ST
    JAMESTOWN,NY14701     		  PC SCHOLARSHIP PROGRAM FUNDING 3,400
    JEFFERSON DEFREES FAMILY CENTER
    207 SECOND AVE
    WARREN,PA16365     		  PC TOUCH A TRUCK EVENT FUNDING 2,500
    JOHNSTOWN AREA REGIONAL INDUSTRIES
    245 MARKET ST
    JOHNSTOWN,PA15901     		  PC TRAINING PROGRAM SUPPORT 3,000
    JUBILEE MINISTRIES
    235 S 12 ST
    LEBANON,PA17042     		  PC DIGITAL SIGN PURCHASE 3 OF 4 7,500
    JULIA HOSPICE & PALLIATIVE CARE
    PO BOX 353
    MCKEAN,PA16426     		  PC FACILITY CONSTRUCTION FUNDING 5,000
    JUNETEENTH FESTIVAL INC
    1517 GENESEE ST
    BUFFALO,NY14211     		  PC PROGRAM FUNDING 5,000
    JUNIOR ACHIEVEMENT OF WNY
    6255 SHERIDAN DR
    WILLIAMSVILLE,NY14221     		  PC STOCK MARKET CHALLENGE SPONSORSHIP 1,505
    KANE AREA FOOD PANTRY
    342 CHASE ST
    KANE,PA16735     		  PC PROGRAM FUNDING 1,500
    KANE AREA REVITAL ENTERPRISE (KARE
    54 FRALEY ST
    KANE,PA16735     		  PC PROGRAM FUNDING 10,000
    KEYSTONE COMMUNITY EDUCATION COUNCI
    206 SENECA ST
    OIL CITY,PA16301     		  PC SMALL BUSINESS JUMPSTART PROGRAM FUN 1,000
    KIVA LOAN PROGRAM
    23 W 10TH ST SUITE 2
    ERIE,PA16501     		  PC LOAN MATCH FUNDING 10,000
    LANCASTER LEBANON HABITAT FOR HUMAN
    443 FAIRVIEW AVE
    LANCASTER,PA17603     		  PC HOMEBUILDING PROGRAM FUNDING 5,000
    LANCASTER SCIENCE FACTORY
    454 NEW HOLLAND AVENUE
    LANCASTER,PA17602     		  PC PROGRAM FUNDING 2,500
    LCADA
    2115 W PARK DR
    LORAIN,OH44053     		  PC THE KEY PROGRAM FUNDING 2,000
    LEADERSHIP LORAIN COUNTY
    1206 E BROAD ST
    ELYRIA,OH44035     		  PC SIGNATURE PROGRAM FUNDING 2,500
    LEBANON VALLEY CHAMBER FOUNDATION
    989 QUENTIN ROAD
    LEBANON,PA17042     		  PC SCHOLARSHIP FUNDING 2,000
    LIFE VENTURES
    100 N SHERIDAN SQUARE
    PITTSBURGH,PA15206     		  PC BLACK EXCELLENCE IN REAL ESTATE GALA 1,000
    LORAIN COUNTY COMM COLLEGE FOUNDATI
    1005 ABBE ROAD NORTH CC22
    ELYRIA,OH44035     		  PC EMERGENCY ASSISTANCE FUND SUPPORT 5,000
    LORAIN COUNTY URBAN LEAGUE
    200 MIDDLE AVE
    ELYRIA,OH44035     		  PC CORPORATE SPONSORSHIP 2,500
    LORAIN COUNTY URBAN LEAGUE
    200 MIDDLE AVE
    ELYRIA,OH44035     		  PC PROJECT WELLNESS PROGRAM FUNDING 1,650
    MCKEAN COUNTY COMMUNITY FOUNDATION
    PO BOX 708
    BRADFORD,PA16701     		  PC START-UP ADMINISTRATION EXPENSES (3 5,000
    MIRACLE CHURCH OF GOD IN CHRIST NO
    120 MERCHANT ST
    AMBRIDGE,PA15003     		  PC PROGRAM FUNDING 2,500
    MISHAWAKA FOOD PANTRY
    315 LINCOLN WAY W
    MISHAWAKA,IN46544     		  PC PROGRAM FUNDING 2,000
    MOM'S HOUSE
    1325 FRANKLIN ST
    JOHNSTOWN,PA15905     		  PC SCHOLARSHIP PROGRAM FUNDING 1,700
    MUNCIE MISSION
    1725 S LIBERTY ST
    MUNCIE,IN47302     		  PC SNOWPLOW AND SUPPLIES FUNDING 10,000
    NEAR NORTHWEST NEIGHBORHOOD
    PO BOX 1132
    SOUTH BEND,IN46624     		  PC ANNUAL ARTS CAFE SPONSORSHIP 2,000
    NEAR NORTHWEST NEIGHBORHOOD
    PO BOX 1132
    SOUTH BEND,IN46624     		  PC COMUTER PURCHASE FUNDING 3,050
    NEIGHBOR WORKS WESTERN PA
    710 FIFTH AVE
    PITTSBURGH,PA15219     		  PC PROGRAM FUNDING 5,000
    NEIGHBORHOOD ALLIANCE
    1536 E 30TH ST
    LORAIN,OH44055     		  PC OPERATING EXPENSE FUNDING 500
    NEIGHBORHOOD ALLIANCE
    1536 E 30TH ST
    LORAIN,OH44055     		  PC PROGRAM FUNDING 2,000
    NET POSITIVE
    298 NORTHHAMPTON ST
    BUFFALO,NY14208     		  PC PROGRAM FUNDING 2,627
    OPEN ARMS FAMILY AND EDUCATIONAL SE
    2417 S 800 W
    LYONES,IN47443     		  PC CHRISTMAS FUNDING 1,600
    OUR LADY OF THE WAYSIDE
    38023 COLORADO AVE
    AVON,OH44011     		  PC PROGRAM FUNDING 2,000
    PATH SONE HOUSING CORP OF INDIANA
    420 S HIGH ST
    MUNCIE,IN47304     		  PC ANNUAL COMMUNITY PARTNERSHIP EVENT F 2,500
    PAUL'S PLACE
    PO BOX 12305
    FORT WAYNE,IN46863     		  PC PROGRAM FUNDING 1,000
    PAUL'S PLACE
    1200 COWEN PL
    FORT WAYNE,IN46825     		  PC TEMPORARY SHELTER FUNDING 750
    PINNACLE HEALTH
    PO BOX 8700
    HARRISBURG,PA17105     		  PC TRANSFORM THE TRAIL CAMPAIGN (2 OF 3 10,000
    PITTSBURGH COMMUNITY REINVESTMENT G
    1901 CENTRE AVENUE
    PITTSBURGH,PA15219     		  PC 11TH ANNUAL COMMUNITY DEVELOPMENT SU 5,000
    PITTSBURGH COMMUNITY REINVESTMENT G
    1901 CENTRE AVENUE
    PITTSBURGH,PA15219     		  PC PROGRAM FUNDING 2,000
    POTTER COUNTY HABITAT FOR HUMANITY
    1423 E 2ND ST
    COUDERSPORT,PA16915     		  PC HOMEBUILDING PROGRAM FUNDING 2,000
    POWER PACKS PROJECT
    1915 OLDE HOMESTEAD LN
    LANCASTER,PA17601     		  PC MEAL PROGRAM FUNDING 6,345
    RANDOLPH CENTER VETERANS SHELTER I
    315 OAK STREET
    WINCHESTER,IN47394     		  PC PROGRAM FUNDING 2,000
    RESOURCE COUNCIL OF WNY INC
    347 E FERRY ST
    BUFFALO,NY14208     		  PC AFTER-SCHOOL PROGRAM FUNDING 5,000
    REVITALIZTION OF YOUNGSVILLE
    40 RAILROAD ST
    YOUNGSVILLE,PA16371     		  PC HEART AND SOUL MUSIC PROGRAM 2,500
    RONALD MCDONALD HOUSE OF MICHIANA
    610 N MICHIGAN ST
    SOUTH BEND,IN46601     		  PC PROGRAM FUNDING 2,000
    SALVATION ARMY KROC CENTER
    900 W WESTERN AVE
    SOUTH BEND,IN46601     		  PC PROGRAM FUNDING 1,000
    SALVATION ARMY LEBANON CORPS
    1031 GUILFORD ST
    LEBANON,PA17046     		  PC PROGRAM FUNDING 1OF 2 2,000
    SAY YES TO EDUCATION BUFFALO
    712 MAIN ST
    BUFFALO,NY14202     		  PC PROGRAM FUNDING 5,000
    SECOND HARVEST FOOD BANK
    1507 GRIMM RD
    ERIE,PA16501     		  PC HOLIDAY BOX PROGRAM FUNDING 4,000
    SECOND HARVEST FOOD BK OF NCENTRAL
    5510 BAUMHART RD
    LORAIN,OH44053     		  PC MEAL PROGRAM FUNDING 10,000
    SHEFFIELD AREA ECUMENICAL FOOD PANT
    PO BOX 721
    SHEFFIELD,PA16347     		  PC PROGRAM FUNDING 2,500
    SOUL TO SOLE
    PO BOX 541
    AVON,OH44011     		  PC 2021 NON GALA SPONSORSHIP 2,500
    SPECIAL OLYMPICS OF WARREN COUNTY
    PO BOX 752
    WARREN,PA16365     		  PC ANNUAL GOLF OUTING SPONSORSHIP 1,000
    SPIRITUS CHRISTI PRISON OUTREACH I
    934 CULVER RD
    ROCHESTER,NY14609     		  PC RESIDENT TRANSITION FUNDING 1,675
    ST MARTIN'S CENTER
    1701 PARADE ST
    ERIE,PA16503     		  PC PROGRAM FUNDING 3,000
    STRUTHERS LIBRARY THEATRE
    302 W THIRD AVE
    WARREN,PA16365     		  PC 2021-2021 PROGRAMMING SPONSORSHIP 25,000
    SWEET DREAMS FOR RANDOLPH COUNTY KI
    536 W FRANKLIN STREET
    WINCHESTER,IN47394     		  PC BED CONSTRUCTION FUNDING 2,000
    THE ERIE DOWNTOWN DEVELOPMENT CORP
    100 STATE ST STE 700
    ERIE,PA16057     		  PC DEDEVELOPMENT/REVITALIZATION PROGRAM 25,000
    THE HUDSON ROTARY FOUNDATION
    PO BOX 323
    HUDSON,OH44236     		  PC PROGRAM FUNDING 2,000
    THE LEANING LAMP
    2025 BEDOFRD ST
    JOHNSTOWN,PA15904     		  PC PROGRAM FUNDING 5,000
    THE LEARNING CENTER
    90 JACKSON AVE
    BRADFORD,PA16701     		  PC PROGRAM FUNDING 850
    THE MARY LEE TUCKER FUND INC
    2500 WEST ERIE AVE
    LORAIN,OH44052     		  PC PROGRAM FUNDING 6,450
    TIOGA COUNTY HOMELESS INITIATIVE
    2580 CHARLESTON RD
    MANSFIELD,PA16933     		  PC NEW FACILITY FUNDING 25,000
    UNITED FUND OF CORRY
    134 EAST MAIN STREET
    CORRY,PA16407     		  PC ANNUAL CAMPAIGN SUPPORT 700
    UNITED FUND OF ERIE COUNTY
    420 W 6TH STREET SUITE 20
    ERIE,PA16507     		  PC VITA PROGRAM SPONSORSHIP 2,500
    UNITED FUND OF WARREN COUNTY
    308 MARKET STREET PO BOX
    WARREN,PA16365     		  PC ANNUAL CAMPAIGN EMPLOYEE MATCH 72,000
    UNITED WAY BRADFORD AREA
    161 MAIN STREET PO BOX 5
    BRADFORD,PA16701     		  PC ANNUAL PIG ROAST SPONSORSHIP 2,000
    UNITED WAY BRADFORD AREA
    161 MAIN STREET PO BOX 5
    BRADFORD,PA16701     		  PC ANNUAL CAMPAIGN CONTRIBUTION 4,350
    UNITED WAY OF BUFFALO & ERIE COUNTY
    742 DELAWARE AVE
    BUFFALO,NY14209     		  PC ANNUAL CAMPAIGN CONTRIBUTION 10,000
    UNITED WAY OF CHAUTAUQUA
    208 PINE STREET
    JAMESTOWN,NY14701     		  PC ANNUAL CAMPAIGN CONTRIBUTION 10,000
    UNITED WAY OF DELAWARE COUNTY IN
    PO BOX 968
    MUNCIE,IN47308     		  PC 2020 CAMPAIGN CELEBRATION 2,500
    UNITED WAY OF ERIE COUNTY
    420 W 6TH STREET SUITE 20
    ERIE,PA16507     		  PC 2021 ERIE FREE TAXES SPONSORSHIP 2,500
    UNITED WAY OF GREATER LORAIN COUNTY
    642 BROADWAY AVE
    LORAIN,OH44052     		  PC MOBILITY MANAGEMENT IMPACT INITIATIV 10,000
    UNITED WAY OF GREATER NIAGARA
    6420 INDUCON DRIVE
    SANBORN,NY14132     		  PC ANNUAL CAMPAIGN CONTRIBUTION 5,000
    UNITED WAY OF ST JOSEPH COUNTY
    3517 E JEFFERSON BLVD
    SOUTH BEND,IN46615     		  PC SE NEIGHBORHOOD CENTER FACILITY FUND 5,000
    UNITED WAY OF THE TITUSVILLE REGION
    208 W SPRING ST
    TITUSVILLE,PA16354     		  PC ANNUAL CAMPAIGN CONTRIBUTION 1,800
    UNITED WAY OF VENANGO COUNTY
    1999 ALLEGHENY BLVD
    RENO,PA16343     		  PC ANNUAL CAMPAIGN CONTRIBUTION 3,500
    UNITED WAY OF WESTERN CRAWFORD COUN
    415 CHESTNUT STREET
    MEADVILLE,PA16335     		  PC ANNUAL CAMPAIGN CONTRIBUTION 3,000
    URBAN LIGHT COMMUNITY DEVELOPMENT C
    1400 S MADISON ST
    MUNCIE,IN47302     		  PC LIGHTHOUSE PROGRAM SPONSORSHIP 10,000
    VARIETY CLUB OF BUFFALO
    6114 BROADWAY
    LANCASTER,NY14086     		  PC ANNUAL TELETHON SPONSORSHIP 10,000
    WARREN COUNTY DEVELOPMENT ASSOCIATI
    308 MARKET STREET
    WARREN,PA16365     		  PC SPECIAL PROJECTS FUND SUPPORT 20,000
    WARREN COUNTY FAIR ASSOCIATION
    PO BOX 230
    PITTSFIELD,PA16340     		  PC MOTORSPORTS AREA NAMING RIGHTS 5 OF 15,500
    WARREN COUNTY YMCA
    212 LEXINGTON AVE
    WARREN,PA16365     		  PC OUTDOOR FITNESS PROJECT 1 OF 5 5,000
    WARREN GENERAL HOSPITAL
    2 CRESCENT PARK WEST
    WARREN,PA16365     		  PC 2021 SUMMER SIZZLER - ALLEGHENY LEVE 5,000
    WARREN LIBRARY ASSOCIATION
    205 MARKET ST
    WARREN,PA16365     		  PC CAPITAL CAMPAIGN 2 OF 3 20,000
    WARREN LIBRARY ASSOCIATION
    205 MARKET ST
    WARREN,PA16365     		  PC MIDWINTER FUNDRAISER SPONSORSHIP 1,000
    WEPA EMPOWERMENT CENTER
    661 HILL TOP ROAD
    MYERSTOWN,PA17067     		  PC FACILITY BUILDING FUNDING 5,000
    YMCA OF CORRY
    906 NORTH CENTER STREET
    CORRY,PA16407     		  PC RAISE THE ROOF CAPITAL CAMPAIGN (3 O 5,000
    YMCA OF GREATER ERIE
    31 WEST 10TH STREET
    ERIE,PA16501     		  PC ANNUAL CAMPAIGN CONTRIBUTION 1,688
    YORK COUNTY LITERACY COUNCIL
    800 EAST KING STREET
    YORK,PA17403     		  PC RELOCATION EXPENSES 2 OF 3 2,500
    YOUTH ENRICHMENT ASSOCIATION
    444 LINCOLN AVE
    PITTSBURGH,PA15206     		  PC PROGRAM FUNDING 2,500
    YWCA OF YORK
    320 E MARKET ST
    YORK,PA17403     		  PC EARLY LEARNING CENTER & QUANTUM OPPO 5,000
    Total .................................bullet 3a 985,987
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 15  
    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 ............     		    14 241  
    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) ..   1,016,711  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,016,711
    (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:
    NORTHWEST CHARITABLE FOUNDATION
    EIN:
    27-1403629
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 1,646 1,646    

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    NORTHWEST CHARITABLE FOUNDATION
    EIN:
    27-1403629
    Name of Stock End of Year Book Value End of Year Fair Market Value
    NORTHWEST BANCSHARES INC. 12,775,650 18,090,320

    TY 2021 InvestmentsOtherSchedule2
    Name:
    NORTHWEST CHARITABLE FOUNDATION
    EIN:
    27-1403629
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    MONEY MARKET AT COST 34,660 34,660
    MUTUAL FUNDS AT COST 857,608 861,256

    TY 2021 OtherProfessionalFeesSchedule
    Name:
    NORTHWEST CHARITABLE FOUNDATION
    EIN:
    27-1403629
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT FEES 18,301 18,301    


    TY 2021 TaxesSchedule
    Name:
    NORTHWEST CHARITABLE FOUNDATION
    EIN:
    27-1403629
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    (EXCISE) TAX EXPENSE 17,197