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 12-01-2021 , and ending 11-30-2022
Name of foundation
SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 29522
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
RALEIGH, NC27626
A Employer identification number

56-6235902
B Telephone number (see instructions)

(919) 755-7148
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$683,264J 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... 22,580 22,536  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 61,630
b Gross sales price for all assets on line 6a 545,969
7 Capital gain net income (from Part IV, line 2)... 61,630
8 Net short-term capital gain......... 0
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........ 84,210 84,166  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 7,500 7,500    
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... Click to see attachment 750 750 0 0
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 988 394   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 9,238 8,644 0 0
25 Contributions, gifts, grants paid....... 21,500 21,500
26 Total expenses and disbursements. Add lines 24 and 25 30,738 8,644 0 21,500
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 53,472
b Net investment income (if negative, enter -0-) 75,522
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.............      
2 Savings and temporary cash investments......... 23,166 25,628 25,628
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
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 bullet0      
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)....... 186,834 Click to see attachment170,816 149,592
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 437,369 Click to see attachment503,973 508,044
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) 647,369 700,417 683,264
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 647,369 700,417
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)..... 647,369 700,417
30 Total liabilities and net assets/fund balances (see instructions). 647,369 700,417
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
647,369
2
Enter amount from Part I, line 27a .....................
2
53,472
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
204
4
Add lines 1, 2, and 3 ..........................
4
701,045
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
628
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
700,417
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 68.912 COLUMBIA CONTRARIAN CORE FUND INSTL #6262   2020-12-10 2021-12-06
b 842.691 COLUMBIA CONTRARIAN CORE FUND INSTL #6262     2021-12-06
c 2.306 GOLDMAN SACHS EMERGING MARKETS EQUITY INSIGHTS FUND CLASS R6 #46   2020-11-10 2021-12-06
d 57. ISHARES RUS TOP 200 ETF     2021-12-31
e 2.059 JOHNSON ENHANCED RETURN FUND   2020-01-06 2021-12-31
73.53 JOHNSON ENHANCED RETURN FUND     2021-12-31
42.518 FEDERATED HERMES MDT SMALL CAP CORE FUND     2022-01-11
277.55 PIMCO STOCKSPLUS SMALL FUND - INST #1885     2022-01-11
409.616 PIMCO STOCKSPLUS SMALL FUND - INST #1885     2022-01-11
21.106 INVESCO SMALL CAP VALUE FUND CLASS Y #8770   2022-01-11 2022-05-04
216.231 AMERICAN BEACON GARCIA HAMILTON QUALITY BOND FUND CL R5 #4851     2022-05-04
336.546 BAIRD INTERMEDIATE BOND FD INSTL #70   2021-04-06 2022-05-04
19.517 FEDERATED HERMES MDT SMALL CAP CORE FUND     2022-05-04
108.189 GOLDMAN SACHS INTERNATIONAL SMALL CAP INSIGHTS FUND CLASS R6 #     2022-05-04
443.531 GOLDMAN SACHS INTERNATIONAL SMALL CAP INSIGHTS FUND CLASS R6 #     2022-05-04
42. ISHARES RUS TOP 200 ETF   2020-10-05 2022-05-04
146.034 MAINSTAY CBRE GLOBAL INFRASTRUCTURE FUND CLASS I #5023     2022-05-04
168.443 NUVEEN GLOBAL INFRASTRUCTURE FUND CLASS I #6726     2022-05-04
25. PROSHARES TR DJ BROOKFIELD GLOBAL INFRASTRUCTURE ETF     2022-05-04
23.521 T ROWE PRICE US EQUITY RESEARCH FUND CL I #358     2022-05-04
177.767 VANGUARD SHORT TERM BOND INDEX ADM #5132   2020-07-13 2022-05-04
12. VANGUARD SCOTTSDALE FDS VNG RUS2000IDX   2020-07-13 2022-05-04
164.298 BLACKROCK MID-CAP GROWTH EQUITY PORTFOLIO CLASS K #1943     2022-07-19
414.06 BLACKROCK MID-CAP GROWTH EQUITY PORTFOLIO CLASS K #1943   2020-10-05 2022-07-19
323.867 FIDELITY MID CAP INDEX FUND INST PREMIUM #2352     2022-07-19
1974.677 FIDELITY MID CAP INDEX FUND INST PREMIUM #2352     2022-07-19
378. ISHARES RUS TOP 200 ETF     2022-07-19
1385. ISHARES RUS TOP 200 ETF     2022-07-19
647.528 JOHNSON ENHANCED RETURN FUND     2022-07-19
1501.82 JOHNSON ENHANCED RETURN FUND     2022-07-19
46.449 MFS MID CAP VALUE R6 #4837     2022-07-19
695.059 MFS MID CAP VALUE R6 #4837     2022-07-19
1.767 PIMCO STOCKSPLUS INTERNATIONAL FUND UNHEDGED INST #321   2021-07-21 2022-07-19
540.122 PIMCO STOCKSPLUS INTERNATIONAL FUND UNHEDGED INST #321   2020-03-23 2022-07-19
27.665 T ROWE PRICE US EQUITY RESEARCH FUND CL I #358     2022-07-19
878.745 T ROWE PRICE US EQUITY RESEARCH FUND CL I #358     2022-07-19
408.669 PIMCO STOCKSPLUS INTERNATIONAL FUND UNHEDGED INST #321     2022-07-26
148.167 PIMCO STOCKSPLUS INTERNATIONAL FUND UNHEDGED INST #321   2021-07-21 2022-07-26
127.825 AMERICAN BEACON GARCIA HAMILTON QUALITY BOND FUND CL R5 #4851   2021-01-07 2022-08-01
178.941 ARTISAN INTERNATIONAL SMALL-MID FUND INSTL #2467     2022-08-01
238.33 BAIRD INTERMEDIATE BOND FD INSTL #70   2021-07-21 2022-08-01
36. ISHARES RUSSELL MID-CAP VALUE ETF   2022-07-19 2022-08-01
29. ISHARES RUSSELL MID-CAP GROWTH ETF   2022-07-19 2022-08-01
433. ISHARES RUSSELL TOP 200 VALUE ETF   2022-07-19 2022-08-01
284. ISHARES RUSSELL TOP 200 GROWTH ETF   2022-07-19 2022-08-01
279.545 MAINSTAY CBRE GLOBAL INFRASTRUCTURE FUND CLASS I #5023     2022-08-01
335.911 NUVEEN GLOBAL INFRASTRUCTURE FUND CLASS I #6726     2022-08-01
300.095 PEAR TREE POLARIS FGN VAL SM CAP R6 #1046     2022-08-01
36. PROSHARES TR DJ BROOKFIELD GLOBAL INFRASTRUCTURE ETF     2022-08-01
210.696 ALLSPRING CORE BOND FUND R6 CLASS #4657   2020-08-11 2022-08-01
18.084 AMERICAN BEACON GARCIA HAMILTON QUALITY BOND FUND CL R5 #4851   2021-01-07 2022-08-03
2.633 ARTISAN INTERNATIONAL SMALL-MID FUND INSTL #2467   2020-05-04 2022-08-03
11.004 ASHMORE EMERGING MARKETS ACTIVE EQUITY FUND - INST   2021-07-21 2022-08-03
3.987 BALLIE GIFFORD EMERGING MARKETS EQUITIES FUND CLASS K   2021-07-21 2022-08-03
32.856 BAIRD INTERMEDIATE BOND FD INSTL #70   2021-07-21 2022-08-03
5.849 BLACKROCK HIGH YIELD BOND PORTFOLIO CLASS K #340   2022-08-01 2022-08-03
1.043 COHEN & STEERS REAL ESTATE SECURITIES FUND CLASS I #1260   2022-08-01 2022-08-03
10.031 DELAWARE SMALL CAP GROWTH FUND INST   2022-01-11 2022-08-03
3.229 FEDERATED HERMES MDT SMALL CAP CORE FUND   2021-07-21 2022-08-03
10.848 GOLDMAN SACHS EMERGING MARKETS EQUITY INSIGHTS FUND CLASS R6 #4   2021-07-21 2022-08-03
5.568 HARTFORD EMERGING MARKETS LOCAL DEBT FUND CLASS Y #1025   2022-08-01 2022-08-03
15.723 WCM FOCUSED INTERNATIONAL GROWTH FUND #840     2022-08-03
10. ISHARES RUSSELL MID-CAP VALUE ETF   2022-07-19 2022-08-03
11. ISHARES RUSSELL MID-CAP GROWTH ETF   2022-07-19 2022-08-03
17. ISHARES RUSSELL TOP 200 VALUE ETF   2022-07-19 2022-08-03
12. ISHARES RUSSELL TOP 200 GROWTH ETF   2022-07-19 2022-08-03
9.205 PEAR TREE POLARIS FGN VAL SM CAP R6 #1046   2020-05-04 2022-08-03
6.859 PEAR TREE POLARIS FOREIGN VALUE FUND CL R6 #8896   2021-07-21 2022-08-03
6.94 T ROWE PRICE INSTITUTIONAL EMERGING MARKETS BOND FUND #163   2022-08-01 2022-08-03
1. PROSHARES TR DJ BROOKFIELD GLOBAL INFRASTRUCTURE ETF   2020-08-11 2022-08-03
12.15 TIAA-CREF EMERGING MARKETS EQUITY INDEX FUND INST #2245   2021-07-21 2022-08-03
125.842 VANGUARD SHORT TERM BOND INDEX ADM #5132   2020-07-13 2022-08-03
5. VANGUARD SCOTTSDALE FDS VNG RUS2000IDX   2021-07-21 2022-08-03
8.205 ALLSPRING CORE BOND FUND R6 CLASS #4657   2020-08-11 2022-08-03
293.007 BLACKROCK HIGH YIELD BOND PORTFOLIO CLASS K #340   2022-08-01 2022-10-17
112.613 COHEN & STEERS REAL ESTATE SECURITIES FUND CLASS I #1260   2022-08-01 2022-10-17
446.967 HARTFORD EMERGING MARKETS LOCAL DEBT FUND CLASS Y #1025   2022-08-01 2022-10-17
82.108 MAINSTAY CBRE GLOBAL INFRASTRUCTURE FUND CLASS I #5023   2021-10-22 2022-10-17
80.937 MAINSTAY CBRE GLOBAL INFRASTRUCTURE FUND CLASS I #5023   2020-08-11 2022-10-17
117.469 NUVEEN GLOBAL INFRASTRUCTURE FUND CLASS I #6726     2022-10-17
80.238 NUVEEN GLOBAL INFRASTRUCTURE FUND CLASS I #6726   2020-08-11 2022-10-17
341.721 T ROWE PRICE INSTITUTIONAL EMERGING MARKETS BOND FUND #163   2022-08-01 2022-10-17
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 2,581   2,091 490
b 31,559   19,167 12,392
c 27   24 3
d 6,516   4,703 1,813
e 36   35 1
1,280   1,395 -115
1,094   562 532
2,875   3,204 -329
4,244   2,338 1,906
439   437 2
1,985   2,185 -200
3,527   3,857 -330
453   246 207
1,333   1,559 -226
5,464   4,260 1,204
4,135   3,438 697
1,970   1,643 327
1,991   1,753 238
1,217   1,030 187
958   778 180
1,799   1,936 -137
903   695 208
5,328   5,935 -607
13,428   15,577 -2,149
8,414   9,427 -1,013
51,302   41,311 9,991
35,212   41,423 -6,211
129,018   104,915 24,103
8,910   11,928 -3,018
20,665   25,503 -4,838
1,327   1,462 -135
19,858   14,903 4,955
23   34 -11
7,092   6,190 902
1,039   1,236 -197
33,006   26,958 6,048
5,399   6,727 -1,328
1,957   2,881 -924
1,199   1,291 -92
2,906   2,614 292
2,512   2,755 -243
3,966   3,784 182
2,590   2,409 181
28,205   27,322 883
39,961   37,448 2,513
3,690   3,495 195
3,910   3,829 81
3,145   2,690 455
1,736   1,643 93
2,482   2,975 -493
168   183 -15
43   35 8
80   147 -67
73   111 -38
344   380 -36
41   41  
19   19  
96   134 -38
71   89 -18
87   138 -51
24   24  
325   346 -21
1,099   1,051 48
992   914 78
1,107   1,073 34
1,699   1,582 117
95   74 21
69   85 -16
44   44  
48   41 7
126   167 -41
1,271   1,370 -99
381   447 -66
96   116 -20
1,913   2,047 -134
1,662   2,070 -408
1,815   1,921 -106
912   1,083 -171
899   909 -10
1,143   1,407 -264
781   833 -52
1,944   2,170 -226
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
      14,099
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       490
b       12,392
c       3
d       1,813
e       1
      -115
      532
      -329
      1,906
      2
      -200
      -330
      207
      -226
      1,204
      697
      327
      238
      187
      180
      -137
      208
      -607
      -2,149
      -1,013
      9,991
      -6,211
      24,103
      -3,018
      -4,838
      -135
      4,955
      -11
      902
      -197
      6,048
      -1,328
      -924
      -92
      292
      -243
      182
      181
      883
      2,513
      195
      81
      455
      93
      -493
      -15
      8
      -67
      -38
      -36
       
       
      -38
      -18
      -51
       
      -21
      48
      78
      34
      117
      21
      -16
       
      7
      -41
      -99
      -66
      -20
      -134
      -408
      -106
      -171
      -10
      -264
      -52
      -226
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 61,630
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 1,050
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 1,050
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 664
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  
7 Total credits and payments. Add lines 6a through 6d.............. 7 664
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 9 386
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 taxBullet0 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$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNC
    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 addressbullet  
    14
    The books are in care ofbulletFIRST CITIZENS BANK TRUST DEPT Telephone no.bullet (919) 755-7148

    Located atbulletPO BOX 29522RALEIGHNC ZIP+4bullet27626
    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)
    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)
    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
    FIRST CITIZENS BANK TRUSTEE
    1     		7,500    
    PO BOX 29522
    RALEIGH,NC27626
    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.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    685,616
    b
    Average of monthly cash balances.......................
    1b
    28,118
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    713,734
    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
    713,734
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    10,706
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    703,028
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    35,151
    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
    35,151
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    1,050
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,050
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    34,101
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    34,101
    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
    34,101
    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 34,101
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 4,754
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 0
    b From 2017...... 0
    c From 2018...... 0
    d From 2019...... 0
    e From 2020...... 0
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 21,500
    a Applied to 2020, but not more than line 2a 4,754
    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..... 16,746
    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 ..........     		17,355
    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.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 0
    d Excess from 2020.... 0
    e Excess from 2021.... 0
    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:
    LINDA F HOFLER
    PO BOX 1 BOX 95
    HOBBSVILLE,NC27946
    (250) 465-8401
    bThe form in which applications should be submitted and information and materials they should include:
    WRITING
    cAny submission deadlines:
    NONE GRADUATES OF GATES COUNTY, NORTH CAROLINA HIGH SCHOOL
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    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
    WESTERN CAROLINA UNIV
    FBO VICTOR ROUNTREE
    1 UNIVERSITY DRIVE
    CULLOWHEE,NC28723     		NONE PC EDUCATION - COLLEGE 5,487
    NC STATE UNIVERSITY
    FBO LILLIAN GRANT
    20 WATAUGA CLUB DRIVE
    RALEIGH,NC27695     		NONE PC EDUCATION - COLLEGE 9,792
    UNIVERSITY OF NORTH CAROLINA
    FBO PARREN WILLIAMS
    200 BYNUM HALL
    CHAPEL HILL,NC27599     		NONE PC EDUCATION - COLLEGE 3,907
    NORTH CAROLINA CENTRAL UNIVERSITY
    FBO JAYVON BUTLER
    1801 FAYETTEVILLE ST
    DURHAM,NC27707     		NONE PC EDUCATION - COLLEGE 2,314
    Total .................................bullet 3a 21,500
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    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 61,630  
    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) ..   84,210  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    84,210
    (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:
    SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
    EIN:
    56-6235902
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 750 750    

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
    EIN:
    56-6235902
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BAIRD AGGREGATE BD FD    
    AMERICAN BEACON GARCIA HAMILTO 26,697 23,375
    WELLS FARGO CORE BOND FUND    
    VANGUARD SHORT TERM 31,884 28,986
    BAIRD INTERMEDIATE INSTL 66,553 58,735
    ALLSPRING CORE BOND FD R6 CKAS 45,682 38,496

    TY 2021 InvestmentsOtherSchedule2
    Name:
    SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
    EIN:
    56-6235902
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    GOLDMAN SACHS INTERNATIONAL SM      
    PIMCO STOCKPLUS INTL FD      
    COLUMBIA CONTRARIAN CORE FD      
    GOLDMAN SACHS EMERGING MKT DEB      
    PEAR TREE POLARIS FOREIGN VALU AT COST 7,296 6,868
    TIAA-CREF EMERGING MKTS EQUITY AT COST 16,647 15,712
    ISHARES MSCI EAFE INTL INDEX      
    MFS MID CAP VALUE      
    PEAR TREE POLARIS FOREIGN VALU AT COST 19,494 18,893
    WCM FOCUSED INTL GROWTH AT COST 16,776 18,112
    ARTISAN INTL S-M      
    ASHMORE EMERGING MKTS      
    BALLIE GIFFORD EMERGING MKTS      
    FEDERATED MDT SC CORE      
    FIDELITY MID CAP INDEX      
    PIMCO STOCKSPLUS SMALL      
    BLACKROCK MID-CAP GROWTH      
    JOHNSON ENHANCED RETURN      
    MAINSTAY CBRE GLOBAL INFRASTRU      
    NUVEEN GLOBAL INFRASTRUCTURE      
    T ROWE PRICE US EQUITY RESEARC      
    ISHARES RUS TOP 200 ETF AT COST 96,522 96,141
    PROSHARES TR DJ BROOKFIELD GLO AT COST 4,589 5,111
    VANGUARD SCOTTSDALE AT COST 12,024 12,180
    ISHARES J.P. MORGAN USD EMERGI AT COST 1,881 2,074
    SPDR BLOOMBERG HIGH YIELD BD E AT COST 1,865 1,949
    INVESCO SMALL CAP VALUE FD CLA AT COST 1,999 2,068
    ARTISAN INTERNATIONAL SMALL-MI AT COST 6,791 6,552
    ASHMORE EMERGING MARKETS ACTIV AT COST 18,829 13,511
    BALLIE GIFFORD EMERG MK EQUITI AT COST 14,588 12,960
    ISHARES MSCI EAFE INTL INDEX F AT COST 21,960 23,977
    DELAWARE SMALL CAP GROWTH FD I AT COST 2,928 2,062
    FEDERATED HERMES MDT SMALL CAP AT COST 3,897 3,957
    GOLDMAN SACHS EMERGING MKT EQU AT COST 13,061 10,279
    ISHARES RUSSELL MID-CAP VALUE AT COST 56,134 59,594
    ISHARES RUSSELL MID-CAP GROWTH AT COST 32,979 35,412
    ISHARES RUSSSELL TOP 200 VALUE AT COST 62,911 67,517
    ISHARES MSCI USA MIN VOL FACTO AT COST 51,839 52,908
    ISHARES TR CORE MSCI EAFE ETF AT COST 14,450 15,258
    J P MORGAN EXCHANGE TRADED FD AT COST 20,850 21,241
    VANGUARD INTL EQUITY INDEX FDS AT COST 2,085 1,946
    VANGUARD REAL ESTATE ETF AT COST 1,578 1,762

    TY 2021 OtherDecreasesSchedule
    Name:
    SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
    EIN:
    56-6235902
    Description Amount
    COST BASIS ADJUSTMENT - WASH SALE 355
    2021 TRANS POSTED IN 2022 273


    TY 2021 OtherIncreasesSchedule
    Name:
    SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
    EIN:
    56-6235902
    Description Amount
    2020 TRANS POSTED IN 2021 114
    REMEDIATION PAYMENT RECEIVED 90


    TY 2021 TaxesSchedule
    Name:
    SPIVEY SCHOLARSHIP TRUST FIRST CITIZENS BANK
    EIN:
    56-6235902
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL ESTIMATES - PRINCIPAL 594 0   0
    FOREIGN TAXES ON QUALIFIED FOR 289 289   0
    FOREIGN TAXES ON NONQUALIFIED 105 105   0