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 06-01-2021 , and ending 05-31-2022
Name of foundation
Healthcare Foundation of Northern Lake
County
Number and street (or P.O. box number if mail is not delivered to street address)1200 University Center Drive 333
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Grayslake, IL60030
A Employer identification number

20-5253008
B Telephone number (see instructions)

(847) 377-0525
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$64,118,835J 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      
4 Dividends and interest from securities... 1,208,729 1,208,729  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 2,808,479
b Gross sales price for all assets on line 6a 4,995,524
7 Capital gain net income (from Part IV, line 2)... 2,808,479
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 10,750 10,750  
12 Total. Add lines 1 through 11........ 4,027,958 4,027,958  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 230,964 6,929   224,035
14 Other employee salaries and wages...... 189,757 21,226   168,531
15 Pension plans, employee benefits....... 99,614 7,112   92,502
16a Legal fees (attach schedule)......... Click to see attachment 5,508 275   5,233
b Accounting fees (attach schedule)....... Click to see attachment 39,665 30,262   9,403
c Other professional fees (attach schedule).... Click to see attachment 282,037 85,598   196,439
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 69,292 15,659   0
19 Depreciation (attach schedule) and depletion... Click to see attachment 987 29  
20 Occupancy.............. 7,500 225   7,275
21 Travel, conferences, and meetings....... 10,689 60   10,629
22 Printing and publications.......... 3,814 114   3,700
23 Other expenses (attach schedule)....... Click to see attachment 47,613 1,992   45,621
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 987,440 169,481   763,368
25 Contributions, gifts, grants paid....... 2,163,274 2,529,862
26 Total expenses and disbursements. Add lines 24 and 25 3,150,714 169,481   3,293,230
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 877,244
b Net investment income (if negative, enter -0-) 3,858,477
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......... 1,107,586 860,161 860,161
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.......... 6,504 14,180 14,180
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 46,973,746 Click to see attachment43,393,887 43,393,887
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).......... 22,214,864 Click to see attachment19,453,403 19,453,403
14 Land, buildings, and equipment: basis bullet7,660
Less: accumulated depreciation (attach schedule) bullet3,083 2,668 Click to see attachment4,577 4,577
15 Other assets (describe bullet) Click to see attachment367,390 Click to see attachment392,627 Click to see attachment392,627
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 70,672,758 64,118,835 64,118,835
Liabilities 17 Accounts payable and accrued expenses.......... 8,631 22,395
18 Grants payable................. 1,709,087 1,342,500
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) Click to see attachment10,197 Click to see attachment0
23 Total liabilities (add lines 17 through 22)......... 1,727,915 1,364,895
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........... 68,622,835 62,456,336
25 Net assets with donor restrictions............ 322,008 297,604
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)..... 68,944,843 62,753,940
30 Total liabilities and net assets/fund balances (see instructions). 70,672,758 64,118,835
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
68,944,843
2
Enter amount from Part I, line 27a .....................
2
877,244
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
69,822,087
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
7,068,147
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
62,753,940
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 Publically Traded Securities      
b Publically Traded Securities      
c Capital Gains Dividends P    
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 460,000   462,609 -2,609
b 2,795,000   1,724,436 1,070,564
c 1,740,524     1,740,524
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       -2,609
b       1,070,564
c       1,740,524
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 2,808,479
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 53,633
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 53,633
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 69,803
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 69,803
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 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 16,170
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet16,170 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)
    bulletIL
    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 addressbulletwww.hfnlc.org
    14
    The books are in care ofbulletThe Foundation Telephone no.bullet (847) 377-0525

    Located atbullet1200 University Center Drive 333GrayslakeIL ZIP+4bullet60030
    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)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    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
    Luis Berrones Chair/Director
    5.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Frances Baxley MD Vice Chair/Director
    5.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Dave Hatton CFP Treasurer/Director
    5.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Casandra Slade Secretary/Director
    5.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Magdalena McElroy RN LCSW Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Laura Ramirez BA Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Carol Sonnenschein MA PhD Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Maria Schwartz MS BSN RN Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Michael Duffy Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Nancy Waites Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Melissa Chen MD Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Igael Hamburg Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Scott McLellan Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Sam Johnson MBA LCPC RDDP Director
    1.00     		0 0 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    Ernest Vasseur Executive Director
    40.00     		230,964 53,001 0
    c/o Healthcare Fdn of Northern Lake
    Cnty 1200 University Ctr Dr 333
    Grayslake,IL60030
    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
    Angela Baran Program Officer
    40.00     		104,852 24,525 0
    c/o Healthcare Fdn of NLC
    Grayslake,IL60030
    Meredith Polirer Office Administrator
    40.00     		84,905 22,088 0
    c/o Healthcare Fdn of NLC
    Grayslake,IL60030
    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
    Kittleman & Assoc LLC Recruiting 73,964
    200 S Wacker Drive Suite 3100
    Chicago,IL60606
    Leading Healthy Futures Consulting 55,600
    1343 IL-19 13196
    Chicago,IL60613
    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
    68,506,147
    b
    Average of monthly cash balances.......................
    1b
    639,436
    c
    Fair market value of all other assets (see instructions)................
    1c
    357,442
    d
    Total (add lines 1a, b, and c).........................
    1d
    69,503,025
    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
    69,503,025
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) Click to see attachment.............................
    4
    3,293,230
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    66,209,795
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    3,310,490
    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
    3,310,490
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    53,633
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    53,633
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    3,256,857
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    3,256,857
    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
    3,256,857
    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 3,256,857
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 2,356,528
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 3,293,230
    a Applied to 2020, but not more than line 2a 2,356,528
    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..... 936,702
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		2,320,155
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    wwwhfnlcorg - All applicants must c
    1200 University Center Drive 333
    Grayslake,IL60030
    (847) 377-0525
    www.hfnlc.org
    bThe form in which applications should be submitted and information and materials they should include:
    The Foundation uses an online grant application and management system for both letters of inquiry and full proposals. We do not accept hard copies of either letters of inquiry or proposals. A letter of inquiry must be submitted prior to a full proposal. The letter of inquiry should include a description of the proposed program or project and the outcomes you hope to achieve, an explanation of the need for the program or project, and a budget including expenses and anticipated sources of support. All applications must address the following components: Need, Access, Sustainability and Evaluation. You can download and print the full set of questions from the online grant application and management system after you are invited to submit a full proposal.
    cAny submission deadlines:
    Letter of inquiry due June 15 and December 15 Proposal due (if invited) August 1 and February 1
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    The Healthcare Foundation of Northern Lake County makes grants only to tax-exempt nonprofit organizations and rarely funds organizations outside Lake County. Grants typically range from $25,000 to $100,000. Our grants to organizations must be used to only serve residents of Antioch, Fox Lake, Grayslake--Third Lake, Great Lakes, Gurnee, and Lake Villa--Lindenhurst, North Chicago, Round Lake, Wadsworth, Waukegan, and Zion. Our grants only fund specific initiatives and do not fund general operating support. The Foundation does not fund Biomedical research, Patient financial aid, Religious activities and Services provided by unqualified persons. A grantee organization may receive up to five consecutive years of funding, at the Foundation's discretion. After five consecutive years of funding the organization will be asked to take a year off in seeking support.
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    wwwhfnlcorg - All applicants must c
    1200 University Center Drive 333
    Grayslake,IL60030
    (847) 377-0525
    www.hfnlc.org
    bThe form in which applications should be submitted and information and materials they should include:
    The Foundation uses an online grant application and management system for both letters of inquiry and full proposals. We do not accept hard copies of either letters of inquiry or proposals. A letter of inquiry must be submitted prior to a full proposal. The letter of inquiry should include a description of the proposed program or project and the outcomes you hope to achieve, an explanation of the need for the program or project, and a budget including expenses and anticipated sources of support. All applications must address the following components: Need, Access, Sustainability and Evaluation. You can download and print the full set of questions from the online grant application and management system after you are invited to submit a full proposal.
    cAny submission deadlines:
    Letter of inquiry due June 15 and December 15 Proposal due (if invited) August 1 and February 1
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    The Healthcare Foundation of Northern Lake County makes grants only to tax-exempt nonprofit organizations and rarely funds organizations outside Lake County. Grants typically range from $25,000 to $100,000. Our grants to organizations must be used to only serve residents of Antioch, Fox Lake, Grayslake--Third Lake, Great Lakes, Gurnee, and Lake Villa--Lindenhurst, North Chicago, Round Lake, Wadsworth, Waukegan, and Zion. Our grants only fund specific initiatives and do not fund general operating support. The Foundation does not fund Biomedical research, Patient financial aid, Religious activities and Services provided by unqualified persons. A grantee organization may receive up to five consecutive years of funding, at the Foundation's discretion. After five consecutive years of funding the organization will be asked to take a year off in seeking support.
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    wwwhfnlcorg - All applicants must c
    1200 University Center Drive 333
    Grayslake,IL60030
    (847) 377-0525
    www.hfnlc.org
    bThe form in which applications should be submitted and information and materials they should include:
    The Foundation uses an online grant application and management system for both letters of inquiry and full proposals. We do not accept hard copies of either letters of inquiry or proposals. A letter of inquiry must be submitted prior to a full proposal. The letter of inquiry should include a description of the proposed program or project and the outcomes you hope to achieve, an explanation of the need for the program or project, and a budget including expenses and anticipated sources of support. All applications must address the following components: Need, Access, Sustainability and Evaluation. You can download and print the full set of questions from the online grant application and management system after you are invited to submit a full proposal.
    cAny submission deadlines:
    Letter of inquiry due June 15 and December 15 Proposal due (if invited) August 1 and February 1
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    The Healthcare Foundation of Northern Lake County makes grants only to tax-exempt nonprofit organizations and rarely funds organizations outside Lake County. Grants typically range from $25,000 to $100,000. Our grants to organizations must be used to only serve residents of Antioch, Fox Lake, Grayslake--Third Lake, Great Lakes, Gurnee, and Lake Villa--Lindenhurst, North Chicago, Round Lake, Wadsworth, Waukegan, and Zion. Our grants only fund specific initiatives and do not fund general operating support. The Foundation does not fund Biomedical research, Patient financial aid, Religious activities and Services provided by unqualified persons. A grantee organization may receive up to five consecutive years of funding, at the Foundation's discretion. After five consecutive years of funding the organization will be asked to take a year off in seeking support.
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    wwwhfnlcorg - All applicants must c
    1200 University Center Drive 333
    Grayslake,IL60030
    (847) 377-0525
    www.hfnlc.org
    bThe form in which applications should be submitted and information and materials they should include:
    The Foundation uses an online grant application and management system for both letters of inquiry and full proposals. We do not accept hard copies of either letters of inquiry or proposals. A letter of inquiry must be submitted prior to a full proposal. The letter of inquiry should include a description of the proposed program or project and the outcomes you hope to achieve, an explanation of the need for the program or project, and a budget including expenses and anticipated sources of support. All applications must address the following components: Need, Access, Sustainability and Evaluation. You can download and print the full set of questions from the online grant application and management system after you are invited to submit a full proposal.
    cAny submission deadlines:
    Letter of inquiry due June 15 and December 15 Proposal due (if invited) August 1 and February 1
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    The Healthcare Foundation of Northern Lake County makes grants only to tax-exempt nonprofit organizations and rarely funds organizations outside Lake County. Grants typically range from $25,000 to $100,000. Our grants to organizations must be used to only serve residents of Antioch, Fox Lake, Grayslake--Third Lake, Great Lakes, Gurnee, and Lake Villa--Lindenhurst, North Chicago, Round Lake, Wadsworth, Waukegan, and Zion. Our grants only fund specific initiatives and do not fund general operating support. The Foundation does not fund Biomedical research, Patient financial aid, Religious activities and Services provided by unqualified persons. A grantee organization may receive up to five consecutive years of funding, at the Foundation's discretion. After five consecutive years of funding the organization will be asked to take a year off in seeking support.
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    wwwhfnlcorg - All applicants must c
    1200 University Center Drive 333
    Grayslake,IL60030
    (847) 377-0525
    www.hfnlc.org
    bThe form in which applications should be submitted and information and materials they should include:
    The Foundation uses an online grant application and management system for both letters of inquiry and full proposals. We do not accept hard copies of either letters of inquiry or proposals. A letter of inquiry must be submitted prior to a full proposal. The letter of inquiry should include a description of the proposed program or project and the outcomes you hope to achieve, an explanation of the need for the program or project, and a budget including expenses and anticipated sources of support. All applications must address the following components: Need, Access, Sustainability and Evaluation. You can download and print the full set of questions from the online grant application and management system after you are invited to submit a full proposal.
    cAny submission deadlines:
    Letter of inquiry due June 15 and December 15 Proposal due (if invited) August 1 and February 1
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    The Healthcare Foundation of Northern Lake County makes grants only to tax-exempt nonprofit organizations and rarely funds organizations outside Lake County. Grants typically range from $25,000 to $100,000. Our grants to organizations must be used to only serve residents of Antioch, Fox Lake, Grayslake--Third Lake, Great Lakes, Gurnee, and Lake Villa--Lindenhurst, North Chicago, Round Lake, Wadsworth, Waukegan, and Zion. Our grants only fund specific initiatives and do not fund general operating support. The Foundation does not fund Biomedical research, Patient financial aid, Religious activities and Services provided by unqualified persons. A grantee organization may receive up to five consecutive years of funding, at the Foundation's discretion. After five consecutive years of funding the organization will be asked to take a year off in seeking support.
    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
    Advocate Charitable Foundation
    3075 Highland Parkway Suite 600
    Downers Grove,IL60515     		None PC Healthcare 36,000
    Antioch Area Health Access Alliance
    874 Main St
    Antioch,IL60002     		None PC Healthcare 120,000
    Arden Shore Child and Family Service
    329 N Genesee Street
    Waukegan,IL60085     		None PC Healthcare 144,092
    Ascend Justice
    555 West Harrison Suite 1900
    Chicago,IL60607     		None PC Healthcare 20,000
    Catholic Charities of the Archdiocese of Chicago
    721 N LaSalle
    Chicago,IL60654     		None PC Healthcare 20,000
    College of Lake County
    19351 W Washington St
    Grayslake,IL60030     		None NC - Public Universi Healthcare 142,500
    Community Youth Network Inc
    18640 W Belvidere Rd
    Grayslake,IL60030     		None PC Healthcare 65,067
    Cristo Rey St Martin College Prep
    3106 Belvidere Road
    Waukegan,IL60085     		None PC Healthcare 65,000
    ElderCARE Lake County
    410 Grand Ave
    Waukegan,IL60085     		None PC Healthcare 45,615
    Equal Hope
    300 S Ashland Ave Ste 202
    Chicago,IL60607     		None PC Healthcare 25,000
    Erie Family Health Center Inc
    1701 W Superior St
    Chicago,IL60622     		None PC Healthcare 125,000
    Family Service of Lake County
    777 Central Ave Ste 17
    Highland Park,IL60035     		None PC Healthcare 40,000
    Hispanic American Community Education & Services Inc
    820 W Greenwood Ave
    Waukegan,IL60087     		None PC Healthcare 60,000
    Josselyn Center
    405 Central Ave
    Northfield,IL60093     		None PC Healthcare 77,500
    Kids Above All fka Childserv
    8765 W Higgins Rd Ste 450
    Chicago,IL60631     		None PC Healthcare 50,000
    Lake County Community Development
    500 W Winchester Rd Unit 101
    Libertyville,IL60048     		None GOV Healthcare 31,875
    Lake County Crisis Center for Prevention & Treatment of Domestic Violence
    2710 17th Street Suite 100
    Zion,IL60099     		None PC Healthcare 55,000
    Lake County Health Department & Community Health Center
    3010 Grand Ave
    Waukegan,IL60085     		None GOV Healthcare 85,000
    Lake County Sheriffs Office
    25 S Martin Luther King Jr Ave
    Waukegan,IL60085     		None GOV Healthcare 50,000
    Mano a Mano Family Resource Center
    6 E Main St
    Round Lake Park,IL60073     		None PC Healthcare 110,000
    Mercy Housing Lakefront
    120 S LaSalle St Suite 1850
    Chicago,IL60603     		None PC Healthcare 10,000
    NICASA NFP
    31979 N Fish Lake Rd
    Round Lake,IL60073     		None PC Healthcare 207,500
    One Hope United
    215 N Milwaukee Ave
    Lake Villa,IL60046     		None PC Healthcare 10,000
    PADS Lake County Inc
    1800 Grand Ave
    Waukegan,IL60085     		None PC Healthcare 185,000
    Rosalind Franklin University Health System
    3333 Green Bay Rd
    North Chicago,IL60064     		None SO I Healthcare 125,000
    Rosalind Franklin University of Medicine & Science
    3333 Green Bay Rd
    North Chicago,IL60064     		None PC Healthcare 50,000
    SGA Youth & Family Services
    11 East Adams Suite 1500
    Chicago,IL60603     		None PC Healthcare 25,000
    The Thresholds
    4101 N Ravenswood
    Chicago,IL60613     		None PC Healthcare 27,500
    United Way of Lake County
    330 South Greenleaf Street
    Gurnee,IL60031     		None PC Healthcare 40,000
    Wauconda Fire District
    109 West Liberty Street
    Wauconda,IL60084     		None GOV Healthcare 63,750
    Waukegan Public Library Foundation
    128 N County St
    Waukegan,IL60085     		None SO I Healthcare 114,713
    Willow House
    2231 Lakeside Drive
    Bannockburn,IL60015     		None PC Healthcare 25,000
    Youth & Family Counseling
    1113 S Milwaukee Ave Ste 104
    Libertyville,IL60048     		None PC Healthcare 10,000
    Youth Conservation Corps
    1020 W Greenwood Ave
    Waukegan,IL60087     		None PC Healthcare 40,000
    Youthbuild Lake County
    1812 Morrow Ave
    North Chicago,IL60064     		None PC Healthcare 37,500
    YWCA Metropolitan Chicago
    1 N LaSalle Street Suite 1700
    Chicago,IL60602     		None PC Healthcare 143,750
    Zacharias Sexual Abuse Center
    4275 Old Grand Avenue
    Gurnee,IL60031     		None PC Healthcare 12,500
    Zion Benton Childrens Service Inc
    1608 23rd St
    Zion,IL60099     		None PC Healthcare 35,000
    Total .................................bullet 3a 2,529,862
    bApproved for future payment
    Arden Shore Child and Family Service
    329 N Genesee Street
    Waukegan,IL60085     		None PC Healthcare 100,000
    Ascend Justice
    555 West Harrison Suite 1900
    Chicago,IL60607     		None PC Healthcare 20,000
    Boys and Girls Club of Lake County
    724 South Genesee
    Waukegan,IL60085     		None PC Healthcare 50,000
    Cancer Wellness Center
    215 Revere Dr
    Northbrook,IL60062     		None PC Healthcare 5,000
    College of Lake County
    19351 W Washington St
    Grayslake,IL60030     		None NC - Public Universi Healthcare 22,500
    Community Youth Network Inc
    18640 W Belvidere Rd
    Grayslake,IL60030     		None PC Healthcare 37,500
    Cristo Rey St Martin College Prep
    3106 Belvidere Road
    Waukegan,IL60085     		None PC Healthcare 20,000
    ElderCARE Lake County
    1701 W Superior St
    Chicago,IL60622     		None PC Healthcare 57,750
    Equal Hope
    300 S Ashland Ave Ste 202
    Chicago,IL60607     		None PC Healthcare 50,000
    Erie Family Health Center
    1701 W Superior St
    Chicago,IL60622     		None PC Healthcare 50,000
    Family Focus Inc
    310 South Peoria Ste 301
    Chicago,IL60607     		None PC Healthcare 40,000
    Family Service of Lake County
    777 Central Ave Ste 17
    Highland Park,IL60035     		None PC Healthcare 35,000
    Hispanic American Community Education & Service Inc
    820 W Greenwood Ave
    Waukegan,IL60087     		None PC Healthcare 17,500
    Josselyn Center
    405 Central Ave
    Northfield,IL60093     		None PC Healthcare 37,500
    Kids Above All fka Childserv
    8765 W Higgins Rd Ste 450
    Chicago,IL60631     		None PC Healthcare 20,000
    Lake County Health Department & Community Health Center
    3010 Grand Ave
    Waukegan,IL60085     		None GOV Healthcare 72,250
    Mano a Mano Family Resource Center
    6 E Main St
    Round Lake Park,IL60073     		None PC Healthcare 85,000
    McDermott Center dba Haymarket Center
    932 W Washington Blvd
    Chicago,IL60607     		None PC Healthcare 50,000
    Mercy Housing Lakefront
    120 S LaSalle St Suite 1850
    Chicago,IL60603     		None PC Healthcare 30,000
    NICASA NFP
    31979 N Fish Lake Rd
    Round Lake,IL60073     		None PC Healthcare 100,000
    PADS Lake County Inc
    1800 Grand Ave
    Waukegan,IL60085     		None PC Healthcare 185,000
    Rosalind Franklin University Health System
    3333 Green Bay Rd
    North Chicago,IL60064     		None SO I Healthcare 50,000
    United Way of Lake County
    330 South Greenleaf Street
    Gurnee,IL60031     		None PC Healthcare 5,000
    Waukegan Public Library Foundation
    128 N County St
    Waukegan,IL60085     		None SO I Healthcare 25,000
    Youth & Family Counseling
    1113 S Milwaukee Ave Ste 104
    Libertyville,IL60048     		None PC Healthcare 75,000
    YouthBuild Lake County
    1812 Morrow Ave
    North Chicago,IL60064     		None PC Healthcare 27,500
    YWCA Metropolitan Chicago
    1 N LaSalle Street Suite 1700
    Chicago,IL60602     		None PC Healthcare 32,500
    Zacharias Sexual Abuse Center
    4275 Old Grand Avenue
    Gurnee,IL60031     		None PC HealthcareHealthcare 12,500
    Zion Benton Childrens Service Inc
    1608 23rd St
    Zion,IL60099     		None PC Healthcare 30,000
    Total .................................bullet 3b 1,342,500
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 2,808,479  
    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 4,027,958 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    4,027,958
    (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:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting fees - E. Vaccariello & Co PC 29,065 27,612   1,453
    Audit fees - Sikich, LLP 10,600 2,650   7,950

    TY 2021 CashDeemedCharitableExplnStmt
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Explanation:
    PART X - LINE 4 - MINIMUM INVESTMENT RETURNThe Healthcare Foundation of Northern Lake County chooses to use the amount of adminstrative expenses and charitable disbursements, as shown in Part I, Line 26D of the return, as the cash deemed held for charitable activities due to the large distributions of the organization.

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2021 DepreciationSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    Three Filing Cabinets (36"wide x 4 drawer) 2008-05-29 1,512 1,512 SL 7.000000000000 0 0    
    Dell Inspirion 15 - Assistant 2017-08-09 1,122 860 SL 5.000000000000 262 0    
    Apple MacBook Pro 2019-11-18 1,673 530 SL 5.000000000000 335 0    
    Dell Inspiron 7000 15 2020-06-15 1,579 316 SL 5.000000000000 315 0    
    HP 15.6 ProBook - Assistant 2022-03-01 1,507   SL 5.000000000000 75 0    
    HP 15.6 ProBook - Exec Director 2022-06-01 1,389   SL 5.000000000000 0 0    

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Name of Stock End of Year Book Value End of Year Fair Market Value
    First Midwest Bank - Equities 43,393,887 43,393,887

    TY 2021 InvestmentsOtherSchedule2
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    First Midwest Bank - Fixed Income FMV 19,453,403 19,453,403

    TY 2021 LandEtcSchedule2
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Three Filing Cabinets (36"wide x 4 drawer) 1,512 1,512 0  
    Apple MacBook Pro 1,673 865 808  
    Dell Inspiron 7000 15 1,579 631 948  
    HP 15.6 ProBook - Assistant 1,507 75 1,432  
    HP 15.6 ProBook - Exec Director 1,389 0 1,389  


    TY 2021 LegalFeesSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Legal fees - Quarles & Brady LLP 5,508 275   5,233


    TY 2021 OtherAssetsSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Accrued Income 15,323 13,640 13,640
    Illinois Workers Compensation Commission 352,067 362,817 362,817
    Section 4940 Excise Tax Deposit 0 16,170 16,170


    TY 2021 OtherDecreasesSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Description Amount
    Unrealized (loss) on investments carried at market value 7,068,147


    TY 2021 OtherExpensesSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Advertising 3,879 0   3,879
    Bank charges 474 474   0
    Dues and memberships 1,515 0   1,515
    Licenses and fees 275 0   275
    Outside services 20,039 601   19,438
    Postage and shipping 532 0   532
    Telephone 2,089 63   2,026
    Insurance 4,992 262   4,730
    Supplies 8,647 592   8,055
    Service contracts 4,750 0   4,750
    Repairs and maintenance 421 0   421


    TY 2021 OtherIncomeSchedule2
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Other Income 10,750 10,750 10,750


    TY 2021 OtherLiabilitiesSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Description Beginning of Year - Book Value End of Year - Book Value
    Section 4940 Excise Tax Payable 10,197 0


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment management - Ellwood Associates 35,493 35,493   0
    Investment custodial - First Midwest Bank 14,163 14,163   0
    Consulting - Leading Healthy Futures 55,600 0   55,600
    Consulting - Jenny Richards 15,000 0   15,000
    Investment management - CAPTRUST 35,942 35,942   0
    Consulting - Partners in Capacity LLC 5,700 0   5,700
    Consulting 13,650 0   13,650
    Marketing - Kym Abrams Design Inc 32,525 0   32,525
    Recruiting - Kittleman & Assoc LLC 73,964 0   73,964


    TY 2021 TaxesSchedule
    Name:
    Healthcare Foundation of Northern Lake
     
    County
    EIN:
    20-5253008
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Foreign Tax W/H 15,659 15,659   0
    Section 4940 excise tax 53,633 0   0