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
CVS FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)ONE CVS DRIVE
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WOONSOCKET, RI02895
A Employer identification number

22-3206973
B Telephone number (see instructions)

(401) 765-1500
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$194,756,165J 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) 50,000,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 889,412 889,412  
4 Dividends and interest from securities... 1,838,676 1,838,676  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 4,944,377 4,944,377 0
12 Total. Add lines 1 through 11........ 57,672,465 7,672,465 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 161,813 0 0 83,304
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 130,000 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 545,698 545,698 0 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 837,511 545,698 0 83,304
25 Contributions, gifts, grants paid....... 10,383,772 10,453,367
26 Total expenses and disbursements. Add lines 24 and 25 11,221,283 545,698 0 10,536,671
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 46,451,182
b Net investment income (if negative, enter -0-) 7,126,767
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets 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............. 56,866,601 56,952,047 56,952,047
2 Savings and temporary cash investments......... 83,182,965 137,804,118 137,804,118
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 140,049,566 194,756,165 194,756,165
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable................. 7,809,079 7,269,486
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)......... 7,809,079 7,269,486
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........... 132,240,487 187,486,679
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)..... 132,240,487 187,486,679
30 Total liabilities and net assets/fund balances (see instructions). 140,049,566 194,756,165
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
132,240,487
2
Enter amount from Part I, line 27a .....................
2
46,451,182
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
8,795,010
4
Add lines 1, 2, and 3 ..........................
4
187,486,679
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
187,486,679
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 99,062
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 99,062
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 86,335
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 375,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 461,335
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 10 362,273
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet362,273 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
 
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)
    bulletDE, MA, RI
    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
    Yes
     
    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 addressbulletCVSHEALTH.COM/SOCIAL-RESPONSIBILITY
    14
    The books are in care ofbulletJOSHUA COLE Telephone no.bullet (401) 770-5815

    Located atbulletONE CVS DRIVEWOONSOCKETRI ZIP+4bullet02895
    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)
    Yes
     
    (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
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    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
    EILEEN H BOONE PRESIDENT & DIRECTOR
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    CAROL A DENALE VICE PRESIDENT/TREASURER/DIRECTOR
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    JOANNE M DWYER DIRECTOR
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    THOMAS S MOFFATT VICE PRESIDENT/SECRETARY/DIRECTOR
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    TRACY L SMITH VICE PRESIDENT/ASSISTANT TREASURER
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    JEFFREY E CLARK ASSISTANT TREASURER
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    MELANIE K ST ANGELO ASSISTANT SECRETARY
    0.50     		0 0 0
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    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 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
    NONE
    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
    134,544,721
    b
    Average of monthly cash balances.......................
    1b
    13,269,478
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    147,814,199
    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
    147,814,199
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    2,217,213
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    145,596,986
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    7,279,849
    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
    7,279,849
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    99,062
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    99,062
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    7,180,787
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    7,180,787
    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
    7,180,787
    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 7,180,787
    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...... 6,203,317
    b From 2017...... 6,429,686
    c From 2018...... 5,656,015
    d From 2019...... 6,802,385
    e From 2020...... 2,419,674
    f Total of lines 3a through e ........ 27,511,077
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 10,536,671
    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..... 7,180,787
    e Remaining amount distributed out of corpus 3,355,884
    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 30,866,961
    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) ...     		6,203,317
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		24,663,644
    10 Analysis of line 9:
    a Excess from 2017.... 6,429,686
    b Excess from 2018.... 5,656,015
    c Excess from 2019.... 6,802,385
    d Excess from 2020.... 2,419,674
    e Excess from 2021.... 3,355,884
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    JOANNE DWYER
    ONE CVS DRIVE
    WOONSOCKET,RI02895
    (401) 765-1500
    JOANNE.DWYER@CVSHEALTH.COM
    bThe form in which applications should be submitted and information and materials they should include:
    THE FOUNDATION HAS THREE MAIN FOCUS AREA: INCREASING ACCESS TO HEALTH CARE FOR UNDERSERVED POPULATIONS; SMOKING CESSATION AND YOUTH TOBACCO PREVENTION; AND PRESCRIPTION DRUG ABUSE PREVENTION. THE FOUNDATION HAS INDIVIDUAL MEMORANDA OF UNDERSTANDING WITH ALL PARTNER ORGANIZATIONS. MANY OF THE PARTNER ORGANIZATIONS ARE NATIONAL IN SCOPE WITH LOCAL AFFILIATES. THE PARTNERS DEVELOP APPLICATIONS WHICH THEY SEND TO THEIR MEMBERSHIP (BASED ON GUIDELINES DEVELOPED WITH THE FOUNDATION). EACH OF THE NATIONAL ORGANIZATIONS REVIEWS ALL APPLICATIONS ELIGIBILITY. THE FOUNDATION ALSO HAS A SELECTION COMMITTEE MADE UP OF INDIVIDUALS FROM THE PARTNER ORGANIZATIONS AS WELL AS SUBJECT MATTER EXPERTS FROM ACROSS THE ENTERPRISE AT CVS. THE SELECTION COMMITTEE COMES TOGETHER FOR A DAY TO REVIEW AND DISCUSS ALL APPLICATIONS. ALL SELECTION COMMITTEE MEMBERS RECEIVE ALL APPLICATIONS AHEAD OF TIME AND ARE ASKED TO COME PREPARED WITH THEIR THOUGHTS. THE SELECTION COMMITTEE DISCUSSES AND VOTES.
    cAny submission deadlines:
    SEE STATEMENT
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    QUALIFYING ORGANIZATIONS ARE ELIGIBLE FOR GRANTS UP TO $1 MILLION. CVS FOUNDATION, PROVIDES THE FOLLOWING GRANTS: SCHOLARSHIPS GRANTS, PHARMACY GRANTS, VOLUNTEER CHALLENGE GRANTS, TRUST GRANTS, MULTI-YEAR GRANTS DISASTER RELIEF GRANTS, FREE CLINIC GRANTEE, COMMUNITY HEALTH CENTER GRANTEE.
    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
    MENTAL HEALTH AMERICA
    500 MONTGOMERY ST STE 820
    ALEXANDRIA,VA22314     		  PC VOLUNTEER CHALLENGE GRANTS 2,500
    ASHLAND UNIVERSITY ASHLAND OH
    401 COLLEGE AVE
    ASHLAND,OH44805     		  PC NURSING GRANTS 3,000
    ASHLAND UNIVERSITY
    401 COLLEGE AVE
    ASHLAND,OH44805     		  PC SCHOLARSHIP GRANTS 3,000
    EMORY UNIVERSITY
    300 BOISFEUILLET JONES CENTER 200
    DOWMAN DR
    ATLANTA,GA30322     		  PC SCHOLARSHIP GRANTS 5,000
    EMORY UNIVERSITY
    300 BOISFEUILLET JONES CENTER 200
    DOWMAN DR
    ATLANTA,GA30322     		  PC SCHOLARSHIP GRANTS 5,000
    GEORGIA INSTITUTE OF TECHNOLOGY
    225 NORTH AVE
    ATLANTA,GA30332     		  PC SCHOLARSHIP GRANTS 3,000
    AUBURN UNIVERSITY
    108 MARY MARTIN HALL
    AUBURN,AL36849     		  PC NURSING GRANTS 3,000
    AUBURN UNIVERSITY
    108 MARY MARTIN HALL
    AUBURN,AL36849     		  PC NURSING GRANTS 3,000
    AUBURN UNIVERSITY
    108 MARY MARTIN HALL
    AUBURN,AL36849     		  PC SCHOLARSHIP GRANTS 3,500
    AUBURN UNIVERSITY
    108 MARY MARTIN HALL
    AUBURN,AL36849     		  PC SCHOLARSHIP GRANTS 3,500
    AZUSA PACIFIC UNIV
    PO BOX 7000
    AZUSA,CA91702     		  PC NURSING GRANTS 3,000
    AZUSA PACIFIC UNIV
    PO BOX 7000
    AZUSA,CA91702     		  PC SCHOLARSHIP GRANTS 5,000
    NOTRE DAME OF MD UNIVERSITY BALTIMORE MD
    NOTRE DAME OF MARYLAND UNIVERSITY
    SCHOOL OF PHARMACY
    BALTIMORE,MD21210     		  PC NURSING GRANTS 3,000
    NOTRE DAME OF MD UNIVERSITY BALTIMORE MD
    NOTRE DAME OF MARYLAND UNIVERSITY
    SCHOOL OF PHARMACY
    BALTIMORE,MD21210     		  PC VOLUNTEER CHALLENGE GRANTS 3,000
    HUSSON UNIVERSITY BANGOR ME
    1 COLLEGE CIRCLE
    BANGOR,ME04401     		  PC SCHOLARSHIP GRANTS 4,500
    ENDICOTT COLLEGE BEVERLY MA
    376 HALE ST
    BEVERLY,MA01915     		  PC SCHOLARSHIP GRANTS 2,000
    MONTGOMERY COUNTY COMMUNITY COBLUE BELL PA
    340 DEKALB PIKE
    BLUE BELL,PA19422     		  PC SCHOLARSHIP GRANTS 3,500
    BOSTON UNIVERSITY BOSTON MA
    881 COMMONWEALTH AVE
    BOSTON,MA02215     		  PC NURSING GRANTS 2,000
    BOSTON UNIVERSITY BOSTON MA
    881 COMMONWEALTH AVE
    BOSTON,MA02215     		  PC SCHOLARSHIP GRANTS 5,000
    CANISIUS COLLEGE BUFFALO NY
    2001 MAIN ST
    BUFFALO,NY14208     		  PC SCHOLARSHIP GRANTS 2,500
    BUNDLES OF LOVE CHARITY APPLE VALLEY MN
    1101 CLIFF RD E
    BURNSVILLE,MN55337     		  PC VOLUNTEER CHALLENGE GRANTS 1,000
    BUTLER COUNTY COMMUNITY COLLEGBUTLER PA
    PO BOX 1203
    BUTLER,PA16003     		  PC SCHOLARSHIP GRANTS 3,000
    BOSTON COLLEGE CHESTNUT HILL MA
    140 COMMONWEALTH AVE
    CHESTNUT HILL,MA02467     		  PC NURSING GRANTS 2,000
    BOSTON COLLEGE CHESTNUT HILL MA
    140 COMMONWEALTH AVE
    CHESTNUT HILL,MA02467     		  PC SCHOLARSHIP GRANTS 5,000
    DEPAUL UNIVERSITY CHICAGO IL
    RM 9100 EAST JACKSON BLVD
    CHICAGO,IL60604     		  PC SCHOLARSHIP GRANTS 4,000
    IL INSTITUTE OF TECHNOLOGY CHICAGO IL
    10 WEST 35TH STREET
    CHICAGO,IL60616     		  PC SCHOLARSHIP GRANTS 4,000
    IL INSTITUTE OF TECHNOLOGY CHICAGO IL
    10 WEST 35TH STREET
    CHICAGO,IL60616     		  PC SCHOLARSHIP GRANTS 3,000
    ILLINOIS INSTITUTE OF TECHNOLOCHICAGO IL
    10 WEST 35TH STREET
    CHICAGO,IL60616     		  PC SCHOLARSHIP GRANTS 2,000
    ILLINOIS INSTITUTE OF TECHNOLOCHICAGO IL
    10 WEST 35TH STREET
    CHICAGO,IL60616     		  PC SCHOLARSHIP GRANTS 5,000
    CASE WESTERN RESERVE UNIV CLEVELAND OH
    1090 EUCLID AVE
    CLEVELAND,OH44106     		  PC SCHOLARSHIP GRANTS 5,000
    COLUMBUS STATE COMMUNITY COLLECOLUMBUS OH
    550 E SPRING ST
    COLUMBUS,OH43215     		  PC SCHOLARSHIP GRANTS 4,000
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 2,000
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 3,500
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 3,500
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 5,000
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 2,500
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 1,000
    OHIO STATE UNIVERSITY COLUMBUS OH
    281 W LANE AVE
    COLUMBUS,OH43210     		  PC SCHOLARSHIP GRANTS 4,000
    CENTRE COLLEGE DANVILLE KY
    600 W WALNUT ST
    DANVILLE,KY40422     		  PC SCHOLARSHIP GRANTS 3,500
    DUKE UNIVERSITY DURHAM NC
    2127 CAMPUS DR ANNEX
    DURHAM,NC27708     		  PC SCHOLARSHIP GRANTS 3,000
    NORTH CAROLINA CENTRAL UNIV DURHAM NC
    1801 FAYETTEVILLE ST
    DURHAM,NC27707     		  PC SCHOLARSHIP GRANTS 3,000
    ELGIN HEAT GIRLS SOFTBALL ELGIN IL
    9N491 HOBART DR
    ELGIN,IL60123     		  PC NURSING GRANTS 2,000
    ELGIN HEAT GIRLS SOFTBALL ELGIN IL
    9N491 HOBART DR
    ELGIN,IL60123     		  PC VOLUNTEER CHALLENGE GRANTS 1,500
    NORTHWESTERN UNIV EVANSTON IL
    1801 HINMAN AVE
    EVANSTON,IL60208     		  PC SCHOLARSHIP GRANTS 3,000
    LONGWOOD UNIVERSITY FARMVILLE VA
    201 HIGH ST
    FARMVILLE,VA23909     		  PC SCHOLARSHIP GRANTS 1,000
    NORTHERN AZ UNIVERSITY FLAGSTAFF AZ
    601 KNOLES DR
    FLAGSTAFF,AZ86011     		  PC SCHOLARSHIP GRANTS 3,000
    NORTHERN AZ UNIVERSITY FLAGSTAFF AZ
    601 KNOLES DR
    FLAGSTAFF,AZ86011     		  PC SCHOLARSHIP GRANTS 2,000
    CA STATE UNIV FRESNO FRESNO CA
    5241 N MAPLE AVE
    FRESNO,CA93740     		  PC SCHOLARSHIP GRANTS 3,000
    GETTYSBURG COLLEGE GETTYSBURG PA
    300 N WASHINGTON ST
    GETTYSBURG,PA17325     		  PC SCHOLARSHIP GRANTS 2,500
    GRINNELL COLLEGE GRINNELL IA
    1227 PARK ST 2ND FL
    GRINNELL,IA50112     		  PC SCHOLARSHIP GRANTS 4,000
    ITHACA COLLEGE ITHACA NY
    953 DANBY RD
    ITHACA,NY14850     		  PC SCHOLARSHIP GRANTS 3,000
    KENNESAW STATE UNIVERSITY KENNESAW GA
    585 COBB AVE NW
    KENNESAW,GA30144     		  PC SCHOLARSHIP GRANTS 4,000
    KENT STATE UNIVERSITY KENT OH
    PO BOX 5190
    KENT,OH44242     		  PC SCHOLARSHIP GRANTS 3,500
    FASHION INSTITUTE OF DESIGN ANLOS ANGELES CA
    919 S GRAND AVE
    LOS ANGELES,CA90015     		  PC SCHOLARSHIP GRANTS 4,000
    MARQUETTE UNIVERSITY MILWAUKEE WI
    1250 W WISCONSIN AVE
    MILWAUKEE,WI53233     		  PC SCHOLARSHIP GRANTS 1,526
    MARQUETTE UNIVERSITY MILWAUKEE WI
    1250 W WISCONSIN AVE
    MILWAUKEE,WI53233     		  PC SCHOLARSHIP GRANTS 4,000
    MILWAUKEE SCHOOL OF ENGINEERINMILWAUKEE WI
    1025 NORTH BROADWAY
    MILWAUKEE,WI53202     		  PC SCHOLARSHIP GRANTS 3,000
    BALL STATE UNIVERSITY MUNCIE IN
    LUCINA HALL RM 245
    MUNCIE,IN47306     		  PC NURSING GRANTS 3,000
    BALL STATE UNIVERSITY MUNCIE IN
    LUCINA HALL RM 245
    MUNCIE,IN47306     		  PC SCHOLARSHIP GRANTS 5,000
    CED NEW YORK NY
    845 THIRD AVE
    NEW YORK,NY10022     		  PC LARGE FOUNDATION GRANTS 100,000
    CED NEW YORK NY
    845 THIRD AVE
    NEW YORK,NY10022     		  PC NURSING GRANTS 2,000
    COLUMBIA UNIV SCHOOL OF ENGINENEW YORK NY
    1130 AMSTERDAM AVE
    NEW YORK,NY10027     		  PC SCHOLARSHIP GRANTS 3,000
    NY UNIV GALLATIN SCHOOL OF INDNEW YORK NY
    383 LAFAYETTE ST
    NEW YORK,NY10003     		  PC SCHOLARSHIP GRANTS 1,000
    NY UNIV GALLATIN SCHOOL OF INDNEW YORK NY
    383 LAFAYETTE ST
    NEW YORK,NY10003     		  PC SCHOLARSHIP GRANTS 2,000
    PARADIGM FOR PARITY NEW YORK NY
    969 FIFTH AVE
    NEW YORK,NY10075     		  PC SCHOLARSHIP GRANTS 1,000
    PARADIGM FOR PARITY NEW YORK NY
    969 FIFTH AVE
    NEW YORK,NY10075     		  PC VOLUNTEER CHALLENGE GRANTS 75,000
    PARISH HILL HIGH SCHOOL CHAPLIN CT
    969 FIFTH AVE
    NEW YORK,NY10075     		  PC VOLUNTEER CHALLENGE GRANTS 1,370
    LAURA BAKER SERVICES ASSC NORTHFIELD MN
    211 OAK ST NORTHFIELD MN 55057
    NORTHFIELD,MN55057     		  PC NURSING GRANTS 2,000
    LAURA BAKER SERVICES ASSC NORTHFIELD MN
    211 OAK ST NORTHFIELD MN 55057
    NORTHFIELD,MN55057     		  PC VOLUNTEER CHALLENGE GRANTS 1,000
    DREAM CORPS OAKLAND CA
    436 14TH ST
    OAKLAND,CA94612     		  PC NURSING GRANTS 5,000
    DREAM CORPS OAKLAND CA
    436 14TH ST
    OAKLAND,CA94612     		  PC VOLUNTEER CHALLENGE GRANTS 2,500
    JOHNSON COUNTY COMMUNITY COLLEOVERLAND PARK KS
    12345 COLLEGE BLVD
    OVERLAND PARK,KS66210     		  PC SCHOLARSHIP GRANTS 2,000
    MIAMIA UNIVERSITY OXFORD OH
    301 S CAMPUS AVE ROOM 123
    OXFORD,OH45056     		  PC SCHOLARSHIP GRANTS 1,000
    JDRF PHOENIX AZ
    4243 EAST CARMELBACK RD STE 230
    PHOENIX,AZ85018     		  PC NURSING GRANTS 5,000
    JDRF PHOENIX AZ
    4243 EAST CARMELBACK RD STE 230
    PHOENIX,AZ85018     		  PC VOLUNTEER CHALLENGE GRANTS 2,500
    BROWN UNIVERSITY PROVIDENCE RI
    69 BROWN ST
    PROVIDENCE,RI02912     		  PC NURSING GRANTS 3,000
    BROWN UNIVERSITY PROVIDENCE RI
    69 BROWN ST
    PROVIDENCE,RI02912     		  PC NURSING GRANTS 4,000
    BROWN UNIVERSITY PROVIDENCE RI
    69 BROWN ST
    PROVIDENCE,RI02912     		  PC SCHOLARSHIP GRANTS 1,000
    BROWN UNIVERSITY PROVIDENCE RI
    69 BROWN ST
    PROVIDENCE,RI02912     		  PC SCHOLARSHIP GRANTS 2,000
    EARLHAM COLLEGE RICHMOND IN
    801 NATIONAL RD W
    RICHMOND,IN47374     		  PC SCHOLARSHIP GRANTS 2,000
    NAZARETH COLLEGE ROCHESTER NY
    4245 EAST AVE
    ROCHESTER,NY14618     		  PC SCHOLARSHIP GRANTS 1,000
    DIRECT RELIEF SANTA BARBARA CA
    6100 WALLACE BECKNELL RD
    SANTA BARBARA,CA93117     		  PC LARGE FOUNDATION GRANTS 100,000
    DIRECT RELIEF SANTA BARBARA CA
    6100 WALLACE BECKNELL RD
    SANTA BARBARA,CA93117     		  PC NURSING GRANTS 2,000
    DIRECT RELIEF SANTA BARBARA CA
    6100 WALLACE BECKNELL RD
    SANTA BARBARA,CA93117     		  PC NURSING GRANTS 2,000
    DIRECT RELIEF SANTA BARBARA CA
    6100 WALLACE BECKNELL RD
    SANTA BARBARA,CA93117     		  PC LARGE FOUNDATION GRANTS 100,000
    GEORGIA SOUTHERN STATESBORO GA
    PO BOX 8155
    STATESBORO,GA30460     		  PC SCHOLARSHIP GRANTS 3,000
    PHILADELPHIA COLLEGE OF OSTEOPSUWANEE GA
    PCOM GEORGIA SUWANEE GA 30024
    SUWANEE,GA30024     		  PC SCHOLARSHIP GRANTS 1,000
    PHILADELPHIA COLLEGE OF OSTEOPSUWANEE GA
    PCOM GEORGIA SUWANEE GA 30024
    SUWANEE,GA30024     		  PC SCHOLARSHIP GRANTS 2,000
    BARRETT THE HONORS COLLEGE AT TEMPE AZ
    PO BOX 870412
    TEMPE,AZ85287     		  PC NURSING GRANTS 2,000
    BARRETT THE HONORS COLLEGE AT TEMPE AZ
    PO BOX 870412
    TEMPE,AZ85287     		  PC SCHOLARSHIP GRANTS 1,000
    PA STATE UNIVERSITY UNIVERISTY PARK PA
    SHIELDS BUILDING 103 CURTIN RD
    UNIVERISTY PARK,PA16802     		  PC SCHOLARSHIP GRANTS 3,000
    PA STATE UNIVERSITY UNIVERISTY PARK PA
    SHIELDS BUILDING 103 CURTIN RD
    UNIVERISTY PARK,PA16802     		  PC SCHOLARSHIP GRANTS 1,500
    PA STATE UNIVERSITY UNIVERSITY PARK PA
    SHIELDS BUILDING 103 CURTIN RD
    UNIVERISTY PARK,PA16802     		  PC SCHOLARSHIP GRANTS 1,000
    PA STATE UNIVERSITY UNIVERSITY PARK PA
    SHIELDS BUILDING 103 CURTIN RD
    UNIVERISTY PARK,PA16802     		  PC SCHOLARSHIP GRANTS 2,000
    PENN STATE UNIV UNIVERSITY PARK PA
    108 SHIELDS BUILDING
    UNIVERSITY PARK,PA16802     		  PC SCHOLARSHIP GRANTS 3,000
    BINGHAMTON UNIV VESTAL NY
    4400 VESTAL PARKWAY EAST
    VESTAL,NY13902     		  PC NURSING GRANTS 3,000
    BINGHAMTON UNIV VESTAL NY
    4400 VESTAL PARKWAY EAST
    VESTAL,NY13902     		  PC SCHOLARSHIP GRANTS 2,000
    ANIMAL SERVICES AND ASSIST PROMARENGO IL
    19309 KISHWAUKEE VALLEY RD
    MARENGO,IL60512     		  PC LARGE FOUNDATION GRANTS 500,000
    BOWERY MISSION NEW YORK NY
    355 LEXINGTON AVENUE 19TH FLOOR NEW
    NEW YORK,NY100176603     		  PC LARGE FOUNDATION GRANTS 500,000
    AKRON FEAR ATHLETICS CUYAHOGA FALLS OH
    2483 6TH ST CUYAHOGA
    CUYAHOGA FLS,OH442212427     		  PC NURSING GRANTS 3,000
    ALMA COLLEGE ALMA MI
    614 W SUPERIOR ST
    ALMA,MI48801     		  PC NURSING GRANTS 2,000
    ARIZONA HUMANE SOCIETY PHOENIX AZ
    1521 WEST DOBBINS ROAD
    PHOENIX,AZ85041     		  PC NURSING GRANTS 3,000
    ARIZONA STATE UNIVERSITY TEMPE AZ
    ASU SCHOLARSHIP OFFICE
    TEMPE,AZ85287     		  PC NURSING GRANTS 2,000
    ARIZONA STATE UNIVERSITY TEMPE AZ
    ASU SCHOLARSHIP OFFICE
    TEMPE,AZ85287     		  PC NURSING GRANTS 3,000
    BOYS AND GIRLS CLUBS OF PROV PROVIDENCE RI
    50 LAUREL HILL AVE
    PROVIDENCE,RI02909     		  PC NURSING GRANTS 2,000
    BRIDGE COMMUNITY CENTER COLUMBUS OH
    7413 MAXTOWN RD
    WESTERVILLE,OH430829040     		  PC NURSING GRANTS 3,000
    BUNDLES OF LOVE CHARITY APPLE VALLEY MN
    1101 CLIFF RD E
    BURNSVILLE,MN55337     		  PC NURSING GRANTS 2,000
    BURBANK YOUTH VOCAL ARTS FOUNDSAN MARINO CA
    510 S SHELTON ST
    BURBANK,CA91506     		  PC NURSING GRANTS 2,000
    CAMPO VERDE HS COYOTE CLUB GILBERT AZ
    1326 S MONTEZUMA CASTLE HIGHWAY
    CAMP
    VERDE,AZ86322     		  PC NURSING GRANTS 3,000
    CAPITAL AREA SOCCER ASSOC HARRISBURG PA
    1288 N MOUNTAIN RD
    HARRISBURG,PA17112     		  PC NURSING GRANTS 5,000
    CATHERINE MCGEE MIDDLE SCHOOL BERLIN CT
    899 NORTON RD
    BERLIN,CT06037     		  PC NURSING GRANTS 3,000
    CHARGERS BASEBALL BOOSTER CLUBBLACKSTONE MA
    PO BOX 2
    BLACKSTONE,MA01504     		  PC NURSING GRANTS 5,000
    CHINMAYA MISSION PITTSBURGH MONROEVILLE PA
    3817 NORTHERN PIKE
    MONROEVILLE,PA15146     		  PC NURSING GRANTS 3,000
    CLEAR CREEK ELEMENTARY BOOSTERSHELBYVILLE KY
    279 CHAPEL HL
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    37212
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    311 MURDOCK AVE
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    700 7TH ST E SAINT
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    MIDWESTERN UNIVERSITY DOWNERS GROVE IL
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    318 MEADOW BROOK RD
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    100 OCHRE POINT AVE
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    5500 CAMPANILE DRIVE SAN
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    501 CRESCENT ST NEW
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    1110 N STONEWALL AVE OKLAHOMA
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    RESURRECTION UNIVERSITY CHICAGO IL
    1431 N CLAREMONT AVE
    CHICAGO,IL606221702     		  PC SCHOLARSHIP GRANTS 2,000
    RHODE ISLAND ZOOLOGICAL SOCIETPROVIDENCE RI
    1000 ELMWOOD AVE
    PROVIDENCE,RI029073655     		  PC SCHOLARSHIP GRANTS 1,000
    ROOTED IN LOVE BUFFALO NY
    670 RILEY ST
    BUFFALO,NY142111222     		  PC SCHOLARSHIP GRANTS 1,500
    SACRED HEART UNIVERSITY FAIRFIELD CT
    5151 PARK AVE
    FAIRFIELD,CT068251000     		  PC SCHOLARSHIP GRANTS 3,000
    SAMARITANS PAWTUCKET RI
    67 PARK PL
    PAWTUCKET,RI028604009     		  PC SCHOLARSHIP GRANTS 1,500
    SOUTH UNIVERSITY SCHOOL OF PHASAVANNAH GA
    709 MALL BLVD
    SAVANNAH,GA314064805     		  PC SCHOLARSHIP GRANTS 6,000
    ST VINCENT DEPAUL PLACE MIDDLEMIDDLETOWN CT
    617 MAIN ST
    MIDDLETOWN,CT064572762     		  PC SCHOLARSHIP GRANTS 1,000
    STOICO FIRSTFED YMCA SWANSEA MA
    271 SHARPSLOT RD
    SWANSEA,MA02777     		  PC SCHOLARSHIP GRANTS 1,000
    STOICO FIRSTFED YMCA SWANSEA MA
    271 SHARPSLOT RD
    SWANSEA,MA02777     		  PC SCHOLARSHIP GRANTS 500
    SYRACUSE ARTS ACADEMY SYRACUSE UT
    2893 W 1700 S
    SYRACUSE,UT840759838     		  PC SCHOLARSHIP GRANTS 1,000
    TEAM RUBICON LOS ANGELES CA
    6171 W CENTURY BLVD NO 310 LOS
    LOS ANGELES,CA900455300     		  PC SCHOLARSHIP GRANTS 1,500
    TEAM WESTERN KY TORNADO RELIEFFRANKFORT KY
    1050 US HIGHWAY 127
    SOUTH FRANKFORT,KY40601     		  PC SCHOLARSHIP GRANTS 100,000
    TEXAS SOUTHERN UNIVERSITY HOUSTON TX
    3100 CLEBURNE ST
    HOUSTON,TX77004     		  PC SCHOLARSHIP GRANTS 2,000
    TEXAS SOUTHERN UNIVERSITY HOUSTON TX
    3100 CLEBURNE ST
    HOUSTON,TX77004     		  PC SCHOLARSHIP GRANTS 3,000
    THOMAS JEFFERSON UNIV COLLEGE PHILADELPHIA PA
    901 WALNUT STREET SUITE 803
    PHILADELPHIA,PA191075567     		  PC SCHOLARSHIP GRANTS 3,000
    TOWN OF SMITHFIELD SCHOOL DEPTSMITHFIELD RI
    11 LIMEROCK ROAD
    SMITHFIELD,RI02917     		  PC SCHOLARSHIP GRANTS 2,500
    TRUCKSVILLE VOLUNTEER FIRE ANDTRUCKSVILLE PA
    11 CARVERTON ROAD
    TRUCKSVILLE,PA187081752     		  PC SCHOLARSHIP GRANTS 1,500
    UCSF SAN FRANCISCO CA
    2130 FULTON ST SAN
    SAN FRANCISCO,CA941171080     		  PC SCHOLARSHIP GRANTS 1,000
    ULM COLLEGE OF PHARMACY MONROE LA
    1800 BIENVILLE DRIVE
    MONROE,LA71201     		  PC SCHOLARSHIP GRANTS 2,000
    UMASS MEMORIAL FDN WORCESTER MA
    100 CARLSON AVENUE
    AVENUE NEWTON,MA02459     		  PC SCHOLARSHIP GRANTS 2,000
    UNICEF USA NEW YORK NY
    125 MAIDEN LANE NEW
    NEW YORK,NY10038     		  PC SCHOLARSHIP GRANTS 2,500
    UNITED WAY HARTFORD CT
    30 LAUREL STREET
    HARTFORD,CT061061361     		  PC SCHOLARSHIP GRANTS 2,500
    UNITED WAY OF CENTRAL IOWA DES MOINES IA
    1111 9TH ST STE 100DES
    DES MOINES,IA503142527     		  PC SCHOLARSHIP GRANTS 1,000
    UNIV OF CINCINNATI CINCINNATI OH
    2624 CLIFTON AVENUE
    AVENUE CINCINNATI,OH452210222     		  PC SCHOLARSHIP GRANTS 3,000
    UNIV OF ILLINOIS AT CHICAGO CHICAGO IL
    28395 NETWORK PLACE
    CHICAGO,IL606731283     		  PC SCHOLARSHIP GRANTS 5,000
    UNIV OF MIAMI SCHL OF NURSING CORAL GABLES FL
    5030 BRUNSON DRIVE CORAL
    CORAL GABLES,FL33146     		  PC SCHOLARSHIP GRANTS 3,000
    UNIV OF MISSOURI KANSAS CITY KANSAS CITY MO
    2464 CHARLOTTE STREET KANSAS
    KANSAS CITY,MO64108     		  PC SCHOLARSHIP GRANTS 1,500
    UNIV OF NC AT CHAPEL HILL CHAPEL HILL NC
    104 AIRPORT DR CB 1270 CHAPEL
    CHAPEL HILL,NC275995023     		  PC SCHOLARSHIP GRANTS 3,000
    UNIV OF SOUTH FLORIDA RESEARCHTAMPA FL
    3702 SPECTRUM BLVD STE 165
    TAMPA,FL336129445     		  PC SCHOLARSHIP GRANTS 3,000
    UNIVERSITY AT BUFFALO SCHOOL OBUFFALO NY
    DEANS OFFICE
    BUFFALO,NY14214     		  PC SCHOLARSHIP GRANTS 2,000
    UNIVERSITY OF HAWAII HONOLULU HI
    1314 SOUTH KING STREET
    HONOLULU,HI96814     		  PC SCHOLARSHIP GRANTS 3,000
    UNIVERSITY OF PUERTO RICO FOUNSAN JUAN PR
    1187 C FLAMBOYAN JARDIN BOTANICO SU
    SAN
    SAN JUAN,PR00926     		  PC SCHOLARSHIP GRANTS 10,000
    UNIVERSITY OF PUERTO RICO FOUNSAN JUAN PR
    1187 C FLAMBOYAN JARDIN BOTANICO SU
    SAN
    SAN JUAN,PR00926     		  PC SCHOLARSHIP GRANTS 3,000
    UNIVERSITY OF SAINT JOSEPH WEST HARTFORD CT
    1678 ASYLUM AVE WEST
    WEST HARTFORD,CT061172764     		  PC SCHOLARSHIP GRANTS 3,000
    UNIVERSITY OF SAINT JOSEPH WEST HARTFORD CT
    1678 ASYLUM AVE WEST
    WEST HARTFORD,CT061172764     		  PC SCHOLARSHIP GRANTS 2,000
    UNIVERSITY OF SAN FRANCISCO SAN FRANCISCO CA
    2130 FULTON ST SAN
    SAN FRANCISCO,CA941171080     		  PC SCHOLARSHIP GRANTS 3,000
    UNIVERSITY OF TEXAS AT EL PASOEL PASO TX
    500 W UNIVERSITY AVE EL
    EL PASO,TX79968     		  PC SCHOLARSHIP GRANTS 4,000
    UNIVERSITY OF TEXAS AT EL PASOEL PASO TX
    500 W UNIVERSITY AVE EL
    EL PASO,TX79968     		  PC SCHOLARSHIP GRANTS 1,000
    UPHILL INTO THE WIND PHOENIX AZ
    16421 S 30TH DR
    PHOENIX,AZ850452271     		  PC SCHOLARSHIP GRANTS 1,000
    URSULINE COLLEGE PEPPER PIKE OH
    2550 LANDER ROAD PEPPER
    PEPPER PIKE,OH44124     		  PC SCHOLARSHIP GRANTS 3,000
    UTAH INFERTILITY RESOURCE CENTSALT LAKE CTY UT
    1565 E 3300 S SALT LAKE
    LAKE CTY,UT841063370     		  PC SCHOLARSHIP GRANTS 1,000
    DHARMA CENTER OF AMERICA
    5 ROYAL CIR
    LEXINGTON,MA024201325     		  PC SCHOLARSHIP GRANTS 2,500
    MEDICAL UNIVERSITY OF SOUTH CAROLINA
    99 JONATHAN LUCAS STREET
    CHARLESTON,SC29425     		  PC SCHOLARSHIP GRANTS 2,000
    MEDICAL UNIVERSITY OF SOUTH CAROLINA
    99 JONATHAN LUCAS STREET
    CHARLESTON,SC29425     		  PC SCHOLARSHIP GRANTS 3,000
    WATER OAK CIRCLE OF SPORTS WATERTOWN CT
    PO BOX 398
    WATERTOWN,CT067950398     		  PC SCHOLARSHIP GRANTS 1,000
    WEST COAST UNIVERSITY LOS ANGELES CA
    590 N VERMONT AVE LOS
    LOS ANGELES,CA90004     		  PC SCHOLARSHIP GRANTS 2,000
    WEST MORRIS SOCCER CLUB MENDHAM NJ
    PO BOX 193
    MENDHAM,NJ079450193     		  PC SCHOLARSHIP GRANTS 1,500
    WILKES UNIVERSITY WILKES BARRE PA
    84 W SOUTH ST WILKES
    WILKES BARRE,PA187660997     		  PC SCHOLARSHIP GRANTS 3,000
    WILKES UNIVERSITY WILKES BARRE PA
    84 W SOUTH ST WILKES
    WILKES BARRE,PA187660997     		  PC SCHOLARSHIP GRANTS 3,000
    WINGATE UNIVERSITY SCHOOL OF PWINGATE NC
    515 N MAIN STREET
    WINGATE,NC28174     		  PC SCHOLARSHIP GRANTS 3,000
    WINGATE UNIVERSITY SCHOOL OF PWINGATE NC
    515 N MAIN STREET
    WINGATE,NC28174     		  PC SCHOLARSHIP GRANTS 1,000
    CAMPAIGN FOR TOBACCO FREE KIDS
    1400 I STREET NW SUITE 1200
    WASHINGTON,DC20005     		  PC LARGE FOUNDATION GRANTS 1,000,000
    ALLIANCE FOR A HEALTHIER GENERATION
    1028 SE WATER AVE STE 215
    PORTLAND,OR972142186     		  PC LARGE FOUNDATION GRANTS 1,100,000
    ALLIANCE FOR A HEALTHIER GENERATION
    1359 BROADWAY NEW
    NEW YORK,NY10018     		  PC LARGE FOUNDATION GRANTS 500,000
    NEW ALTERNATIVES FOR CHILDREN
    37 W 26TH ST NEW
    NEW YORK,NY10010     		  PC LARGE FOUNDATION GRANTS 500,000
    AMERICAN FDN FOR SUICIDE PREVENTION
    199 WATER STREET 11TH FLOOR NEW
    NEW YORK,NY10038     		  PC LARGE FOUNDATION GRANTS 750,000
    BOYS & GIRLS CLUB HARTFORD
    170 SIGOURNEY ST
    HARTFORD,CT061051908     		  PC LARGE FOUNDATION GRANTS 100,000
    BOYS & GIRLS CLUB PROVIDENCE
    550 WICKENDEN STREET
    PROVIDENCE,RI02903     		  PC LARGE FOUNDATION GRANTS 100,000
    FROST VALLEY YMCA
    2000 FROST VALLEY RD
    CLARYVILLE,NY127255221     		  PC LARGE FOUNDATION GRANTS 90,000
    PHILANTHROPIC INITIATIVES
    75 ARLINGTON ST 3RD FLOOR
    BOSTON,MA02116     		  PC LARGE FOUNDATION GRANTS 502,000
    Total .................................bullet 3a 10,453,367
    bApproved for future payment
    ALLIANCE FOR A HEALTHIER GENERATION
    1028 SE WATER AVE STE 215
    PORTLAND,OR972142186     		  PC LARGE FOUNDATION GRANTS 550,000
    PARKINSON'S FOUNDATION INC
    200 SE 1ST STREET STE 800
    MIAMI,FL33131     		  PC LARGE FOUNDATION GRANTS 250,000
    NEW ALTERNATIVES FOR CHILDREN
    37 W 26TH ST NEW
    NEW YORK,NY10010     		  PC LARGE FOUNDATION GRANTS 300,000
    AMERICAN FDN FOR SUICIDE PREVENTION
    199 WATER STREET 11TH FLOOR NEW
    NEW YORK,NY10038     		  PC LARGE FOUNDATION GRANTS 375,000
    BOYS & GIRLS CLUB HARTFORD
    170 SIGOURNEY ST
    HARTFORD,CT061051908     		  PC LARGE FOUNDATION GRANTS 100,000
    BOYS & GIRLS CLUB PROVIDENCE
    550 WICKENDEN STREET
    PROVIDENCE,RI02903     		  PC LARGE FOUNDATION GRANTS 100,000
    FROST VALLEY YMCA (SCHOLARSHIPS)
    2000 FROST VALLEY RD
    CLARYVILLE,NY127255221     		  PC LARGE FOUNDATION GRANTS 90,000
    Total .................................bullet 3b 1,765,000
    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 ...........     		    14 889,412  
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 7,672,465 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    7,672,465
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


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

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

    22-3206973
    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
    CVS FOUNDATION
          		Employer identification number
    22-3206973
    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
    CVS HEALTH
     
    ONE CVS DRIVE
     
    WOONSOCKET, RI02895

    		$ 50,000,000


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

    		$  


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

    		$  


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

    		$  


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

    		$  


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

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    CVS FOUNDATION
          		Employer identification number

    22-3206973
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    CVS FOUNDATION
          		Employer identification number

    22-3206973
    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 OtherExpensesSchedule
    Name:
    CVS FOUNDATION
    EIN:
    22-3206973
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK SERVICE CHARGES 12,928 12,928 0 0
    ADVISORY FEES 527,904 527,904 0 0
    OTHER 4,866 4,866 0 0


    TY 2021 OtherIncomeSchedule2
    Name:
    CVS FOUNDATION
    EIN:
    22-3206973
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    TRUST MANAGEMENT REVENUE 4,944,377 4,944,377 0


    TY 2021 OtherIncreasesSchedule
    Name:
    CVS FOUNDATION
    EIN:
    22-3206973
    Description Amount
    UNREALIZED GAIN ON INVESTMENT 8,794,065
    TAX-EXEMPT INCOME 945


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    CVS FOUNDATION
    EIN:
    22-3206973
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PHILANTHROPIC 161,813 0 0 83,304


    TY 2021 TaxesSchedule
    Name:
    CVS FOUNDATION
    EIN:
    22-3206973
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAXES 130,000 0 0 0