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 05-01-2021 , and ending 04-30-2022
Name of foundation
BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
 
Number and street (or P.O. box number if mail is not delivered to street address)10 S DEARBORN IL1-0111
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL60603
A Employer identification number

36-6692339
B Telephone number (see instructions)

(800) 496-2583
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$1,588,316J 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... 55,221 55,221  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 324,879
b Gross sales price for all assets on line 6a 1,283,692
7 Capital gain net income (from Part IV, line 2)... 324,879
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)....... Click to see attachment 205 5  
12 Total. Add lines 1 through 11........ 380,305 380,105  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 29,503 15,157   14,346
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).......        
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 3,753 667   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)....... Click to see attachment 15     15
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 33,271 15,824 0 14,361
25 Contributions, gifts, grants paid....... 575,616 575,616
26 Total expenses and disbursements. Add lines 24 and 25 608,887 15,824 0 589,977
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -228,582
b Net investment income (if negative, enter -0-) 364,281
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............. 2,521 6,864 6,864
2 Savings and temporary cash investments......... 20,955 127,822 127,822
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)....... 890,267 Click to see attachment734,274 748,965
c Investments—corporate bonds (attach schedule)....... 571,102 Click to see attachment399,920 371,784
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 314,233 Click to see attachment324,622 332,881
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) 1,799,078 1,593,502 1,588,316
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........ 1,799,078 1,593,502
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)..... 1,799,078 1,593,502
30 Total liabilities and net assets/fund balances (see instructions). 1,799,078 1,593,502
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
1,799,078
2
Enter amount from Part I, line 27a .....................
2
-228,582
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
23,062
4
Add lines 1, 2, and 3 ..........................
4
1,593,558
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
56
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
1,593,502
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 1572.633 DOUBLELINE TTL RTRN BND-R6   2016-11-28 2021-05-12
b 26. ISHARES MSCI ASIAN EX JAPAN   2019-07-22 2021-05-12
c 13. ISHARES MSCI ASIAN EX JAPAN   2020-02-28 2021-05-12
d 300. DEERE & CO   2008-10-14 2021-05-19
e 860.72 BLACKSTONE ALT MULTI-STRAT-Y   2017-10-18 2021-05-20
355.196 COHEN & STEERS RL EST-F   2020-02-10 2021-05-20
385.921 DODGE & COX INCOME FUND   2017-01-11 2021-05-20
274.916 FIDELITY INTL INDX-INST PRM   2018-01-11 2021-05-20
162.409 FIDELITY 500 INDEX FUND   2019-01-28 2021-05-20
19. INVESCO QQQ TRUST SERIES 1   2020-03-26 2021-05-20
75. ISHARES MSCI ASIAN EX JAPAN   2020-02-28 2021-05-20
61. ISHARES MSCI INDIA ETF   2017-01-05 2021-05-20
89. ISHARES MSCI JAPAN ETF   2019-10-30 2021-05-20
106.288 MATTHEWS CHINA FUND-INS   2020-05-22 2021-05-20
297.724 NEUBERGER BERMAN LONG SH-INS   2017-10-18 2021-05-20
424.724 PIMCO TOTAL RETURN FIND   2019-07-15 2021-05-20
191.981 PARNASSUS EQTY INCOME FD-INS   2017-09-11 2021-05-20
242.744 PIMCO COMMODITYPL STRAT-INS   2020-02-14 2021-05-20
129. SCHWAB U.S. TIPS ETF   2018-04-16 2021-05-20
53. AMEX CONSUMER SVC SELECT SPD   2020-01-09 2021-05-20
63. SECTOR SPDR TRUST   2021-02-24 2021-05-20
1425.36 VANGUARD TTL BD MKT IDX-ADM   2020-03-26 2021-05-20
51. VANGUARD FINANCIALS VIPERS   2019-07-25 2021-05-20
9. ISHARES MSCI JAPAN ETF   2020-09-15 2021-06-07
138. ISHARES MSCI JAPAN ETF   2019-10-30 2021-06-07
310. ISHARES GOLD TRUST   2019-07-15 2021-06-28
18. ISHARES MSCI ASIAN EX JAPAN   2020-02-28 2021-06-28
181. ISHARES MSCI ASIAN EX JAPAN   2020-02-28 2021-06-28
19. ISHARES MSCI ASIAN EX JAPAN   2020-02-28 2021-06-28
3532.504 BLACKSTONE ALT MULTI-STRAT-Y   2017-10-18 2021-07-02
364.026 DODGE & COX INCOME FUND   2018-08-31 2021-07-02
531.609 PIMCO TOTAL RETURN FIND   2019-07-15 2021-07-02
5924.864 VANGUARD TTL BD MKT IDX-ADM   2020-03-26 2021-07-02
103.674 EDGEWOOD GROWTH FUND   2020-04-09 2021-07-06
260.767 BLACKROCK EVNT DRVN EQ-INST   2021-07-02 2021-07-06
504.764 BLACKSTONE ALT MULTI-STRAT-Y   2017-10-18 2021-07-06
315.23 COHEN & STEERS RL EST-F   2020-02-10 2021-07-06
284.714 DODGE & COX INCOME FUND   2018-08-31 2021-07-06
135.238 DOUBLELINE TTL RTRN BND-R6   2017-06-21 2021-07-06
75.733 FIDELITY INTL INDX-INST PRM   2018-08-31 2021-07-06
115.54 FIDELITY 500 INDEX FUND   2019-01-28 2021-07-06
44.804 GMO SGM MAJOR MARKETS-VI   2021-07-02 2021-07-06
55.744 OAKMARK INTERNATIONAL-R6   2017-11-28 2021-07-06
19. INVESCO QQQ TRUST SERIES 1   2020-03-26 2021-07-06
31. ISHARES GOLD TRUST   2019-07-15 2021-07-06
20. ISHARES RUSSELL 1000 VALUE INDEX FD   2020-05-27 2021-07-06
68. ISHARES CORE MSCI EMERGING   2019-02-06 2021-07-06
33. ISHARES MSCI JAPAN ETF   2020-09-15 2021-07-06
119.639 MATTHEWS CHINA FUND-INS   2020-05-22 2021-07-06
286.967 NEUBERGER BERMAN LONG SH-INS   2017-10-18 2021-07-06
396.351 PIMCO TOTAL RETURN FIND   2019-07-15 2021-07-06
81.398 PARNASSUS EQTY INCOME FD-INS   2017-09-11 2021-07-06
247.005 PIMCO UNCONSTRAINED BD FD INSTL CL*   2021-02-05 2021-07-06
243.176 PIMCO MTGE OPPORTUNITIES IS   2021-07-02 2021-07-06
52. SCHWAB U.S. TIPS ETF   2018-04-16 2021-07-06
28. AMEX CONSUMER SVC SELECT SPD   2020-01-09 2021-07-06
21. SECTOR SPDR TRUST   2021-02-24 2021-07-06
1745.197 VANGUARD TTL BD MKT IDX-ADM   2020-04-24 2021-07-06
59. VANGUARD SHORT-TERM TIPS   2021-04-12 2021-07-06
52. VANGUARD EUROPEAN ETF   2021-01-27 2021-07-06
113. VANGUARD FINANCIALS VIPERS   2019-07-25 2021-07-06
538.965 OAKMARK INTERNATIONAL-R6   2020-08-10 2021-07-16
654.768 OAKMARK INTERNATIONAL-R6   2017-11-28 2021-07-16
96. VANGUARD FINANCIALS VIPERS   2019-07-25 2021-07-16
94. SECTOR SPDR TRUST   2021-02-24 2021-09-16
103. SECTOR SPDR TRUST   2021-02-24 2021-09-16
400.614 FIDELITY INTL INDX-INST PRM   2019-02-06 2021-10-11
126. ISHARES GOLD TRUST   2019-07-15 2021-10-11
203.208 EDGEWOOD GROWTH FUND   2020-04-09 2021-11-03
70.977 FIDELITY 500 INDEX FUND   2019-01-28 2021-11-03
69.902 PARNASSUS EQTY INCOME FD-INS   2017-09-11 2021-11-03
1018.499 VANGUARD TTL BD MKT IDX-ADM   2020-04-24 2021-11-05
131.266 EDGEWOOD GROWTH FUND   2020-04-09 2021-11-18
235.399 COHEN & STEERS RL EST-F   2020-02-10 2021-11-18
193.211 FIDELITY 500 INDEX FUND   2020-03-04 2021-11-18
45. INVESCO QQQ TRUST SERIES 1   2020-03-26 2021-11-18
62. ISHARES RUSSELL 1000 VALUE INDEX FD   2020-05-27 2021-11-18
139.099 PARNASSUS EQTY INCOME FD-INS   2017-09-11 2021-11-18
357.77 PIMCO COMMODITYPL STRAT-INS   2020-02-14 2021-11-18
28. SECTOR SPDR TRUST   2021-02-24 2021-11-18
533.413 VANGUARD TTL BD MKT IDX-ADM   2020-04-24 2021-11-18
86. VANGUARD FINANCIALS VIPERS   2020-03-26 2021-11-18
638.685 GMO SGM MAJOR MARKETS-VI   2021-07-02 2021-11-24
58.293 FIDELITY 500 INDEX FUND   2020-03-04 2021-12-09
843.532 VANGUARD TTL BD MKT IDX-ADM   2020-04-24 2021-12-09
197. DEERE & CO   2008-10-13 2022-01-12
1350.521 DODGE & COX INCOME FUND   2019-05-07 2022-01-31
253.726 EDGEWOOD GROWTH FUND   2020-06-12 2022-02-14
325.609 BLACKROCK EVNT DRVN EQ-INST   2021-07-02 2022-02-14
575.952 BLACKSTONE ALT MULTI-STRAT-Y   2017-10-18 2022-02-14
118.694 COHEN & STEERS RL EST-F   2020-02-10 2022-02-14
28.298 FIDELITY 500 INDEX FUND   2020-03-04 2022-02-14
36. INVESCO QQQ TRUST SERIES 1   2020-09-15 2022-02-14
57. ISHARES GOLD TRUST   2020-03-10 2022-02-14
57. ISHARES RUSSELL 1000 VALUE INDEX FD   2020-05-27 2022-02-14
324.583 NEUBERGER BERMAN LONG SH-INS   2017-10-18 2022-02-14
132.272 PARNASSUS EQTY INCOME FD-INS   2017-09-11 2022-02-14
320.873 PIMCO UNCONSTRAINED BD FD INSTL CL*   2021-02-05 2022-02-14
1038.841 PIMCO COMMODITYPL STRAT-INS   2020-02-14 2022-02-14
341.927 PIMCO MTGE OPPORTUNITIES IS   2021-07-02 2022-02-14
89.231 T ROWE PR JAPAN FUND-I   2020-02-20 2022-02-14
123. SCHWAB U.S. TIPS ETF   2018-04-16 2022-02-14
65. AMEX CONSUMER SVC SELECT SPD   2020-01-09 2022-02-14
34. VANECK OIL SERVICES ETF   2021-12-09 2022-02-14
1341.234 VANGUARD TTL BD MKT IDX-ADM   2020-04-24 2022-02-14
45. VANGUARD SHORT-TERM TIPS   2021-04-12 2022-02-14
105. VANGUARD EUROPEAN ETF   2021-01-27 2022-02-14
61. VANGUARD FINANCIALS VIPERS   2020-03-26 2022-02-14
954.673 VANGUARD TTL BD MKT IDX-ADM   2020-05-07 2022-03-02
32. INVESCO QQQ TRUST SERIES 1   2020-09-23 2022-03-14
527.129 PIMCO TOTAL RETURN FIND   2019-07-15 2022-03-14
229. VANGUARD EUROPEAN ETF   2021-01-27 2022-03-25
2. SECTOR SPDR TRUST   2021-05-19 2022-04-05
121. SECTOR SPDR TRUST   2021-02-24 2022-04-05
21. SECTOR SPDR TRUST   2021-05-19 2022-04-05
25. VANGUARD FINANCIALS VIPERS   2020-03-26 2022-04-13
229. VANGUARD FINANCIALS VIPERS   2020-03-26 2022-04-13
836.476 T ROWE PR JAPAN FUND-I   2020-02-20 2022-04-25
131. VANGUARD FINANCIALS VIPERS   2020-05-27 2022-04-25
318.686 AMERICAN BEACON AHL MGD-R5   2021-11-24 2022-04-28
382.271 BLACKROCK EVNT DRVN EQ-INST   2021-07-02 2022-04-28
697.16 BLACKSTONE ALT MULTI-STRAT-Y   2017-10-18 2022-04-28
717.82 DOUBLELINE TTL RTRN BND-R6   2019-07-15 2022-04-28
342.89 FIDELITY INTL INDX-INST PRM   2019-02-06 2022-04-28
524.103 OAKMARK INTERNATIONAL-R6   2020-08-10 2022-04-28
128. ISHARES MSCI INDIA ETF   2017-01-05 2022-04-28
170. ISHARES CORE MSCI EMERGING   2019-02-06 2022-04-28
747.121 JPM MANAGED INCOME - INSTL FUND 2119   2020-12-11 2022-04-28
270.393 NEUBERGER BERMAN LONG SH-INS   2017-10-18 2022-04-28
1029.092 PIMCO TOTAL RETURN FIND   2019-07-15 2022-04-28
266.522 PIMCO UNCONSTRAINED BD FD INSTL CL*   2021-02-05 2022-04-28
44.063 PIMCO COMMODITYPL STRAT-INS   2021-06-17 2022-04-28
637.397 PIMCO COMMODITYPL STRAT-INS   2020-02-14 2022-04-28
245.686 PIMCO MTGE OPPORTUNITIES IS   2021-07-02 2022-04-28
86. SCHWAB U.S. TIPS ETF   2018-04-16 2022-04-28
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(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 16,528   16,927 -399
b 2,323   1,788 535
c 1,162   884 278
d 108,118   12,345 95,773
e 9,149   9,408 -259
6,692   6,514 178
5,499   5,233 266
13,655   12,113 1,542
23,478   14,934 8,544
6,236   3,646 2,590
6,916   5,098 1,818
2,632   1,663 969
6,005   5,204 801
2,980   1,995 985
5,094   4,234 860
4,370   4,383 -13
11,494   8,265 3,229
2,947   2,461 486
8,005   7,074 931
6,600   5,447 1,153
6,440   5,877 563
15,978   15,993 -15
4,657   3,622 1,035
628   533 95
9,633   8,069 1,564
10,504   8,403 2,101
1,709   1,215 494
17,184   12,217 4,967
1,804   1,282 522
38,080   38,610 -530
5,220   4,903 317
5,529   5,486 43
67,129   67,214 -85
6,543   3,790 2,753
2,668   2,670 -2
5,446   5,517 -71
6,264   5,781 483
4,094   3,837 257
1,432   1,450 -18
3,760   3,034 726
17,415   10,624 6,791
1,334   1,337 -3
1,636   1,605 31
6,788   3,646 3,142
1,057   840 217
3,157   2,291 866
4,446   3,501 945
2,223   1,955 268
3,286   2,246 1,040
5,071   4,081 990
4,130   4,090 40
5,072   3,504 1,568
2,668   2,690 -22
2,668   2,665 3
3,255   2,852 403
3,571   2,878 693
2,136   1,959 177
19,843   20,140 -297
3,068   3,047 21
3,492   3,138 354
10,078   8,026 2,052
15,511   10,979 4,532
18,844   17,084 1,760
8,526   5,922 2,604
9,556   8,770 786
10,480   9,609 871
19,674   15,612 4,062
4,204   3,954 250
13,261   7,429 5,832
11,485   6,919 4,566
4,612   3,009 1,603
11,529   11,753 -224
8,568   5,568 3,000
5,080   4,317 763
31,592   21,039 10,553
18,078   11,512 6,566
10,251   7,103 3,148
8,765   5,988 2,777
2,851   3,628 -777
2,975   2,612 363
5,980   6,156 -176
8,473   4,567 3,906
18,554   19,052 -498
9,464   6,348 3,116
9,464   9,734 -270
74,215   8,217 65,998
18,624   18,543 81
12,699   10,768 1,931
3,217   3,334 -117
5,938   6,295 -357
2,322   2,177 145
4,327   3,081 1,246
12,509   9,813 2,696
2,028   1,803 225
9,268   7,354 1,914
5,619   4,616 1,003
7,759   5,694 2,065
3,356   3,494 -138
9,329   10,534 -1,205
3,655   3,748 -93
1,337   1,318 19
7,427   6,745 682
8,379   6,681 1,698
8,138   6,551 1,587
14,378   15,466 -1,088
2,291   2,324 -33
6,776   6,337 439
5,917   3,239 2,678
10,234   10,979 -745
10,181   8,575 1,606
5,082   5,440 -358
14,217   13,821 396
202   205 -3
12,229   11,288 941
2,112   2,149 -37
2,256   1,328 928
20,666   13,344 7,322
10,715   12,355 -1,640
11,549   7,731 3,818
3,799   3,761 38
3,781   3,914 -133
7,167   7,620 -453
6,884   7,654 -770
14,868   13,653 1,215
12,704   10,676 2,028
5,704   3,490 2,214
8,861   8,752 109
7,434   7,501 -67
4,643   3,845 798
9,499   10,620 -1,121
2,692   2,902 -210
425   308 117
6,145   6,463 -318
2,528   2,693 -165
5,129   4,716 413
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
      13,722
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       -399
b       535
c       278
d       95,773
e       -259
      178
      266
      1,542
      8,544
      2,590
      1,818
      969
      801
      985
      860
      -13
      3,229
      486
      931
      1,153
      563
      -15
      1,035
      95
      1,564
      2,101
      494
      4,967
      522
      -530
      317
      43
      -85
      2,753
      -2
      -71
      483
      257
      -18
      726
      6,791
      -3
      31
      3,142
      217
      866
      945
      268
      1,040
      990
      40
      1,568
      -22
      3
      403
      693
      177
      -297
      21
      354
      2,052
      4,532
      1,760
      2,604
      786
      871
      4,062
      250
      5,832
      4,566
      1,603
      -224
      3,000
      763
      10,553
      6,566
      3,148
      2,777
      -777
      363
      -176
      3,906
      -498
      3,116
      -270
      65,998
      81
      1,931
      -117
      -357
      145
      1,246
      2,696
      225
      1,914
      1,003
      2,065
      -138
      -1,205
      -93
      19
      682
      1,698
      1,587
      -1,088
      -33
      439
      2,678
      -745
      1,606
      -358
      396
      -3
      941
      -37
      928
      7,322
      -1,640
      3,818
      38
      -133
      -453
      -770
      1,215
      2,028
      2,214
      109
      -67
      798
      -1,121
      -210
      117
      -318
      -165
      413
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 2 324,879
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 5,064
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 5,064
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 2,028
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 5,972
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 8,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 2,936
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet2,936 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)
    bulletIL
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletJPMORGAN CHASE BANK NA Telephone no.bullet (800) 496-2583

    Located atbullet10 S DEARBORN IL1-0111CHICAGOIL ZIP+4bullet60603
    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)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    JP MORGAN CHASE BANK NA TRUSTEE
    2     		29,503    
    10 S DEARBORN IL1-0111
    CHICAGO,IL60603
    David Rydell CO-TRUSTEE
    1     		0    
    Bergstrom Inc 2390 Blackhawk Road
    Rockford,IL611093605
    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 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,870,964
    b
    Average of monthly cash balances.......................
    1b
    25,749
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,896,713
    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
    1,896,713
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    28,451
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    1,868,262
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    93,413
    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
    93,413
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    5,064
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    5,064
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    88,349
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    2,500
    5
    Add lines 3 and 4............................
    5
    90,849
    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
    90,849
    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 90,849
    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...... 411,058
    b From 2017...... 494,940
    c From 2018...... 464,335
    d From 2019...... 460,803
    e From 2020...... 444,260
    f Total of lines 3a through e ........ 2,275,396
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 589,977
    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..... 90,849
    e Remaining amount distributed out of corpus 499,128
    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 2,774,524
    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) ...     		411,058
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		2,363,466
    10 Analysis of line 9:
    a Excess from 2017.... 494,940
    b Excess from 2018.... 464,335
    c Excess from 2019.... 460,803
    d Excess from 2020.... 444,260
    e Excess from 2021.... 499,128
    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:
    DAVE RYDELL BERGSTROM INC
    2390 BLACKHAWK ROAD
    ROCKFORD,IL61109
    (815) 394-4655
    NONE@JPMORGAN.COM
    bThe form in which applications should be submitted and information and materials they should include:
    OUTLINE PURPOSE OF PROPOSED GRANTS OR FUNDS INCLUDE COPY OF 501(C)(3) LETTER
    cAny submission deadlines:
    N/A
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    PREFERENCE TO IL RESIDENTS AND CHARITABLE ORGANIZATIONS OTHERS CONSIDERED FOR RELIGIOUS, CHARITABLE OR EDUCATIONAL PURPOSE
    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
    AMERICAN CANCER SOCIETY INC
    250 WILLIAMS STREET NW
    ATLANTA,GA30303     		NONE PC BERGSTROM CARES-FUNDRAISING 4,116
    FAMILY PEACE CENTER
    315 N MAIN STREET
    ROCKFORD,IL61101     		NONE PC GENERAL 10,000
    R2OC
    3301 N MULFORD RD
    ROCKFORD,IL61114     		NONE PC GENERAL 1,000
    ROCK RIVER VALLEY PANTRY
    421 SOUTH ROCKTON AVENUE
    ROCKFORD,IL61102     		NONE PC GENERAL 2,000
    ROY GAYLE PONY BASEBALL-SOFTBALL INC
    PO BOX 1011
    ROCKFORD,IL61105     		NONE PC GENERAL 5,000
    UNITED WAY OF ROCK RIVER VALLEY
    612 NORTH MAIN STREET SUITE 300
    ROCKFORD,IL61103     		NONE PC MUSIC AT MIDWAY SPONSORSHIP 2,500
    YOUTH FOR CHRIST USA INC
    AKA STATELINE YOUTH FOR CHRIST
    1288 S ALPINE RD
    ROCKFORD,IL61108     		NONE PC GENERAL 10,000
    ROCK RIVER DEVELOPMENT PARTNERSHIP
    PO BOX 4244
    ROCKFORD,IL61110     		NONE PC GENERAL 2,500
    ALIGNMENT ROCKFORD
    330 SPRING CREEK RD
    ROCKFORD,IL61107     		NONE PC GENERAL 5,000
    BRAVEHEARTS THERAPEUTIC RIDING
    7319 MAXON RD
    HARVARD,IL60033     		NONE PC GENERAL 5,000
    UNIVERSITY OF NOTRE DAME
    724 GRACE HALL CONTROLLERS OFFICE
    NOTRE DAME,IN46556     		NONE PC GENERAL 2,500
    REGIONAL ACCESS MOBILIZATION
    PROJECT INC
    202 MARKET ST
    ROCKFORD,IL61107     		NONE PC GENERAL 22,500
    DISCOVERY CENTER MUSEUM OF ROCKFORD
    INC
    711 N MAIN STREET
    ROCKFORD,IL61103     		NONE PC GENERAL 5,000
    KLEHM ARBORETUM AND BOTANICAL
    GARDEN INC
    2715 S MAIN STREET
    ROCKFORD,IL61102     		NONE PC GENERAL 5,000
    ROCKFORD ROTARY CHARITABLE
    PO BOX 1323
    ROCKFORD,IL61105     		NONE PC GENERAL 3,000
    KIWANIS CHARITIES OF ROCKFORD
    PO BOX 8472
    ROCKFORD,IL61126     		NONE PC GENERAL 1,250
    LAURENT FOUNDATION INC
    4949 HARRISON AVENUE
    ROCKFORD,IL61108     		NONE PC GENERAL 5,000
    ALPINE KIWANIS CHARITIES FUND
    PO BOX 5132
    ROCKFORD,IL61125     		NONE PC GENERAL 1,250
    HABITAT FOR HUMANITY
    5183 HARLEM RD
    LOVES PARK,IL611113448     		NONE PC GENERAL 25,000
    YOUTH SERVICES NETWORK INC
    15501 SAN FERNANDO MISSION BLV SUIT
    MISSION HILLS,CA91345     		NONE PC GENERAL 5,000
    LUTHERAN OUTDOOR MINISTRIES
    CENTER
    1834 S IL ROUTE 2
    OREGON,IL61061     		NONE PC GENERAL 2,500
    AMERICAN RED CROSS ROCK
    727 NORTH CHURCH STREET
    ROCKFORD,IL61103     		NONE PC GENERAL 2,500
    CRUSADERS HEALTH FOUNDATION
    1200 W STATE ST
    ROCKFORD,IL22112     		NONE PC GENERAL 5,000
    MUSCULAR DYSTROPHY ASSOCIATION
    3300 E SUNRISE DRIVE
    TUCSON,AZ85718     		NONE PC GENERAL 3,500
    WINNEBAGO COUNTY CASA
    211 S COURT ST RM 258
    ROCKFORD,IL61101     		NONE PC GENERAL 2,500
    ROCKFORD ART MUSEUM
    711 N MAIN ST
    Rockford,IL61103     		NONE PC GENERAL 5,000
    CLUB BLUE ROCKFORD INC
    2224 PRINCETON AVE
    ROCKFORD,IL73255     		NONE PC GENERAL 2,500
    SWEDISHAMERICAN FOUNDATION
    1415 E STATE ST
    ROCKFORD,IL61104     		NONE PC GENERAL 10,000
    GIGI'S PLAYHOUSE INC
    2350 W HIGGINS RD
    HOFFMAN ESTATES,IL60169     		NONE PC GENERAL 5,000
    SOUNDS OF GOOD NEWS INC
    2627 WOODMAR RD
    ROCKFORD,IL61114     		NONE PC GENERAL 10,000
    HARRY AND DELLA BURPEE
    MUSEUM ASSOCIATION
    737 N MAIN ST
    ROCKFORD,IL611036971     		NONE PC GENERAL 5,000
    THE UNIVERSITY OF ILLINOIS
    COLLEGE OF MEDICINE
    1835 W POLK ST
    CHICAGO,IL60612     		NONE PC GENERAL 20,000
    ROCKFORD SYMPHONY ORCHESTRA
    711 N MAIN STREET
    ROCKFORD,IL61103     		NONE PC GENERAL 10,000
    ROCKFORD RESCUE MISSION MINISTRIES
    PO BOX 4083
    ROCKFORD,IL61110     		NONE PC GENERAL 10,000
    ROCKFORD AREA ARTS COUNCIL
    713 E STATE STREET
    ROCKFORD,IL61104     		NONE PC GENERAL 3,500
    ROCKFORD PARK DISTRICT
    401 S MAIN ST
    ROCKFORD,IL61101     		NONE PC GENERAL 10,000
    ROSECRANCE FOUNDATION
    3815 HARRISON AVENUE
    ROCKFORD,IL61108     		NONE PC GENERAL 10,000
    BOY SCOUTS OF AMERICA - BLACKHAWK
    AREA COUNCIL
    PO BOX 4085
    ROCKFORD,IL61110     		NONE PC GENERAL 1,500
    MILESTONE INC
    4060 MCFARLAND ROAD
    ROCKFORD,IL61111     		NONE PC GENERAL 5,000
    AUGUSTANA COLLEGE
    639 - 39TH STREET
    ROCK ISLAND,IL61201     		NONE PC GENERAL 50,000
    NORTHERN ILLINOIS FOOD BANK
    320 S AVON STREET
    ROCKFORD,IL61102     		NONE PC GENERAL 5,000
    MOSAIC
    225 S THIRD STREET
    ROCKFORD,IL61104     		NONE PC GENERAL 10,000
    LUTHERAN SOCIAL SERVICE OF
    ILLINOIS
    1001 E TOUHY
    DES PLAINES,IL60018     		NONE PC GENERAL 10,000
    GOLDEN APPLE FOUNDATION
    OF ROCKFORD
    7210 E STATE STREET
    ROCKFORD,IL61108     		NONE PC GENERAL 10,000
    PATRIOTS GATEWAY COMMUNITY
    CENTER
    615 S FIFTH STREET
    ROCKFORD,IL61104     		NONE PC GENERAL 10,000
    FRIENDS OF THE CORONADO
    314 N MAIN STREET
    ROCKFORD,IL61101     		NONE PC GENERAL 23,000
    MIDWAY VILLAGE AND MUSEUM CENTER
    6799 GUILFORD ROAD
    ROCKFORD,IL61107     		NONE PC GENERAL 10,000
    KIDS AROUND THE WORLD INC
    2424 CHARLES STREET
    ROCKFORD,IL61108     		NONE PC GENERAL 7,500
    ILLINOIS GROWTH ENTERPRISES
    6151 MONTAGUE ROAD
    ROCKFORD,IL61102     		NONE PC GENERAL 5,000
    BARBARA OLSON CENTER OF HOPE
    3206 N CENTRAL AVENUE
    ROCKFORD,IL61101     		NONE PC GENERAL 5,000
    GOLDIE FLOBERG CENTER FOR CHILDREN
    58 W ROCKTON ROAD
    ROCKFORD,IL61072     		NONE PC GENERAL 5,000
    YMCA OF ROCK RIVER VALLEY
    200 Y BOULEVARD
    ROCKFORD,IL61107     		NONE PC GENERAL 5,000
    ALZHEIMERS ASSOCIATION
    4777 E STATE ST
    ROCKFORD,IL61108     		NONE PC GENERAL 2,500
    CARPENTERS PLACE
    1149 RAILROAD AVE
    ROCKFORD,IL61104     		NONE PC GENERAL 10,000
    CENTER FOR SIGHT AND HEARING
    8038 MACINTOSH LANE
    ROCKFORD,IL61103     		NONE PC GENERAL 7,500
    COMMUNITY FOUNDATION OF NORTHERN
    ILLINOIS
    946 NORTH SECOND STREET
    ROCKFORD,IL61107     		NONE PC GENERAL 5,000
    CHILDRENS HOME AND AID SOCIETY
    910 2ND AVE 103
    ROCKFORD,IL61104     		NONE PC GENERAL 3,000
    PHANTOM REGIMENT DRUM & BUGLE
    CORPS
    5050 E STATE STREET
    ROCKFORD,IL61108     		NONE PC GENERAL 1,000
    ROCKFORD UNIVERSITY
    5050 E STATE ST
    ROCKFORD,IL61108     		NONE PC GENERAL 12,500
    ROCKFORD DANCE CO
    SPECIAL GIFT FOR STUDIO PROJECT
    711 N MAIN ST
    Rockford,IL61103     		NONE PC GENERAL 3,500
    TRANSFORM ROCKFORD
    303 N MAIN SUITE 110
    ROCKFORD,IL61101     		NONE PC GENERAL 25,000
    FAMILY COUNSELING SERVICES OF
    NORTHERN ILLINOIS
    210 N LONGWOOD ST
    Rockford,IL61107     		NONE PC GENERAL 2,500
    THE ALS ASSOCIATION
    220 WEST HURON STREET- SUITE 4003
    CHICAGO,IL60654     		NONE PC GENERAL 1,000
    REMEDIES RENEWING LIVES
    516 GREEN ST
    Rockford,IL61102     		NONE PC GENERAL 5,000
    OSF HEALTHCARE SYSTEM
    FOR GENERAL SUPPORT OF ST ANTHONY HOSPI
    800 NE GLEN OAK
    Avenue Peoria,IL61603     		NONE PC GENERAL 3,000
    THE LITERACY COUNCIL
    982 N MAIN STREET
    ROCKFORD,IL61103     		NONE PC GENERAL 2,500
    GIRL SCOUTS OF THE UNITED
    STATES OF AMERICA
    420 5TH AVE
    New York,NY10018     		NONE PC GENERAL 1,000
    SHELTER CARE MINISTRIES
    412 N CHURCH ST
    ROCKFORD,IL61103     		NONE PC GENERAL 5,000
    ANDERSON GARDENS
    318 SPRING CREEK RD
    ROCKFORD,IL61107     		NONE PC GENERAL 4,000
    ROCK VALLEY COLLEGE FOUNDATION
    3301 N MULFORD ROAD
    ROCKFORD,IL61111     		NONE PC GENERAL 55,000
    SALVATION ARMY
    220 S MADISON STREET
    ROCKFORD,IL61104     		NONE PC GENERAL 10,000
    GOODWILL INDUSTRIES OF NORTHERN
    ILLINOIS INC
    615 N LONGWOOD STREET
    Rockford,IL61110     		NONE PC GENERAL 2,500
    ZION DEVELOPMENT CORPORATION
    502 SEVENTH STREET
    ROCKFORD,IL61104     		NONE PC GENERAL 12,500
    Total .................................bullet 3a 575,616
    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 ............     		    18 324,879  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aILAG FEE REFUND     		    1 200  
    bMISC INCOME     1 5  
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   380,305  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    380,305
    (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 InvestmentsCorpBondsSchedule
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Name of Bond End of Year Book Value End of Year Fair Market Value
    256210105 DODGE & COX INCOME-I 38,545 33,828
    921937603 VANGUARD TOT BD MKT 102,840 90,815
    808524870 SCHWAB U.S. TIPS ETF 69,654 68,757
    48121A415 JPM MANAGED INCOME F 70,255 69,671
    693390700 PIMCO TOTAL RETURN F 40,954 36,179
    258620566 DOUBLELINE TTL RTRN 40,512 36,153
    922020805 VANGUARD SHORT-TERM 37,160 36,381

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Name of Stock End of Year Book Value End of Year Fair Market Value
    46429B598 ISHARES MSCI INDIA E 9,191 12,568
    464288182 ISHARES MSCI ALL COU 8,654 7,659
    46429B671 ISHARES MSCI CHINA E 10,104 7,418
    701769408 PARNASSUS CORE EQUIT 55,835 61,201
    315911727 FIDELITY INTL INDX-I 111,010 100,578
    315911750 FIDELITY 500 INDEX-I 102,754 139,758
    46434G822 ISHARES MSCI JAPAN E 41,731 37,313
    46090E103 INVESCO QQQ TRUST SE 43,155 42,915
    46434G103 ISHARES CORE MSCI EM 55,730 51,310
    92189F106 VANECK GOLD MINERS E 23,382 20,154
    92204A405 VANGUARD FINANCIALS    
    0075W0759 EDGEWOOD GROWTH FUND 41,382 35,262
    77956H286 T ROWE PR JAPAN FUND    
    77956H385 T ROWE PRICE NEW ASI 19,918 16,947
    81369Y209 HEALTH CARE SELECT S 32,277 40,650
    413838574 OAKMARK INTERNATIONA 36,809 33,143
    464287598 ISHARES RUSSELL 1000 53,116 56,158
    577130818 MATTHEWS CHINA FUND- 22,070 17,178
    81369Y704 INDUSTRIAL SELECT SE    
    922042874 VANGUARD FTSE EUROPE 49,875 46,070
    92189H607 VANECK OIL SERVICES 17,281 22,683

    TY 2021 InvestmentsOtherSchedule2
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    464285105 ISHARES GOLD TRUST      
    09257V508 BLACKSTONE ALT MULTI AT COST 62,036 59,427
    64128R608 NEUBERGER BERMAN LON AT COST 40,929 44,750
    72201P175 PIMCO COMMODITYPL ST AT COST 22,253 29,891
    191912708 COHEN & STEERS REAL AT COST 79,553 83,339
    72201M487 PIMCO DYNAMIC BOND-I AT COST 31,845 29,583
    024525669 AMERICAN BEACON AHL AT COST 14,812 14,924
    09250J734 BLACKROCK EVNT DRVN AT COST 30,858 29,713
    464285204 ISHARES GOLD TRUST AT COST 10,664 11,605
    72201U638 PIMCO MRTG OPP & BND AT COST 31,672 29,649

    TY 2021 OtherDecreasesSchedule
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Description Amount
    MUTUAL FUND ADJUSTMENT 54
    ROUNDING 2


    TY 2021 OtherExpensesSchedule
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ATTORNEY GENERAL FEE 15 0   15


    TY 2021 OtherIncomeSchedule2
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    IL AG FEE REFUND 200 0  
    OTHER INCOME 5 5  


    TY 2021 OtherIncreasesSchedule
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Description Amount
    COST BASIS NOT REPORTED ON STATEMENT 12,345
    COST BASIS ADJUSTMENT 8,217
    RECOVERY OF PRIOR YEAR GRANTS 2,500


    TY 2021 TaxesSchedule
    Name:
    BERGSTROM INC CHARITABLE FOUNDATION XXXXX2008
    EIN:
    36-6692339
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL TAX PAYMENT - PRIOR YE 2,132 0   0
    FEDERAL ESTIMATES - INCOME 954 0   0
    FOREIGN TAXES ON QUALIFIED FOR 469 469   0
    FOREIGN TAXES ON NONQUALIFIED 198 198   0