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 07-01-2021 , and ending 06-30-2022
Name of foundation
PEMCO FOUNDATION INC
 
Number and street (or P.O. box number if mail is not delivered to street address)1300 DEXTER AVE N
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SEATTLE, WA98109
A Employer identification number

91-6072723
B Telephone number (see instructions)

(206) 628-4285
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$2,510,707J 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) 574,099
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 50,477 50,477  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 92,369
b Gross sales price for all assets on line 6a 663,499
7 Capital gain net income (from Part IV, line 2)... 92,369
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 716,945 142,846 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)....... Click to see attachment 3,500 0 0 0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 2,510 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 2,827 2,827 0 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 8,837 2,827 0 0
25 Contributions, gifts, grants paid....... 370,089 370,089
26 Total expenses and disbursements. Add lines 24 and 25 378,926 2,827 0 370,089
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 338,019
b Net investment income (if negative, enter -0-) 140,019
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............. 18,374 99,895 99,895
2 Savings and temporary cash investments.........      
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).......... 2,310,416 Click to see attachment2,410,812 2,410,812
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) 2,328,790 2,510,707 2,510,707
Liabilities 17 Accounts payable and accrued expenses.......... 25,474 42,087
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 25,474 42,087
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........... 1,532,417 1,697,721
25 Net assets with donor restrictions............ 770,899 770,899
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)..... 2,303,316 2,468,620
30 Total liabilities and net assets/fund balances (see instructions). 2,328,790 2,510,707
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
2,303,316
2
Enter amount from Part I, line 27a .....................
2
338,019
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
6,640
4
Add lines 1, 2, and 3 ..........................
4
2,647,975
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
179,355
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,468,620
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 PUBLICLY TRADED SECURITIES      
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 663,499   571,130 92,369
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       92,369
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 92,369
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 92,369
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 1,946
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 1,946
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 1,619
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 1,619
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 9 327
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 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
     
    No
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bullet
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
     
    No
    Website addressbulletN/A
    14
    The books are in care ofbulletLESLIE HAYDEN Telephone no.bullet (206) 628-4285

    Located atbullet1300 DEXTER AVE NSEATTLEWA ZIP+4bullet98109
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
    Yes
     
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
    No
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    STAN W MCNAUGHTON PRESIDENT & TREASURER
    0.50     		0 0 0
    1300 DEXTER AVE N
    SEATTLE,WA98106
    SANDRA M KURACK VICE-PRESIDENT
    0.25     		0 0 0
    1300 DEXTER AVE N
    SEATTLE,WA98106
    DENICE M TOWN SECRETARY
    0.50     		0 0 0
    1300 DEXTER AVE N
    SEATTLE,WA98106
    BRIAN R MCNAUGHTON TRUSTEE
    0.25     		0 0 0
    1300 DEXTER AVE N
    SEATTLE,WA98106
    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
    2,562,565
    b
    Average of monthly cash balances.......................
    1b
    207,546
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,770,111
    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
    2,770,111
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    41,552
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    2,728,559
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    136,428
    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
    136,428
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    1,946
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,946
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    134,482
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    134,482
    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
    134,482
    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 7 134,482
    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...... 241,360
    b From 2017...... 173,037
    c From 2018...... 352,803
    d From 2019...... 152,678
    e From 2020...... 264,406
    f Total of lines 3a through e ........ 1,184,284
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 370,089
    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..... 134,482
    e Remaining amount distributed out of corpus 235,607
    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 1,419,891
    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) ...     		241,360
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		1,178,531
    10 Analysis of line 9:
    a Excess from 2017.... 173,037
    b Excess from 2018.... 352,803
    c Excess from 2019.... 152,678
    d Excess from 2020.... 264,406
    e Excess from 2021.... 235,607
    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:
    SCHOLARSHIPS CO PEMCO FOUNDATION
    1300 DEXTER AVE N
    SEATTLE,WA98109
    (206) 628-4285
    SCHOLARSHIPS@PEMCO.COM
    bThe form in which applications should be submitted and information and materials they should include:
    APPLICATIONS SHOULD BE MAILED, EMAILED, OR FAXED TO THE FOUNDATION. A COMPLETED APPLICATION INCLUDES: A COPY OF AN OFFICIAL TRANSCRIPT, THREE LETTERS OF RECOMMENDATION, AND A BUDGET FORM FOR THE UPCOMING TERM.
    cAny submission deadlines:
    APPLICATIONS SHOULD BE SUBMITTED TO THE FOUNDATION 30 DAYS BEFORE THE QUARTER OR SEMESTER BEGINS.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    APPLICANTS ARE LIMITED TO DEPENDANTS OF EMYPLOYEES OF PEMCO INSURANCE WHO HAVE OR WILL GRADUATE HIGH SCHOOL AND ATTEND A UNIVERSITY OR COLLEGE. APPLICANTS ARE REQUIRED TO MAINTAIN A COURSE LOAD MINIMUM OF 10 CREDITS PER SEMESTER/QUARTER. TO BE ELIGIBLE, THE EMPLOYEE MUST HAVE HELD EMPLOYMENT WITH PEMCO INSURANCE FOR AT LEAST THREE YEARS.
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    PEMCO FOUNDATION INC
    PO BOX 778
    SEATTLE,WA98111
    (206) 628-4285
    SCHOLARSHIPS@PEMCO.COM
    bThe form in which applications should be submitted and information and materials they should include:
    APPLICATIONS SHOULD BE MAILED, EMAILED, OR FAXED TO THE FOUNDATION. A COMPLETED APPLICATION INCLUDES: A COPY OF AN OFFICIAL TRANSCRIPT, THREE LETTERS OF RECOMMENDATION, AND A PERSONAL INTERVIEW, IF REQUESTED, BEFORE THE SCHOLARSHIP COMMITTEE.
    cAny submission deadlines:
    APPLICATIONS SHOULD BE SUBMITTED TO THE FOUNDATION 30 DAYS BEFORE THE QUARTER OR SEMESTER BEGINS.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    APPLICANTS ARE LIMITED TO PERSONS WHO HAVE OR WILL GRADUATE HIGH SCHOOL AND ATTEND A UNIVERSITY OR COLLEGE. APPLICANTS ARE REQUIRED TO MAINTAIN A COURSE LOAD MINIMUM OF 10 CREDITS PER SEMESTER/QUARTER.
    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
    CASCADE PUBLIC MEDIA
    401 MERCER STREET
    SEATTLE,WA98109     		  501(C)(3) GOLDEN APPLE AWARDS 57,000
    INDEPENDENT COLLEGES OF WASHINGTON
    600 STEWART ST SUITE 600
    SEATTLE,WA98101     		  501(C)(3) DONATION 45,000
    WASHINGTON BUSINESS WEEK
    PO BOX 1170
    RENTON,WA98057     		  501(C)(3) DONATION 30,310
    AMERICAN RED CROSS
    1900 25TH AVE S
    SEATTLE,WA98122     		  501(C)(3) DONATION 26,347
    PHCC SPECIAL EVENTS CHRISTMAS TREE AUCTION
    ATTN PATRICIA SZABO 2811 S 102ND ST
    TUKWILA,WA98168     		  501(C)(3) DONATION 21,500
    CRIMESTOPPERS OF PUGET SOUND
    PO BOX 906
    BELLEVUE,WA98009     		  501(C)(3) DONATION 18,000
    CAMP FIRE OF SNOHOMISH COUNTY
    4312 RUCKER AVENUE
    EVERETT,WA98203     		  501(C)(3) DONATION 15,000
    EASTERN WASHINGTON UNIVERSITY FOUNDATION
    127 HARGREAVES HALL
    CHENEY,WA99004     		  501(C)(3) DONATION 10,237
    FIRST AME CHURCH
    1522 14TH AVENUE
    SEATTLE,WA98122     		  501(C)(3) DONATION 10,000
    JOYA CHILD & FAMILY DEVELOPMENT
    2118 WEST GARLAND AVE
    SPOKANE,WA99205     		  501(C)(3) DONATION 10,000
    JUNIOR ACHIEVEMENT OF WASHINGTON
    1610 PERIMETER RD
    AUBURN,WA98001     		  501(C)(3) DONATION 10,000
    YOUGIVEGOODS FOUNDATION
    88 EAST MAIN ST SUITE 406
    MENDHAM,NJ07945     		  501(C)(3) DONATION 9,975
    SEATTLE PUBLIC LIBRARY
    1000 FOURTH AVE
    SEATTLE,WA98104     		  501(C)(3) DONATION 5,000
    YMCA YOUTH AND GOVERNMENT PROGRAM
    909 4TH AVE
    SEATTLE,WA98104     		  501(C)(3) DONATION 5,000
    BIG BROTHERSBIG SISTERS
    222 W MISSION AVE STE 40
    SPOKANE,WA99201     		  501(C)(3) DONATION 3,500
    MARY'S PLACE
    PO BOX 1711
    SEATTLE,WA98111     		  501(C)(3) DONATION 2,550
    EMBRACE WASHINGTON
    2202 E SPRAGUE AVE STE 3
    SPOKANE,WA99202     		  501(C)(3) DONATION 2,500
    HOLLY HOUSE
    4211 ALDERWOOD MALL BLVD SUITE 205
    LYNNWOOD,WA98036     		  501(C)(3) DONATION 2,500
    TABOR 100
    7100 FORT DENT WAY STE 100
    TUKWILA,WA98188     		  501(C)(3) DONATION 2,500
    TOYS FOR TOTS
    18251 QUANTICO GATEWAY DR
    TRAINGLE,VA22172     		  501(C)(3) DONATION 2,500
    TREEHOUSE
    2100 24TH AVE S 200
    SEATTLE,WA98144     		  501(C)(3) DONATION 2,500
    ADDIS WAGENER
    1660 KENARD ST NW
    SALEM,OR97304     		  INDIVIDUAL SCHOLARSHIP 2,400
    NAMIC
    PO BOX 68700
    INDIANAPOLIS,IN46268     		  501(C)(3) DONATION 2,000
    PAWS
    PO BOX 1037
    LYNNWOOD,WA98046     		  501(C)(3) DONATION 1,955
    JASON KIM
    23820 114TH AVE SE
    KENT,WA98031     		  INDIVIDUAL SCHOLARSHIP 1,500
    JIMMY WHITE
    21346 SE 265 ST
    MAPLE VALEY,WA98038     		  INDIVIDUAL SCHOLARSHIP 1,500
    MARYAM ASLAM
    4061 S 262ND ST
    KENT,WA98032     		  INDIVIDUAL SCHOLARSHIP 1,500
    OLAWUMI OLANIYAN
    17710 33RD DRIVE SE
    BOTHELL,WA98012     		  INDIVIDUAL SCHOLARSHIP 1,500
    ZANIYA ELLE
    17633 SE 162ND PL
    RENTON,WA98058     		  INDIVIDUAL SCHOLARSHIP 1,500
    CLAIRE LANG
    2037 BERRY ST NE
    OLYMPIA,WA98506     		  INDIVIDUAL SCHOLARSHIP 1,250
    ISABELLA BOLEN
    1209 175TH PL SW
    LYNNWOOD,WA98037     		  INDIVIDUAL SCHOLARSHIP 1,250
    JILLIAN OSBURN
    20928 53RD AVE W
    LYNNWOOD,WA98036     		  INDIVIDUAL SCHOLARSHIP 1,250
    RACHEL MCAMIS
    3916 N 31ST ST
    TACOMA,WA98407     		  INDIVIDUAL SCHOLARSHIP 1,250
    RILEY BECK
    9216 215TH ST SW
    EDMONDS,WA98020     		  INDIVIDUAL SCHOLARSHIP 1,250
    SOPHIA AUSTVOLD
    3632 165TH PL SW
    LYNNWOOD,WA98037     		  INDIVIDUAL SCHOLARSHIP 1,250
    ANDREA TALAMANTES
    3900 VETERANS DR APT H304
    KENT,WA98032     		  INDIVIDUAL SCHOLARSHIP 1,050
    CENTRAL COAST HUMANE SOCIETY
    310 SW 2ND STREET
    NEWPORT,OR97365     		  501(C)(3) DONATION 920
    AMERICAN HEART ASSOCIATION
    710 2ND AVE STE 900
    SEATTLE,WA98104     		  501(C)(3) DONATION 915
    PROJECT GIRL MENTORING PROGRAM
    4114 198TH ST SW 4
    LYNNWOOD,WA98036     		  501(C)(3) DONATION 915
    BRITTANY ANDERSON
    17819 79TH DR NE
    ARLINGTON,WA98223     		  INDIVIDUAL SCHOLARSHIP 900
    CAITLYNNE BURKE
    5014 TAMARISK DR
    PASCO,WA99301     		  INDIVIDUAL SCHOLARSHIP 900
    CATHERINE AHRENDT
    PO BOX 628
    NINE MILE FALLS,WA99026     		  INDIVIDUAL SCHOLARSHIP 900
    CHEER SEATTLE
    PO BOX 24042
    SEATTLE,WA98124     		  501(C)(3) DONATION 900
    CIARRA JUDSON
    210 BERKELEY AVE
    FIRCREST,WA98466     		  INDIVIDUAL SCHOLARSHIP 900
    CLAIRE GOLDING
    6912 320TH ST E
    EATONVILLE,WA98328     		  INDIVIDUAL SCHOLARSHIP 900
    DASAANI BASCOMB-BROWN
    11100 SE PETROVISKY RD APT F104
    RENTON,WA98055     		  INDIVIDUAL SCHOLARSHIP 900
    EMILY BARRY
    4984 ADMIRAL ST
    GIG HARBOR,WA98332     		  INDIVIDUAL SCHOLARSHIP 900
    EMILY BUNDY
    411 HARVEL LN
    PORT ANGELES,WA98362     		  INDIVIDUAL SCHOLARSHIP 900
    EMILY LOCKMAN
    265 NW WASHINGTON ST
    WHITE SALMON,WA98672     		  INDIVIDUAL SCHOLARSHIP 900
    EMMA LEDBETTER
    12103 SE 71ST PL
    NEWCASTLE,WA98056     		  INDIVIDUAL SCHOLARSHIP 900
    JT TUMANUVAO
    3603 SE 198TH AVE
    CAMAS,WA98607     		  INDIVIDUAL SCHOLARSHIP 900
    JANESSA COLBURN
    PO BOX 115
    TROUT LAKE,WA98650     		  INDIVIDUAL SCHOLARSHIP 900
    JASMINE CARRINGER
    832 10TH STREET
    CLARKSTON,WA99403     		  INDIVIDUAL SCHOLARSHIP 900
    MADISON SHERMAN
    1303 SPRUCE ST
    LONGVIEW,WA98632     		  INDIVIDUAL SCHOLARSHIP 900
    MAKESHA CONZUELO
    1825 SOUTH STEVENS ST APT 16
    TACOMA,WA98405     		  INDIVIDUAL SCHOLARSHIP 900
    MEGAN LOW
    5519 1ST AVE SE
    EVERETT,WA98203     		  INDIVIDUAL SCHOLARSHIP 900
    MEGAN WILKS
    297 CHILVERS ROAD
    CHEHALIS,WA98532     		  INDIVIDUAL SCHOLARSHIP 900
    RAVEN CLARK
    1031 CENTRAL DRIVE
    COULEE DAM,WA99116     		  INDIVIDUAL SCHOLARSHIP 900
    REILLY SCHOENING
    6223 PINE FLATS LOOP
    CASHMERE,WA98815     		  INDIVIDUAL SCHOLARSHIP 900
    SAMANTHA VANLOO
    2039 HALVERSTICK RD
    LYNDEN,WA98264     		  INDIVIDUAL SCHOLARSHIP 900
    SIERRA PAULEY
    1590 JUNIPER RD
    MESA,WA99343     		  INDIVIDUAL SCHOLARSHIP 900
    SOFIA LEOTTA
    2005 CASTLE DRIVE
    BOTHELL,WA98021     		  INDIVIDUAL SCHOLARSHIP 900
    SOPHIE BLASINGIM
    14018 SW 220 ST
    VASHON,WA98070     		  INDIVIDUAL SCHOLARSHIP 900
    SUMMER ISABEL
    4422 S PINEGROVE LANE
    SPOKANE,WA99223     		  INDIVIDUAL SCHOLARSHIP 900
    SYDNEY WILLOUGHBY
    5512 NE 26TH ST
    RENTON,WA98059     		  INDIVIDUAL SCHOLARSHIP 900
    TABITHA REVAK
    PO BOX 673
    EVERSON,WA98247     		  INDIVIDUAL SCHOLARSHIP 900
    TARYN GENGER
    5876 STORR RD
    FERNDALE,WA98248     		  INDIVIDUAL SCHOLARSHIP 900
    WRITE253
    2602 S 38TH ST BOX 285
    LAKEWOOD,WA98409     		  501(C)(3) DONATION 895
    VANESSA BEHAN CRISIS NURSERY
    1004 E 8TH AVE
    SPOKANE,WA99202     		  501(C)(3) DONATION 765
    ALLISON HOLDER
    2713 45TH AVE SE
    OLYMPIA,WA98501     		  INDIVIDUAL SCHOLARSHIP 750
    KASSIDY NAEF
    61 GEMINI DRIVE
    PASCO,WA99301     		  INDIVIDUAL SCHOLARSHIP 750
    MALLORY SWENSON
    18133 46TH DR SE
    BOTHELL,WA98012     		  INDIVIDUAL SCHOLARSHIP 750
    EARLY LEARNING & DEVELOPMENT CENTER
    225 N 70TH ST
    SEATTLE,WA98103     		  501(C)(3) DONATION 715
    RICHARD HUGO HOUSE
    1634 11TH AVE
    SEATTLE,WA98122     		  501(C)(3) DONATION 705
    ONE HEART
    10101 N NEVADA ST
    SPOKANE,WA99218     		  501(C)(3) DONATION 655
    PROVAIL
    12550 AURORA AVE NORTH
    SEATTLE,WA98133     		  501(C)(3) DONATION 655
    BETHANY LOCKE
    13837 SE 78TH PL
    NEW CASTLE,WA98059     		  INDIVIDUAL SCHOLARSHIP 600
    BREANN JONES
    419 NW 150TH WAY
    VANCOUVER,WA98685     		  INDIVIDUAL SCHOLARSHIP 600
    ELIZABETH SCOTT
    1203 NORTH WILLOW STREET
    ELLENSBURG,WA98926     		  INDIVIDUAL SCHOLARSHIP 600
    ERICA GIBSON
    32704 2ND PL S
    FEDERAL WAY,WA98003     		  INDIVIDUAL SCHOLARSHIP 600
    GYNNA DOYLE
    5216 MADRID LANE
    PASCO,WA99301     		  INDIVIDUAL SCHOLARSHIP 600
    KATELYN SEELIG
    REMIT 431 WINDSOR DR SE
    SAMMAMISH,WA98074     		  INDIVIDUAL SCHOLARSHIP 600
    SARAH DIXON
    PO BOX 193
    MALOTT,WA98829     		  INDIVIDUAL SCHOLARSHIP 600
    SENECA DEHUFF
    PO BOX 529
    EASTON,WA98925     		  INDIVIDUAL SCHOLARSHIP 600
    TASHA KOISTINEN
    2817 NE CEDAR CREEK RD
    WOODLAND,WA98674     		  INDIVIDUAL SCHOLARSHIP 600
    COCOON HOUSE
    2929 PINE ST
    EVERETT,WA98201     		  501(C)(3) DONATION 500
    SEATTLE UNIVERSITY - ALBERS SCHOOL OF BUSINESS
    PO BOX 222000
    SEATTLE,WA98122     		  501(C)(3) DONATION 500
    ALYSSA TANNEBERG
    5204 GRAHAM AVENUE
    SUMNER,WA98390     		  INDIVIDUAL SCHOLARSHIP 450
    ASHLYNN TIBBOT
    2733 DIAMOND STREET UNIT B
    MILTON,WA98354     		  INDIVIDUAL SCHOLARSHIP 450
    CORRIGAN NIEL
    170 LANGFORD ROAD
    ELTOPIA,WA99330     		  INDIVIDUAL SCHOLARSHIP 450
    ELLA TRUE
    23133 RD J3 NE
    STRATFORD,WA98853     		  INDIVIDUAL SCHOLARSHIP 450
    EMILY DRISKEL
    2618 W JARED CT
    SPOKANE,WA99208     		  INDIVIDUAL SCHOLARSHIP 450
    EMILY ROSENKRANZ
    1203 E PIONEER LOOP
    LA CENTER,WA98629     		  INDIVIDUAL SCHOLARSHIP 450
    EVELYN BOLLES
    8908 W RUTTER PARKWAY
    SPOKANE,WA99208     		  INDIVIDUAL SCHOLARSHIP 450
    GABRIELA VELAZQUEZ
    2105 BRIDGEPORT WAY WEST
    UNIVERSITY PLACE,WA98466     		  INDIVIDUAL SCHOLARSHIP 450
    GRACE JACOBSEN
    4922 NE 237TH AVE
    VANCOUVER,WA98682     		  INDIVIDUAL SCHOLARSHIP 450
    JAELA THORNBURG
    7610 S WEST TERRACE DR
    CHENEY,WA99004     		  INDIVIDUAL SCHOLARSHIP 450
    JENNA ESTEP
    23215 37TH AVE NE
    ARLINGTON,WA98223     		  INDIVIDUAL SCHOLARSHIP 450
    LAUREN KERT
    62 MOUNTAINSIDE DRIVE
    CASHMERE,WA98815     		  INDIVIDUAL SCHOLARSHIP 450
    LYNDSI STREETER
    195 VIEWMONT DRIVE
    OKANOGAN,WA98840     		  INDIVIDUAL SCHOLARSHIP 450
    MADISON FREEMAN
    27130 SE 25TH PL
    SAMMAMISH,WA98075     		  INDIVIDUAL SCHOLARSHIP 450
    MEGHAN CALLAWAY
    172 KRANICHWOOD ST
    RICHLAND,WA99352     		  INDIVIDUAL SCHOLARSHIP 450
    OLIVIA STOLLER-BLACK
    383 ORCHARD WAY
    WAPATO,WA98951     		  INDIVIDUAL SCHOLARSHIP 450
    PEYTON OGLE
    8431 BERTHUSEN RD
    LYNDEN,WA98264     		  INDIVIDUAL SCHOLARSHIP 450
    SAVANNAH LARSON
    1695 ANTHEM LANE SW
    TUMWATER,WA98512     		  INDIVIDUAL SCHOLARSHIP 450
    SIDNEY APPEL
    123 651 SR 26
    COLFAX,WA99111     		  INDIVIDUAL SCHOLARSHIP 450
    SYDNEY SCHMIERER
    799 NW COLE AVE
    WILBUR,WA99185     		  INDIVIDUAL SCHOLARSHIP 450
    TAYLOR LANGHAIM
    127 SKIVIEW DRIVE
    WINLOCK,WA98596     		  INDIVIDUAL SCHOLARSHIP 450
    TAYLOR NAMCHEK
    PO BOX 1104
    CONNELL,WA99326     		  INDIVIDUAL SCHOLARSHIP 450
    THALISA SALDIVAR
    880 ROCKY FORD ROAD
    TOPPENISH,WA98948     		  INDIVIDUAL SCHOLARSHIP 450
    TYLER HOPP
    14125 SE 281ST ST
    KENT,WA98042     		  INDIVIDUAL SCHOLARSHIP 450
    AMY BOEDIGHEIMER
    1301 N WILLOW ST APT6
    ELLENSBURG,WA98926     		  INDIVIDUAL SCHOLARSHIP 300
    EMMA ODOM
    8184 HIGHWAY 14
    LYLE,WA98635     		  INDIVIDUAL SCHOLARSHIP 300
    MADELINE MCKINNEY
    4908 E PATRICIA RD
    MEAD,WA99021     		  INDIVIDUAL SCHOLARSHIP 300
    MADISON SAIZ
    2216 W 12TH ST
    PORT ANGELES,WA98363     		  INDIVIDUAL SCHOLARSHIP 300
    NAOMI ELYARD-JAEGER
    PO BOX 251
    HUSUM,WA98623     		  INDIVIDUAL SCHOLARSHIP 300
    REID COLKITT
    4130 RIDGE RD W
    UNIVERSITY PLACE,WA98466     		  INDIVIDUAL SCHOLARSHIP 300
    CHILD
    2640 BENSON RD S
    RENTON,WA98055     		  501(C)(3) DONATION 250
    WHITMAN COLLEGE
    345 BOYER AVE
    WALLA WALLA,WA99362     		  501(C)(3) DONATION 250
    WILLAMETTE UNIVERSITY
    900 STATE STREET
    SALEM,OR97301     		  501(C)(3) DONATION 250
    NATHAN MOORE
    4260 HUDSON RD
    OUTLOOK,WA98938     		  INDIVIDUAL SCHOLARSHIP 225
    PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
    2811 S 102ND ST SUITE 220
    TUKWILA,WA98168     		  501(C)(3) DONATION 200
    UNIVERSITY OF ROCHESTER
    PO BOX 270032
    ROCHESTER,NY14627     		  501(C)(3) DONATION 150
    UNIVERSITY OF WASHINGTON
    PO BOX 359305
    SEATTLE,WA98195     		  501(C)(3) DONATION 150
    WOLF HAVEN INTERNATIONAL
    3111 OFFUT LAKE ROAD SE
    TENINO,WA98589     		  501(C)(3) DONATION 150
    ALDERWOOD BOYS & GIRLS CLUB
    19719 24TH AVE W
    LYNNWOOD,WA98036     		  501(C)(3) DONATION 100
    EVERETT GOSPEL MISSION
    PO BOX 544
    EVERETT,WA98206     		  501(C)(3) DONATION 100
    MUST
    4093 LETITIA AVENUE SOUTH
    SEATTLE,WA98118     		  501(C)(3) DONATION 100
    RONALD MCDONALD HOUSE OF INLAND NW
    1028 W 5TH AVENUE
    SPOKANE,WA99204     		  501(C)(3) DONATION 100
    WASHINGTON STEM
    210 S HUDSON STREET
    SEATTLE,WA98134     		  501(C)(3) DONATION 100
    FIRST WASHINGTON
    22426 72ND AVENUE SOUTH
    KENT,WA98032     		  501(C)(3) DONATION 50
    Total .................................bullet 3a 370,089
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    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 92,369  
    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) .. 0 142,846 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    142,846
    (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
    PEMCO FOUNDATION INC
     
    Employer identification number

    91-6072723
    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
    PEMCO FOUNDATION INC
          		Employer identification number
    91-6072723
    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
    PEMCO MUTUAL INSURANCE COMPANY
     
    1300 DEXTER AVE N
     
    SEATTLE, WA98109

    		$ 570,016


    (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
    PEMCO FOUNDATION INC
          		Employer identification number

    91-6072723
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    1
    		 STOCKS $ 570,016 2021-08-12
    (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
    PEMCO FOUNDATION INC
          		Employer identification number

    91-6072723
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    PEMCO FOUNDATION INC
    EIN:
    91-6072723
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 3,500 0 0 0

    TY 2021 InvestmentsOtherSchedule2
    Name:
    PEMCO FOUNDATION INC
    EIN:
    91-6072723
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    VANGUARD FUNDS AT COST 2,410,812 2,410,812

    TY 2021 OtherDecreasesSchedule
    Name:
    PEMCO FOUNDATION INC
    EIN:
    91-6072723
    Description Amount
    UNREALIZED LOSS 179,355


    TY 2021 OtherExpensesSchedule
    Name:
    PEMCO FOUNDATION INC
    EIN:
    91-6072723
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK FEES 2,827 2,827 0 0


    TY 2021 OtherIncreasesSchedule
    Name:
    PEMCO FOUNDATION INC
    EIN:
    91-6072723
    Description Amount
    RETURNED GRANTS 6,640


    TY 2021 TaxesSchedule
    Name:
    PEMCO FOUNDATION INC
    EIN:
    91-6072723
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL INCOME TAX 2,510 0 0 0