Form990-PF
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Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 06-01-2021 , and ending 05-31-2022
Name of foundation
The Molina Healthcare Charitable Foundation
 
% Foundation Source
Number and street (or P.O. box number if mail is not delivered to street address)Foundation Source 501 Silverside Rd
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Wilmington, DE198091377
A Employer identification number

85-1496438
B Telephone number (see instructions)

(800) 839-1754
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$6,023,085J 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) 91,677
2 Check bullet.............
3 Interest on savings and temporary cash investments 17,408 17,408  
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 109,085 17,408  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 15,000 0 0 15,000
c Other professional fees (attach schedule).... Click to see attachment 2,060     2,060
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 150      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications.......... 1,076     1,076
23 Other expenses (attach schedule)....... Click to see attachment 160,204     160,204
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 178,490 0 0 178,340
25 Contributions, gifts, grants paid....... 6,817,916 6,799,175
26 Total expenses and disbursements. Add lines 24 and 25 6,996,406 0 0 6,977,515
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -6,887,321
b Net investment income (if negative, enter -0-) 17,408
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 12,910,406 5,994,239 5,994,239
3 Accounts receivable bullet25,000
Less: allowance for doubtful accounts bullet     25,000 25,000
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)   Click to see attachment3,846 Click to see attachment3,846
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 12,910,406 6,023,085 6,023,085
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 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........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 12,910,406 6,023,085
29 Total net assets or fund balances (see instructions)..... 12,910,406 6,023,085
30 Total liabilities and net assets/fund balances (see instructions). 12,910,406 6,023,085
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
12,910,406
2
Enter amount from Part I, line 27a .....................
2
-6,887,321
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
6,023,085
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
6,023,085
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 242
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 242
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 7
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 300
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 307
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
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 65
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet65 RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (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
Yes
 
If "Yes," attach the statement required by General Instruction T.Click to see attachment
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletDE
    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 ofbulletFoundation Source Telephone no.bullet (800) 839-1754

    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    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
    Lawrence Anderson Dir
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Jeff Barlow Sec
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Carolyn Ingram Dir, Executive Dir
    25.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Mark Keim Treas
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Ronald Kurtz Chair, Executive Dir
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    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
     
    Total number of other employees paid over $50,000...................bullet  
    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
    Foundation Source Administrative 85,236
    55 Walls Drive 3rd Fl
    Fairfield,CT06824
    Total number of others receiving over $50,000 for professional services.............bullet  
    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
    0
    b
    Average of monthly cash balances.......................
    1b
    8,746,300
    c
    Fair market value of all other assets (see instructions)................
    1c
    9,726
    d
    Total (add lines 1a, b, and c).........................
    1d
    8,756,026
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    8,756,026
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    131,340
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    8,624,686
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    431,234
    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
    431,234
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    242
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    242
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    430,992
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    430,992
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    430,992
    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 7 430,992
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:2019, 2018, 2017  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020...... 1,794,926
    f Total of lines 3a through e ........ 1,794,926
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 6,996,256
    a Applied to 2020, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount..... 430,992
    e Remaining amount distributed out of corpus 6,565,264
    5 Excess distributions carryover applied to 2021.    
    (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 8,360,190
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    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......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    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) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		8,360,190
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020.... 1,794,926
    e Excess from 2021.... 6,565,264
    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).)
    NONE
    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 email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    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
    4 REAL CHURCH INC
    1607 CRAWFORD RD
    CLEVELAND,OH44106     		N/A PC Holiday Connections program 6,000
    A C T I O N INC
    PO BOX 456
    YOUNGSTOWN,OH44501     		N/A PC Charitable Event 675
    ACCESS OF WNY INC
    609 RIDGE RD
    LACKAWANNA,NY14218     		N/A PC MolinaCares Summer Safety Community Day 1,500
    ACCESS OF WNY INC
    609 RIDGE RD
    LACKAWANNA,NY14218     		N/A PC Charitable Event 7,500
    ACUMEN FUND INC
    40 WORTH ST STE 303
    NEW YORK,NY10013     		N/A PC Medicaid Innovation Collaborative fund 150,000
    ADELANTE INC
    520 BROADWAY ST
    TOLEDO,OH43604     		N/A PC to purchase Holiday Gifts and Meals 2,000
    AFRICAN AMERICAN BREASTFEEDING NETWORK INC
    PO BOX 1979
    MILWAUKEE,WI53201     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 1,443
    AFRICAN AMERICAN BREASTFEEDING NETWORK INC
    PO BOX 1979
    MILWAUKEE,WI53201     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 2,854
    AFRICAN AMERICAN BREASTFEEDING NETWORK INC
    PO BOX 1979
    MILWAUKEE,WI53201     		N/A PC Lift Up Every Baby Series 5,000
    AGAPE WORSHIP CENTER
    PO BOX 60353
    ROCHESTER,NY14606     		N/A PC Girls Youth Mentoring Program 5,000
    ALIANZA HISPANA-HISPANIC ALLIANCE
    PO BOX 17934
    GREENVILLE,SC29606     		N/A PC Community Teams PROGRAM 5,000
    ALZHEIMERS DISEASE AND RELATED DISORDERS ASSOCIATI
    225 N MICHIGAN AVE 17TH FL
    CHICAGO,IL60601     		N/A PC Project ECHO Southern California HUB 180,000
    ALZHEIMERS DISEASE AND RELATED DISORDERS ASSOCIATI
    309 WAVERLEY OAKS RD
    WALTHAM,MA02452     		N/A PC Charitable Event 17,500
    AMERICAN CANCER SOCIETY
    PO BOX 1685
    ATLANTA,GA30303     		N/A PC Making Strides Against Breast Cancer 5,000
    AMERICAN CANCER SOCIETY INC
    PO BOX 22718
    OKLAHOMA CITY,OK73123     		N/A PC Relay for Life of Clark County 1,000
    AMERICAN HEART ASSOCIATION
    2929 SOUTH 48TH ST
    TEMPE,AZ85282     		N/A PC Feeding Phoenix Families program 20,000
    AMERICAN HEART ASSOCIATION
    2007 O ST
    SACRAMENTO,CA95811     		N/A PC Social Emotional Learning Program & Random Acts of Kindness Campaign 75,000
    AMERICAN INDIAN COMMUNITY CENTER ASSOCIATION
    1025 W INDIANA AVE
    SPOKANE,WA99205     		N/A PC Holiday Event - Winter Ball 5,000
    AMERICAN NATIONAL RED CROSS
    431 18TH ST NW
    WASHINGTON,DC20006     		N/A PC Hometown Hero - Winter Weather program 10,000
    AMERICAN RED CROSS
    2000 CENTURY DR
    WORCESTER,MA01606     		N/A PC The Sickle Cell Initiative 10,000
    ARIZONA WOMENS RECOVERY CENTER
    4201 N 16TH ST STE 140
    PHOENIX,AZ85016     		N/A PC General & Unrestricted 25,000
    ASAFO COMMUNITY DEVELOPMENT ASSOCIATION
    2447 VISTAVIA RD
    N CHARLESTON,SC29406     		N/A PC General & Unrestricted 2,000
    ASAFO COMMUNITY DEVELOPMENT ASSOCIATION
    2447 VISTAVIA RD
    N CHARLESTON,SC29406     		N/A PC Winter Coats for Charleston Hispanic Association 1,000
    ASAFO COMMUNITY DEVELOPMENT ASSOCIATION
    2447 VISTAVIA RD
    N CHARLESTON,SC29406     		N/A PC Thanksgiving Giveaway FUND 5,000
    ASOCIACION HISPANO AMERICANA DE MUJERES
    PO BOX 17674
    GREENVILLE,SC29606     		N/A PC Scholarships fund for Higher Education 10,000
    AUDUBON AREA COMMUNITY SERVICES INC
    1700 W 5TH ST
    OWENSBORO,KY42301     		N/A PC Community Impact Program 10,000
    AVONDALE DEVELOPMENT CORPORATION
    3635 READING RD
    CINCINNATI,OH45229     		N/A PC Thanksgiving Food Distribution FUND 2,500
    BACK BAY MISSION
    1012 DIVISION ST
    BILOXI,MS39530     		N/A PC Project Helping the Homeless 1,500
    BBLESS2 OUTREACH MINISTRIES INC
    4977 KARL RD
    COLUMBUS,OH43229     		N/A PC Homeless Outreach and Job Readiness Training Program 2,000
    BELIEVE CENTER INC
    1 AURORA L GONZALEZ DR
    TOLEDO,OH43609     		N/A PC Fall & Holiday Meals fund 2,500
    BETHESDA WORLD HARVEST INTERNATIONAL CHURCH
    PO BOX 852
    BUFFALO,NY14209     		N/A PC Funding Community Events 2,500
    BIDDY MASON CHARITABLE FOUNDATION
    2193 W 25TH ST
    LOS ANGELES,CA90018     		N/A PC Biddy Mason Capitol Campaign 20,000
    BIRTHMATTERS
    501 HOWARD ST STE A
    SPARTANBURG,SC29303     		N/A PC Uplifting Families in Need 1,500
    BLACK PHYSICIAN NETWORK OF GREATER ROCHESTER INC
    200 CANAL VIEW BLVD STE 202
    ROCHESTER,NY14623     		N/A PC Black Physicians Network -Healthcare Professional pipeline scholarship fund 10,000
    BLOC MINISTRIES INC
    911 W 8TH ST
    CINCINNATI,OH45203     		N/A PC Holiday Distribution fund 2,500
    BLUE GRASS COMMUNITY FOUNDATION INC
    499 EAST HIGH ST SUITE 112
    LEXINGTON,KY40507     		N/A PC Charitable Event 20,000
    BOISE STATE UNIVERSITY FOUNDATION INC
    1173 W UNIVERSITY DR
    BOISE,ID83706     		N/A PC Charitable Event 3,000
    BOYS & GIRLS CLUBS INC
    3900 CRITTENDEN DR
    LOUISVILLE,KY40209     		N/A PC After-school/Summer Programming Scholarship Fund 15,000
    BOYS & GIRLS CLUBS OF THE CRESCENT REGION
    500 GRACERN RD
    COLUMBIA,SC29210     		N/A PC Family Day at Riverbanks Zoo and Winter Camps 20,000
    BOYS & GIRLS CLUBS OF WASHINGTON COUNTY
    PO BOX 1415
    GREENVILLE,MS38702     		N/A PC Access to Healthy Foods Program and Education 25,000
    BRANCHES INC
    11500 NW 12TH AVE
    MIAMI,FL33168     		N/A PC Branches Back to School Beautification Project 8,000
    BRANCHES INC
    11500 NW 12TH AVE
    MIAMI,FL33168     		N/A PC Thanksgiving Meal Giveaway fund 5,000
    BRAVE WARRIOR PROJECT
    PO BOX 3221
    WENATCHEE,WA98807     		N/A PC 2021 Virtual Auction 1,000
    BRENTWOOD CHURCH OF CHRIST
    6425 N 60TH ST
    MILWAUKEE,WI53223     		N/A PC Brentwood Church of Christ Food Drive 1,300
    BRENTWOOD CHURCH OF CHRIST
    6425 N 60TH ST
    MILWAUKEE,WI53223     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 965
    BUFFALO ARTS AND TECHNOLOGY CENTER INC
    1221 MAIN ST
    BUFFALO,NY14209     		N/A PC Mental Health Awareness Mural 2,000
    BUFFALO GO GREEN INC
    45 PEMBROKE AVE
    BUFFALO,NY14215     		N/A PC Farm to Fork Program 20,000
    CALIFORNIA ACCESS COALITION
    455 CAPITOL MALL STE 315
    SACRAMENTO,CA95814     		N/A PC Crisis Call Center Training and Evaluation 200,000
    CALIFORNIA PRIMARY CARE ASSOCIATION
    1231 I ST
    SACRAMENTO,CA95814     		N/A PC Leadership Equity Program 550,000
    CAMERON COMMUNITY MINISTRIES INC
    CAMERON COMMUNITY MINISTRIES INC 48
    ROCHESTER,NY14606     		N/A PC General & Unrestricted 2,500
    CAMILLUS HOUSE INC
    PO BOX 11829
    MIAMI,FL33101     		N/A PC Day Center Shower & Clothing Program 10,000
    CARING AND NURTURING
    PO BOX 2433
    EASLEY,SC29641     		N/A PC Repack the Backpack PROGRAM 1,500
    CAROLINA HUMAN REINVESTMENT
    PO BOX 2440
    GEORGETOWN,SC29442     		N/A PC Charitable Event 5,000
    CASE WESTERN RESERVE UNIVERSITY
    10900 EUCLID AVE
    CLEVELAND,OH44106     		N/A PC annual tuition-based scholarships for a total of four (4) students in each of the academic years commencing fall of 2021, 2022, 2023, and 2024 300,000
    CATHOLIC CHARITIES A COMMUNITY SERVICE MINISTRY OF
    3888 PADUCAH DR
    SAN DIEGO,CA92117     		N/A PC Charitable Event 5,000
    CENTER FOR CLOSING THE HEALTH GAP IN GREATER CINCI
    3120 BURNET AVE STE 201
    CINCINNATI,OH45229     		N/A PC The Health Gap Holiday Funding 5,000
    CENTRAL MIDLANDS DEVELOPMENT CORPORATION
    236 STONERIDGE DR
    COLUMBIA,SC29210     		N/A PC Christmas Giveaway fund 3,500
    CENTRAL NEW YORK JAZZ ARTS FOUNDATION INC
    441 E WASHINGTON ST
    SYRACUSE,NY13202     		N/A PC Charitable Event 5,000
    CHAMPION ACADEMY EXTREME MENTORING & EMPOWERMENT I
    1 PLEASANT ST STE 406
    ROCHESTER,NY14604     		N/A PC Champion Academy/Passport to the World Program 15,000
    CHARLESTON COMMUNITY IMPACT
    4870 PIEDMONT AVE
    N CHARLESTON,SC29406     		N/A PC Holiday Turkey Giveaway fund 10,000
    CHARLESTON PROMISE NEIGHBORHOOD
    1834 SUMMERVILLE AVE STE 200
    N CHARLESTON,SC29405     		N/A PC KidsWell School-Based Health Program 5,000
    CHAUTAUQUA COUNTY RURAL MINISTRIES INC
    319 WASHINGTON AVE
    DUNKIRK,NY14048     		N/A PC General & Unrestricted 5,000
    CHAUTAUQUA OPPORTUNITIES INC
    17 W COURTNEY ST
    DUNKIRK,NY14048     		N/A PC COI Diaper Days Community Giveaway fund 10,000
    CHIEF SEATTLE CLUB
    410 2ND AVE EXT S
    SEATTLE,WA98104     		N/A PC Winter Warm Gear Distribution fund 3,200
    CHILD ADVOCACY CENTER OF SNOHOMISH COUNTY
    1509 CALIFORNIA ST
    EVERETT,WA98201     		N/A PC Charitable Event 1,000
    CHILD AND FAMILY RESOURCE FOUNDATION
    718 S 4TH ST
    HARTSVILLE,SC29550     		N/A PC Christmas on Home program 2,000
    CHILDRENS HEALTH INVESTMENT PROGRAM INC
    1302 JEFFERSON ST
    CHESAPEAKE,VA23324     		N/A PC CHIP Store & Food Program 10,000
    CHILDRENS HOME SOCIETY OF WASHINGTON
    12360 LAKE CITY WAY NE STE 450
    SEATTLE,WA98125     		N/A PC Behavioral Health Support fund 10,000
    CHINESE CHRISTIAN UNION CHURCH
    2301 S WENTWORTH AVE
    CHICAGO,IL60616     		N/A PC Meal Outreach Program 40,000
    CHRISTMAS BOX INTERNATIONAL
    3660 S W TEMPLE
    S SALT LAKE,UT84115     		N/A PC Project Elf 3,000
    CHURCH WOMEN UNITED THRIFT SHOP INC
    PO BOX 366
    HOLLAND,OH43528     		N/A PC thrift shops food and clothing programming for families in need 2,000
    CICATELLI ASSOCIATES INC
    505 EIGHT AVE 16TH FL
    NEW YORK,NY10018     		N/A PC Workforce Development Programming 15,000
    CINCINNATI-HAMILTON COUNTY COMMUNITY ACTION AGENCY
    1740 LANGDON FARM RD
    CINCINNATI,OH45237     		N/A PC Charitable Event 2,500
    CLARA WHITE MISSION INC
    613 W ASHLEY ST
    JACKSONVILLE,FL32202     		N/A PC Daily Feeding Program 5,000
    CLEVELAND HILL ELEMENTARY SCHOOL
    105 MAPLEVIEW RD
    CHEEKTOWAGA,NY14225     		N/A GOV Basic School Supply funds 500
    CLIMB COMMUNITY DEVELOPMENT CORPORATION
    1526 MILLS AVE
    GULFPORT,MS39501     		N/A PC MolinaCares Workforce Training Scholarship fund 25,000
    CODAC INC
    1052 PARK AVE
    CRANSTON,RI02910     		N/A PC OTP Infrastructure fund 25,000
    COLUMBIA URBAN LEAGUE INC
    1400 BARNWELL ST
    COLUMBIA,SC29201     		N/A PC Thanksgiving Giveaway fund 5,000
    COLUMBUS KAPPA FOUNDATION
    1461 MOUNT VERNON AVE
    COLUMBUS,OH43203     		N/A PC Thanksgiving Food Giveaway & Christmas Toy Drive fund 4,000
    COMMONWEALTH OF KENTUCKY
    500 MERO ST 218-NC
    FRANKFORT,KY40601     		N/A GOV Team Western Kentucky Tornado Relief Fund 200,000
    COMMUNITIES IN SCHOOLS OF WHATCOM COUNTY
    PO BOX 6071
    BELLINGHAM,WA98227     		N/A PC Basic Needs Resource Closet 2,500
    COMMUNITY ACTION PARTNERSHIP OF PROVIDENCE
    518 HARTFORD AVE
    PROVIDENCE,RI02909     		N/A PC CAPP Cares - Access to Healthcare and Basic Needs 50,000
    COMMUNITY DEVELOPMENT FOR ALL PEOPLE
    946 PARSONS AVE
    COLUMBUS,OH43206     		N/A PC Charitable Event 2,500
    COMMUNITY FARM ALLIANCE INC
    327 CHESTNUT ST STE 1
    BEREA,KY40403     		N/A PC Healthy Communities - KY Double Dollars fund 20,000
    COMMUNITY HEALTH ACTION NETWORK
    15000 7TH ST STE 208G
    VICTORVILLE,CA92395     		N/A PC Children's Toy Drive 1,500
    COMMUNITY HEALTH CENTERS INC
    2621 S 3270 W
    W VALLEY CITY,UT84119     		N/A PC Charitable Event 2,500
    COMMUNITY OUTREACH MINISTRY
    23905 CLINTON KEITH RD
    WILDOMAR,CA92595     		N/A PC Charitable Event 5,000
    COMMUNITY SHELTER BOARD
    355 E CAMPUS VIEW BLVD
    COLUMBUS,OH43235     		N/A PC Home for the Holidays Campaign 5,000
    COMPASS HEALTH
    4526 FEDERAL AVE M/S 49
    EVERETT,WA98203     		N/A PC Compass Health Broadway Campus Redevelopment Project 100,000
    CORNERSTONE CHRISTIAN CENTER OF HOMESTEAD FLORIDA
    10844 SW 188TH ST
    CUTLER BAY,FL33157     		N/A PC to purchase Holiday Meals 2,500
    CORNERSTONE COMMUNITY CHURCH
    1481 CHESTNUT ST
    ORANGEBURG,SC29115     		N/A PC Outreach Ministry, Emergency Food Assistance Pantry 1,000
    COUNCIL FOR THE HOMELESS
    2500 MAIN ST
    VANCOUVER,WA98660     		N/A PC Making Home Possible program 1,500
    CRISTO REY RICHMOND HIGH SCHOOL INC
    304 N SHEPPARD ST
    RICHMOND,VA23221     		N/A PC Corporate Work Study Program 20,000
    CURLEYS HOUSE OF STYLE INC
    6025 NW 6TH CT
    MIAMI,FL33127     		N/A PC MolinaCares Holiday Programming 10,000
    DARE TO CARE INC
    5803 FERN VALLEY RD
    LOUISVILLE,KY40228     		N/A PC Feeding Families Program 15,000
    DAVIS CITIZENS COALITION AGAINST VIOLENCE
    223 LARSEN LN
    LAYTON,UT84041     		N/A PC Sub for Santa - Safe Harbor 5,000
    DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH INC
    10 PETERBORO ST
    DETROIT,MI48201     		N/A PC Workforce Retention Program 10,000
    DISCOVERY CENTER OF SCIENCE AND TECHNOLOGY
    500 S FRANKLIN ST
    SYRACUSE,NY13202     		N/A PC Exclusive Lifetime Sponsorship of the Multi-Media lab 75,000
    DOMESTIC VIOLENCE SERVICES OF SNOHOMISH COUNTY
    PO BOX 7
    EVERETT,WA98206     		N/A PC Charitable Event 1,000
    DOWNTOWN STREETS INC
    1671 THE ALAMEDA STE 306
    SAN JOSE,CA95126     		N/A PC MolinaCares Champions - Sacramento 5,000
    DOWNTOWN STREETS INC
    1671 THE ALAMEDA STE 306
    SAN JOSE,CA95126     		N/A PC Committed 2 Care - Workforce Program 80,228
    DRAGON KIM FOUNDATION
    13217 JAMBOREE RD
    TUSTIN,CA92782     		N/A PC Fellowship Program 5,000
    DREAM BUILDERS GROUP INC
    6759 S COUNTY RD 25A
    TIPP CITY,OH45371     		N/A PC Charitable Event 3,000
    DRESS FOR SUCCESS CINCINNATI
    4623 WESLEY AVE STE H
    CINCINNATI,OH45212     		N/A PC 2021 Dress for Success Campaign 2,000
    EARLY CHILDHOOD INVESTMENT CORPORATION
    8164 EXECUTVE COURT STE A
    LANSING,MI48917     		N/A GOV Think Babies Michigan Mini program 100,000
    EAST COUNTY TRANSITIONAL LIVING CENTER INC
    1527 E MAIN ST
    EL CAJON,CA92021     		N/A PC Winter Coat Giveaway fund 5,000
    EAST TOLEDO FAMILY CENTER INC
    1020 VARLAND AVE
    TOLEDO,OH43605     		N/A PC Holiday Gift Distribution fund 2,000
    EAU CLAIRE COOPERATIVE HEALTH CENTER INC
    169 LAURELHURST AVE
    COLUMBIA,SC29210     		N/A PC Thanksgiving Giveaway fund 5,000
    EL CENTRO DE LA RAZA
    2524 16TH AVE S
    SEATTLE,WA98144     		N/A PC Charitable Event 2,000
    EL PASO CHILD GUIDANCE CENTER INC
    PO BOX 1769
    EL PASO,TX79949     		N/A PC Raise the Roof on Mental Health program 5,000
    EL SOL NEIGHBORHOOD EDUCATIONAL CENTER
    766 N WATERMAN AVE
    SN BERNRDNO,CA92410     		N/A PC Charitable Event 5,000
    EPISCOPAL COMMUNITY SERVICES
    401 MILE OF CARS WAY STE 350
    NATIONAL CITY,CA91950     		N/A PC General & Unrestricted 5,000
    EPWORTH CHILDRENS HOME
    2900 MILLWOOD AVE
    COLUMBIA,SC29205     		N/A SO I Shop with Jocks - Connor Shaw 5,000
    EVANGELICAL TRINITY LUTHERAN CHURCH OF HOLY TRINIT
    50 N PROSPECT ST
    AKRON,OH44304     		N/A PC Holiday Giving fund 5,000
    EVERGREEN TREATMENT SERVICES
    1700 AIRPORT WAY S
    SEATTLE,WA98134     		N/A PC Fourth Annual Event - Roots of Recovery 1,000
    EVOLVE502 INC
    334 E BROADWAY
    LOUISVILLE,KY40202     		N/A PC Evolve502 Scholars Scholarship Fund 25,000
    EXCELSIOR WELLNESS
    3754 W INDIAN TRAIL RD
    SPOKANE,WA99208     		N/A PC MEET Excelsior & Excelsior Equity Scholarship Fund 100,000
    EXPLORE & MORE A CHILDRENS MUSEUM
    130 MAIN ST
    BUFFALO,NY14202     		N/A PC Molina Mondays at the Museum 20,000
    FAMILY CONNECTION OF SOUTH CAROLINA INC
    1800 SAINT JULIAN PL STE 104
    COLUMBIA,SC29204     		N/A PC Project Breathe Easy 5,000
    FAMILY HEALTH CENTERS INC
    PO BOX 1806
    ORANGEBURG,SC29116     		N/A PC Toys For Tots program 1,000
    FAMILY SCHOLAR HOUSE INC
    403 REG SMITH CIR
    LOUISVILLE,KY40208     		N/A PC Houston Family Scholar House 75,000
    FAMILY SCHOLAR HOUSE INC
    403 REG SMITH CIR
    LOUISVILLE,KY40208     		N/A PC LouieConnect.com web-app kiosks for Elizabethtown 15,000
    FAMILY SERVICE ASSOCIATION
    21250 BOX SPRINGS RD SU11E 215
    MORENO VALLEY,CA92557     		N/A PC General & Unrestricted 5,000
    FAMILY SERVICE OF RHODE ISLAND INC
    134 THURBERS AVE
    PROVIDENCE,RI02905     		N/A PC AIDS Project RI & Project SOS 30,000
    FAMILY SUPPORT CENTER
    1760 W 4805 S
    TAYLORSVILLE,UT84129     		N/A PC Lifestart Village program 3,500
    FARM SHARE INC
    14125 SW 320TH ST
    HOMESTEAD,FL33033     		N/A PC True Grit Mural Project 20,000
    FEAST COLLECTIVE
    1321 W 3RD AVE
    SPOKANE,WA99201     		N/A PC General & Unrestricted 2,500
    FEDERATION OF FAMILIES OF CENTRAL FLORIDA INC
    2605 MAITLAND CTR PKWY
    MAITLAND,FL32751     		N/A PC MolinaCares Youth Program 15,000
    FEEDING AMERICA KENTUCKYS HEARTLAND INC
    PO BOX 821
    ELIZABETHTOWN,KY42702     		N/A PC Emergency Mobile Food Pantries 10,000
    FILL A HEART 4 KIDS INC
    400 E ILLINOIS RD
    LAKE FOREST,IL60045     		N/A PC Mobile School Pantry 50,000
    FIRST FIVE FUNDAMENTALS
    1501 PACIFIC AVE STE 201
    TACOMA,WA98402     		N/A PC Help Me Grow Pierce Diaper Bank 1,000
    FIRST GENESIS BAPTIST CHURCH INC
    292 HUDSON AVE
    ROCHESTER,NY14605     		N/A PC Community Giving Events & Distributions fund 15,000
    FIRST GENESIS BAPTIST CHURCH INC
    292 HUDSON AVE
    ROCHESTER,NY14605     		N/A PC Aenon Baptist Church - Single Mom Sunday program 5,000
    FLYING HIGH INC
    6 FEDERAL PLZ CENTRAL 7TH FLOOR
    YOUNGSTOWN,OH44503     		N/A PC Professional Development Center - MolinaCares Workforce training facility 100,000
    FOOD BANK OF THE RIO GRANDE VALLEY INC
    PO BOX 6251
    MCALLEN,TX78502     		N/A PC Food Bank Transportation Access fund 100,000
    FOODCORPS INC
    1140 SE 7TH AVE STE 110
    PORTLAND,OR97214     		N/A PC Connecting MS Kids to Healthy Food in Schools 50,000
    FOSTER FORWARD
    55 S BROW ST
    EAST PROVIDENCE,RI02914     		N/A PC Your Way Home Program 25,000
    FOUNDATION FOR BLACK WOMENS WELLNESS
    6601 GRAND TETON PLAZA STE A2
    MADISON,WI53719     		N/A PC Charitable Event 2,500
    FREE SPIRIT MISSIONARY BAPTIST CHURCH
    PO BOX 517
    BUFFALO,NY14240     		N/A PC Charitable Event 2,000
    FREE SPIRIT MISSIONARY BAPTIST CHURCH
    PO BOX 517
    BUFFALO,NY14240     		N/A PC MolinaCares Summer Safety Community Day 2,000
    FREE TO THRIVE
    1050 UNIVERSITY AVE STE E107 84
    SAN DIEGO,CA92103     		N/A PC Charitable Event 5,000
    FREESTORE-FOODBANK INC
    1141 CENTRAL PKWY
    CINCINNATI,OH45202     		N/A PC Holiday Distribution fund 10,000
    FRIENDLY INN SETTLEMENT INC
    2386 UNWIN RD
    CLEVELAND,OH44104     		N/A PC Community Collaboration program 5,000
    FRIENDS OF LUCAS COUNTY CHILDREN SERVICES
    441
    MAUMEE,OH43537     		N/A PC Holiday Gift Giving for Foster Teens 6,000
    FRIENDS OF THE CHILDREN - SOUTHWEST WASHINGTON - S
    6603 IDAHO ST
    VANCOUVER,WA98661     		N/A PC Friends Take Flight 1,000
    GARRARD COUNTY FOOD PANTRY INC
    PO BOX 408
    LANCASTER,KY40444     		N/A PC Holiday fund 15,000
    GENESIS CENTER
    620 POTTERS AVE
    PROVIDENCE,RI02907     		N/A PC General & Unrestricted 5,000
    GIGIS PLAYHOUSE INC
    5885 E CIR DR STE 250
    CICERO,NY13039     		N/A PC GigiFit Acceptance Challenge for the Downs Syndrome community 2,500
    GLOBAL VISIONARIES
    2524 16TH AVE S STE 206
    SEATTLE,WA98144     		N/A PC Charitable Event 1,000
    GODS PANTRY FOOD BANK INC
    1685 JAGGIE FOX WAY
    LEXINGTON,KY40511     		N/A PC Food Bank's School Pantry Program 25,000
    GRACE COMMUNITY CENTER INC
    406 W DELAWARE AVE
    TOLEDO,OH43610     		N/A PC Community Garden fund 1,200
    GRACE GUEST HOUSE INC
    2315 SENECA ST
    BUFFALO,NY14210     		N/A PC General & Unrestricted 1,000
    GRACE IMPACT DEVELOPMENT CENTER INC
    401 STONY LANDING RD
    MONCKS CORNER,SC29461     		N/A PC Micro Learning Centers 3,000
    GRANITE EDUCATION FOUNDATION INC
    2500 S STATE ST
    SALT LAKE CITY,UT84115     		N/A PC Granite School Food Pantries & Weekend Meal Kits program 20,000
    GREATER BINGHAMTON SOCCER ASSOC
    1500 AIRPORT RD
    BINGHAMTON,NY13905     		N/A PC funds for Youth Sports 15,000
    GREATER HOPE MINISTRY
    1163 JOHNNY FOREST RD
    SUMMIT,MS39666     		N/A PC Project Helping the Homeless 2,000
    GREATER METRO PARKS FOUNDATION
    4702 S 19TH ST
    TACOMA,WA98405     		N/A PC Charitable Event 5,000
    HABITAT FOR HUMANITY INTERNATIONAL INC
    PO BOX 871570
    VANCOUVER,WA98687     		N/A PC Raising the Roof Annual Event 2,500
    HALLELUJAH COMMUNITY CHURCH
    226 SE 15TH ST
    CAPE CORAL,FL33990     		N/A PC Haitian Community Closet 4,000
    HAMILTON COMMUNITY HEALTH NETWORK INC
    225 E 5TH ST STE 300
    FLINT,MI48502     		N/A PC Charitable Event 10,000
    HARC INC
    41550 ECLECTIC ST SUITE 100B
    PALM DESERT,CA92260     		N/A PC Charitable Event 5,000
    HARPURSVILLE CENTRAL SCHOOL DISTRICT
    PO BOX 147
    HARPURSVILLE,NY13787     		N/A GOV Community Closet Program 4,542
    HARRY CHAPIN FOOD BANK OF SOUTHWEST FLORIDA INC
    3760 FOWLER ST
    FORT MYERS,FL33901     		N/A PC Meal Program 10,000
    HARRY CHAPIN FOOD BANK OF SOUTHWEST FLORIDA INC
    3760 FOWLER ST
    FORT MYERS,FL33901     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 502
    HARVARD COMMUNITY SERVICES CENTER
    18240 HARVARD AVE
    CLEVELAND,OH44128     		N/A PC HCSC Holiday Giving fund 2,000
    HARVEST HOPE FOOD BANK
    2220 SHOP RD
    COLUMBIA,SC29201     		N/A PC Holiday Food Mobile Event 5,000
    HARVEST HOPE FOOD BANK
    2220 SHOP RD
    COLUMBIA,SC29201     		N/A PC Holiday Mobile Food Event 5,000
    HEALTH CARE PARTNERS OF SOUTH CAROLINA INC
    1708 OAK ST
    CONWAY,SC29526     		N/A PC Thanksgiving Giveaway fund 5,000
    HEALTHY COMMUNITY ALLIANCE INC
    1 SCHOOL ST
    GOWANDA,NY14070     		N/A PC CBO and Service Tool Project 10,000
    HELPING LINK
    1032 S JACKSON ST SUITE C
    SEATTLE,WA98104     		N/A PC Charitable Event 1,000
    HISPANIC COALITION CORP
    5659 W FLAGLER ST
    CORAL GABLES,FL33134     		N/A PC MolinaCares Community Closet 3,000
    HOME OF THE INNOCENTS
    1100 MARKET ST
    LOUISVILLE,KY40206     		N/A PC Multi-Systemic Therapy program 15,000
    HOMELESS ID PROJECT
    206 S 12TH AVE
    PHOENIX,AZ85007     		N/A PC General & Unrestricted 10,000
    HOMELESS YOUTH WORKGROUP OF YAKIMA COUNTY DBA RODS
    PO BOX 2283
    YAKIMA,WA98907     		N/A PC Charitable Event 2,500
    HOPE IN CHRIST MINISTRIES DBA THE COFFEE OASIS
    837 4TH ST
    BREMERTON,WA98337     		N/A PC funds for youth opioid use disorder/substance abuse counseling and outreach program 2,500
    HOPE OF BUFFALO INC
    660 SMITH ST
    BUFFALO,NY14210     		N/A PC Hygiene funds and General & Unrestricted 2,500
    HOPESPARKS
    6424 N 9TH ST
    TACOMA,WA98406     		N/A PC Charitable Event 2,500
    HUI INTERNATIONAL
    5628 MARSDEN ST
    DAVIS,CA95618     		N/A PC Ulysses Syndrome/Migratory Mourning One Pager and Video program 9,850
    HUMAN SERVICES CAMPUS L L C
    204 S 12TH AVE
    PHOENIX,AZ85007     		N/A PC General & Unrestricted 60,000
    HURLEY FOUNDATION
    1 HURLEY PLZ
    FLINT,MI48503     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 275
    I SERVE WITH JOY
    PO BOX 41783
    N CHARLESTON,SC29423     		N/A PC Winter Giveaway fund 5,000
    ICNA RELIEF USA PROGRAMS INC
    1529 JERICHO TPKE
    NEW HYDE PARK,NY11040     		N/A PC Community Pediatric Outreach program 1,000
    IDAHO FOODBANK WAREHOUSE
    3630 E COMMERCIAL CT
    MERIDIAN,ID83642     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 1,418
    IDAHO FOODBANK WAREHOUSE
    3630 E COMMERCIAL CT
    MERIDIAN,ID83642     		N/A PC Hope for the Holidays - Mobile Food Pantries fund 10,000
    IDAHO FOODBANK WAREHOUSE
    3630 E COMMERCIAL CT
    MERIDIAN,ID83642     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 1,544
    IDAHO ORAL HEALTH ALLIANCE INC
    PO BOX 2309
    BOISE,ID83701     		N/A PC Oral Health Training for Idaho Medical Providers fund 5,000
    INLAND CONGREGATION UNITED FOR CHANGE SPONSORING C
    1441 N D ST STE 208
    SN BERNRDNO,CA92405     		N/A PC Charitable Event 5,000
    INTERFAITH SANCTUARY HOUSINGSERVICES INC
    PO BOX 9334
    BOISE,ID83707     		N/A PC to Purchase PPE - Protective Gloves 3,000
    IOWA HEALTH CARE ASSOCIATION FOUNDATION
    1775 90TH ST
    WDM,IA50266     		N/A PC IHCA Foundation High School Scholarship Program 30,000
    JORDAN COMMUNITY RESIDENTIAL CENTER
    2231 N TAYLOR RD
    CLEVELAND,OH44112     		N/A PC Holiday Giving fund 1,500
    KENTUCKY YOUTH ADVOCATES INC
    10200 LINN STA RD STE 310
    LOUISVILLE,KY40223     		N/A PC Kentucky KIDS COUNT Project 50,000
    KINGDOM KEEPERS CHURCH INC
    1466 E 55TH ST
    CLEVELAND,OH44103     		N/A PC Holiday Giving fund 1,500
    LA CASA HOGAR
    106 S 6TH ST
    YAKIMA,WA98901     		N/A PC Adult Education Summer Program 2,000
    LACKAWANNA CITY SCHOOL DISTRICT
    245 S SHORE BLVD
    LACKAWANNA,NY14218     		N/A GOV to Purchase a Washer/Dryer 2,206
    LASA
    PO BOX 98619
    LAKEWOOD,WA98496     		N/A PC Charitable Event 2,000
    LATINO LEADERSHIP INC
    8617 E COLONIAL DR STE 1600
    ORLANDO,FL32817     		N/A PC Clinica Mi Salud Exam Room Expansion fund 12,000
    LEARN - LIFELONG EDUCATION AND AGING RESOURCE NETW
    5707 W HIDDEN SPRINGS DR
    BOISE,ID83714     		N/A PC Charitable Event 5,000
    LOCAL FOOD HUB
    PO BOX 4647
    CHARLOTTESVLE,VA22905     		N/A PC Fresh Farmacy Partnership program 20,000
    LONG BEACH RESCUE MISSION
    1430 PACIFIC AVE
    LONG BEACH,CA90813     		N/A PC Meal Program / MolinaCares Closet 10,000
    LORD OF LIFE LUTHERAN CHURCH
    9225 SW 137TH AVE
    MIAMI,FL33186     		N/A PC Community Closet 3,000
    LOS ALAMOS NATIONAL LABORATORY FOUNDATION
    1112 PLZ DEL NORTE
    ESPANOLA,NM87532     		N/A PC Governor's STEM Challenge 5,000
    LOWCOUNTRY FOOD BANK INC
    2864 AZALEA DR
    CHARLESTON,SC29405     		N/A PC Fighting Food Insecurity in the Lowcountry 5,000
    LUTHERAN COMMUNITY SERVICES NORTHWEST
    4040 S 188TH ST
    SEATAC,WA98188     		N/A PC Thanksgiving Basket funds 2,000
    LUTHERAN COMMUNITY SERVICES NORTHWEST
    4040 S 188TH ST
    SEATAC,WA98188     		N/A PC Benefits Refugees NW 500
    LUTHERAN SOCIAL SERVICES OF CENTRAL OHIO INC
    1105 SCHROCK RD STE 100
    COLUMBUS,OH43229     		N/A PC Thankful Holiday 2021 2,500
    LYDIAS BOWELS OF MERCY HOME INC
    PO BOX 551
    JOHNSONVILLE,SC29555     		N/A PC Holiday Turkey Giveaway fund 5,000
    MAHONING COUNTY PUBLIC HEALTH
    50 WESTCHESTER DR
    YOUNGSTOWN,OH44515     		N/A GOV Breastfeeding Awareness Month 1,000
    MAHONING YOUNGSTOWN COMMUNITY ACTION PARTNERSHIP
    1325 5TH AVE
    YOUNGSTOWN,OH44504     		N/A PC Charitable Event 1,000
    MARYS PLACE
    9529 29TH ST NE
    LAKE STEVENS,WA98258     		N/A PC Vaccination Outreach program 1,750
    MARYSVILLE SCHOOL DISTRICT
    4220 80TH ST NE
    MARYSVILLE,WA98270     		N/A GOV Day of the Child Program 2,000
    MEALS ON WHEELS OF GREENVILLE INC
    15 OREGON ST
    GREENVILLE,SC29605     		N/A PC Daily Meal Delivery Program 4,000
    MERRIMACK VALLEY FOOD BANK INC
    735 BROADWAY ST
    LOWELL,MA01854     		N/A PC Food Bank program 12,500
    MIAMI VALLEY HOUSING OPPORTUNITIES INC
    907 W 5TH ST
    DAYTON,OH45402     		N/A PC 30th Anniversary Campaign - Improving Quality of Life of Citizens of Montgomery County 3,000
    MICHIGAN ORGANIZING PROJECT
    PO BOX 402
    OSHTEMO,MI49077     		N/A PC Oakland Forward Citizen Engagement Project 3,000
    MILL COMMUNITY MINISTRIES
    1186 PENDLETON ST
    GREENVILLE,SC29611     		N/A PC FoodShare Greenville program 20,000
    MILLENNIA MINISTRIES
    3426 BROADWAY STE 201 202
    EVERETT,WA98201     		N/A PC Back to School Event for youth in Transitional Housing 2,000
    MILWAUKEE HEALTH SERVICES INC
    2555 N MARTIN LUTHER KING DR
    MILWAUKEE,WI53212     		N/A PC Conquer COVID-19 Food Giveaway 6,000
    MISSISSIPPI CHILDRENS MUSEUM
    PO BOX 12870
    JACKSON,MS39236     		N/A PC MCM Happy Health Families 25,000
    MISSISSIPPI CHILDRENS MUSEUM
    PO BOX 12870
    JACKSON,MS39236     		N/A PC MCM Healthy Heroes XRAY Exhibit 25,000
    MISSISSIPPI FOOD NETWORK INC
    440 BEATTY ST
    JACKSON,MS39201     		N/A PC Mississippi Food Network mobile food pantry fund 34,650
    MISSISSIPPI FOOD NETWORK INC
    440 BEATTY ST
    JACKSON,MS39201     		N/A PC Mobile Pantry & Backpack Program 73,000
    MITNEY PROJECT
    PO BOX 349
    GEORGETOWN,SC29442     		N/A PC Wellness Works Learning Lab 2,000
    MOBILEMED1 INC
    950 RICHMOND RD TR 205
    LYNDHURST,OH44124     		N/A PC MedWork Equity Dental Clinic 2,500
    MUSLIM COMMUNITY AND HEALTH
    803 W LAYTON AVE
    MILWAUKEE,WI53221     		N/A PC Sakina Senior Center Programs 5,000
    NAMI GREATER CLEVELAND
    2012 W 25TH ST STE 600
    CLEVELAND,OH44113     		N/A PC Charitable Event 500
    NAMI GREATER ORLANDO INC
    300 CROWN OAK CENTRE DR
    LONGWOOD,FL32750     		N/A PC NAMIGO Educational and Mental Health fund 5,000
    NAMI VALLEY OF THE SUN
    5025 E WASHINGTON ST STE 112
    PHOENIX,AZ85034     		N/A PC General & Unrestricted 20,000
    NAMI WASHINGTON
    1107 NE 45TH ST STE 340
    SEATTLE,WA98105     		N/A PC NAMI Walks 2021 1,000
    NATIONAL AFRICAN AMERICAN MALE WELLNESS AGENCY
    2780 AIRPORT DR STE 333
    COLUMBUS,OH43219     		N/A PC AAMWW - Statewide Walks 35,000
    NATIONAL ALLIANCE ON MENTAL ILLNESS-IOWA INC
    3839 MERLE HAY RD STE 229
    DES MOINES,IA50310     		N/A PC NAMI Iowa Signature Program Training 25,000
    NEAR WEST SIDE INITIATIVE INC
    115 OTISCO ST
    SYRACUSE,NY13204     		N/A PC Charitable Event 2,500
    NEIGHBORHOOD HEALTH CARE INCORPORATED
    3569 RIDGE RD
    CLEVELAND,OH44102     		N/A PC MolinaCares Maternal and Family Health program 2,000
    NEW COVENANT CHURCH OF GOD
    1667 ROSE DR
    SUMMERVILLE,SC29486     		N/A PC Christmas In the Community 5,000
    NEW LIFE BAPTIST MISSION
    PO BOX 68
    HAMILTON,OH45012     		N/A PC Holiday Meal Programs 2,000
    NORTH COUNTY LIFELINE INC
    200 MICHIGAN AVE
    VISTA,CA92084     		N/A PC MolinaCares Pantry 20,000
    NORTH SOUND ACCOUNTABLE COMMUNITY OF HEALTH
    1204 RAILROAD AVE STE 200
    BELLINGHAM,WA98225     		N/A PC Community Health Worker / Promotoras Fund 10,000
    NORTHEAST MISSISSIPPI COMMUNITY COLLEGE DEVELOPMEN
    101 CUNNINGHAM BLVD
    BOONEVILLE,MS38829     		N/A PC MolinaCares Work Force Training Scholarship fund 25,000
    NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES INC
    4800 PAYNE AVE
    CLEVELAND,OH44103     		N/A PC Holiday Basket Giveaway fund 1,000
    NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES INC
    4800 PAYNE AVE
    CLEVELAND,OH44103     		N/A PC MolinaCares and NEON Collaboration program 2,600
    NUESTRA GENTE COMMUNITY PROJECTS INC
    PO BOX 140661
    TOLEDO,OH43614     		N/A PC Charitable Event 2,500
    OFFICE OF EARLY CHILDHOOD INITIATIVES
    200 E WELLS ST RM 606
    MILWAUKEE,WI53202     		N/A GOV Welcome to Milwaukee Care Packages 20,000
    OKANOGAN COUNTY COMMUNITY ACTION COUNCIL INC
    PO BOX 1067
    OKANOGAN,WA98840     		N/A PC Winter Community fund 5,000
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC CPAA Winter Outreach Events 35,000
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC Winter Coat Giveaway fund 63,100
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC Winter Coat Giveaway fund 36,250
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC Boys & Girls Club of Utah County Back to School program 5,000
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 366
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC Franklin Elementary / Project Success Coalition Di 20,000
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 4,429
    OPERATION WARM INC
    PO BOX 822431
    PHILADELPHIA,PA19182     		N/A PC General & Unrestricted 2,351
    OTHER SIDE ACADEMY
    667 E 100 S
    SALT LAKE CTY,UT84102     		N/A PC The Other Side Village 20,000
    PATHSTONE CORPORATION
    400 E AVE
    ROCHESTER,NY14607     		N/A PC Project Homeless Connect Rochester 10,000
    PATHWAY INC
    505 HAMILTON ST
    TOLEDO,OH43604     		N/A PC Charitable Event 2,000
    PAVE
    6316 S 12TH ST
    TACOMA,WA98465     		N/A PC SPARK Peer Learning Center 77,228
    PENINSULA COMMUNITY HEALTH SERVICES
    PO BOX 960
    BREMERTON,WA98337     		N/A PC Keeping Kids in School Safely 25,000
    PIERCE COUNTY A I D S FOUNDATION
    3009 S 40TH ST
    TACOMA,WA98409     		N/A PC Programming for Queert/trans/intersex People of Color (QTIPOC) 2,000
    PIERCE COUNTY A I D S FOUNDATION
    3009 S 40TH ST
    TACOMA,WA98409     		N/A PC Oasis Youth Center 1,500
    PIONEER HUMAN SERVICES
    7440 W MARGINAL WAY S
    SEATTLE,WA98108     		N/A PC 2021 Change Maker Creating Change & Leading 1,500
    PORT GAMBLE SKLALLAM FOUNDATION
    31912 LITTLE BOSTON RD NE
    KINGSTON,WA98346     		N/A PC Hauted Heronswood Traditional Storytelling and Wellness program 2,500
    POWER IN CHANGING
    6615 TWO NOTCH RD
    COLUMBIA,SC29223     		N/A PC Bundles of Joy Diaper Bank 2,500
    PREGNANCY RESOURCE CENTER OF SNOHOMISH CONTY
    4310 HOYT AVE
    EVERETT,WA98203     		N/A PC STI Community Program 1,000
    PRINCE OF PEACE CHRISTIAN CHURCH
    6500 MAIN ST STE 5
    WILLIAMSVILLE,NY14221     		N/A PC Holiday Turkey and Warm Meal Give Away 5,000
    PRISMA HEALTH - UPSTATE
    300 E MCBEE AVESUITE 302
    GREENVILLE,SC29601     		N/A PC Wheels to Wellness Bike Skills Program 15,000
    PROGRESSO LATINO
    626 BROAD ST
    CENTRAL FALLS,RI02863     		N/A PC Quality Health Home 50,000
    PROJECT HOST INC
    525 S ACADEMY ST
    GREENVILLE,SC29601     		N/A PC Culinary Training Program 2,500
    PROVINCE OF ST JOSEPH OF THE CAPUCHIN ORDER INC
    1820 MOUNT ELLIOTT ST
    DETROIT,MI48207     		N/A PC Charitable Event 5,000
    PROYECTO JUAN DIEGO INC
    3910 PAREDES LINE RD
    BROWNSVILLE,TX78526     		N/A PC P.E.S.A.S. fund 5,000
    R I D G E PROJECT INC
    J169 STATE RTE 65
    MCCLURE,OH43534     		N/A PC Thanksgiving Turkey Giveaway fund 3,100
    RAINBOW CENTER
    2215 PACIFIC AVE
    TACOMA,WA98402     		N/A PC Charitable Event 1,000
    RAMP GLOBAL MISSIONS
    111 W HUMBOLDT PKWY
    BUFFALO,NY14214     		N/A PC Project Mona's House 1,000
    REACH OUT WEST END
    1126 W FOOTHILL BLVD STE 250
    UPLAND,CA91786     		N/A PC Mamas Y Bebes fund 120,000
    REACH SERVICES INC
    6157 31ST AVE N
    ST PETERSBURG,FL33710     		N/A PC Mobile Grocery Store fund 30,000
    RECOVERY CAFE
    2022 BOREN AVE
    SEATTLE,WA98121     		N/A PC 2021 Standing in the Gap 1,000
    REFUGEE & IMMIGRANT SELF-EMPOWERMENT INC
    302 BURT ST
    SYRACUSE,NY13202     		N/A PC Immigrant Services Programmatic Support 10,000
    REGENTS UNIVERSITY OF CALIFORNIA LOS ANGELES
    BOX 957089
    1125 MURPHY HALL 405 HILGARD AVE
    LOS ANGELES,CA90095     		N/A PC Health Equity Challenge 125,000
    RHODE ISLAND CENTER FOR JUSTICE
    1 EMPIRE PLZ STE 410
    PROVIDENCE,RI02903     		N/A PC Access to Justice 10,000
    RHODE ISLAND COMMUNITY FOOD BANK ASSOCIATION
    200 NIANTIC AVE
    PROVIDENCE,RI02907     		N/A PC Healthy Habits: Eating Well on a Budget 25,000
    ROCHESTER CITY SCHOOL DISTRICT
    131 W BROAD ST
    ROCHESTER,NY14614     		N/A GOV Cultural Dance Program & Racial Equality Education 10,000
    ROCHESTER JEWELS INC
    178 W MAIN ST
    ROCHESTER,NY14614     		N/A PC Mentoring Program & New Building Project 10,000
    ROLLING START INCORPORATED
    1955 HUNTS LN STE 101
    SN BERNRDNO,CA92408     		N/A PC Holiday Giveaway Events 5,000
    RON FOLEY PANCREATIC CANCER FOUNDATION INC
    1000 FARMINGTON AVE STE 108A
    WEST HARTFORD,CT06107     		N/A PC Ron's Run for the Roses 2,500
    SACRAMENTO SELF-HELP HOUSING INC
    1010 HURLEY WAY STE 500
    SACRAMENTO,CA95825     		N/A PC MolinaCares Champions - Sacramento 5,000
    SALVATION ARMY
    16130 NORTHLAND DR
    SOUTHFIELD,MI48075     		N/A PC Charitable Event 90,000
    SAN DIEGO RESCUE MISSION INC
    120 ELM ST
    SAN DIEGO,CA92101     		N/A PC Charitable Event 5,000
    SAN FRANCISCO PUBLIC HEALTH FOUNDATION
    1 HALLIDIE PLZ STE 808
    SAN FRANCISCO,CA94102     		N/A PC Transitions Clinic Network (TCN) Reentry Healthcare Hub 250,000
    SANTA MARIA COMMUNITY SERVICES
    617 STEINER ST
    CINCINNATI,OH45204     		N/A PC The Sharing Table 2,500
    SEATTLE CHILDRENS HOSPITAL FOUNDATION
    PO BOX 5371 MAIL STOP 818-F
    SEATTLE,WA98145     		N/A PC Integrating RUBI Support for Primary Care 40,500
    SHALOM CENTER OF INTERFAITH NETWORK OF KENOSHA COU
    4314 39TH AVE
    KENOSHA,WI53144     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 1,751
    SHALOM CENTER OF INTERFAITH NETWORK OF KENOSHA COU
    4314 39TH AVE
    KENOSHA,WI53144     		N/A PC Back2School Bash 2,000
    SHAWNEE CHRISTIAN HEALTHCARE CENTER INC
    234 AMY AVE
    LOUISVILLE,KY40212     		N/A PC Shawnee Christian Healthcare Center for the Holidays 20,000
    SHOWERED AND EMPOWERED INC
    7496 2ND ST N
    ST PETERSBURG,FL33702     		N/A PC General & Unrestricted 5,000
    SOJOURNER HOUSE
    386 SMITH ST
    PROVIDENCE,RI02908     		N/A PC Supportive Services for Victims of Abuse 50,000
    SOMOS MUJERES LATINAS WASHINGTON
    12349 ROOSEVELT WAY NE STE 101
    SEATTLE,WA98125     		N/A PC Charitable Event 750
    SOUL AND BODY INITIATIVES
    6079 ANDOVER BLVD
    GARFIELD HTS,OH44125     		N/A PC Winter Supply and Meal Distribution fund 3,500
    SOUTH BREVARD SHARING CENTER INC
    17 E HIBISCUS BLVD
    MELBOURNE,FL32901     		N/A PC Food Pantry fund 4,000
    SOUTH EASTERN IDAHO COMMUNITY
    641 N 8TH AVE
    POCATELLO,ID83201     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 566
    SOUTH EASTERN IDAHO COMMUNITY
    641 N 8TH AVE
    POCATELLO,ID83201     		N/A PC 2021 Socks for Seniors Stocking Drive 9,000
    SOUTHERN CALIFORNIA REHABILITAION SERVICES INCORPO
    2023 LINCOLN AVE
    PASADENA,CA91103     		N/A PC Thanksgiving Turkey Giveaway fund 2,500
    SPECIAL OLYMPICS SOUTH CAROLINA
    109 OAK PARK DR
    IRMO,SC29063     		N/A PC Special Olympics SC Sports and Health Program 5,000
    SPRINGBOARD TO SUCCESS INC
    60 E VAN BUREN ST STE 1100
    CHICAGO,IL60605     		N/A PC College Preparedness - Technology program 20,000
    ST ANNES CENTER INC
    269 W 33RD ST
    OGDEN,UT84401     		N/A PC Sub for Santa fund 2,500
    ST JAMES HEALTH AND WELLNESS INC
    PO BOX 608
    MCCLELLANVLE,SC29458     		N/A PC Charitable Event 5,000
    ST STEPHENS COMMUNITY HOUSE
    1500 E 17TH AVE
    COLUMBUS,OH43219     		N/A PC Christmas Cares/Union Shares 3,000
    ST STEPHENS COMMUNITY HOUSE
    1500 E 17TH AVE
    COLUMBUS,OH43219     		N/A PC Community Family Dinners 4,000
    STARK COUNTY FATHERHOOD COALITION
    221 3RD ST SE
    CANTON,OH44702     		N/A PC Charitable Event 1,500
    STEWPOT COMMUNITY SERVICES INC
    1100 W CAPITOL ST
    JACKSON,MS39203     		N/A PC Project Helping the Homeless 1,500
    SURVIVORS PATHWAY CORPORATION
    1801 CORAL WAY STE 200
    MIAMI,FL33145     		N/A PC MolinaCares Food Pantry 2,250
    TABITHAS WAY
    45 EAST 100 N
    SPANISH FORK,UT84660     		N/A PC Thanksgiving Food Baskets 5,000
    TACOMA COMMUNITY HOUSE
    PO BOX 5107
    TACOMA,WA98415     		N/A PC Be a Champion of Social Justice 1,000
    TANDEM HEALTH SC
    550 S PIKE W
    SUMTER,SC29150     		N/A PC to purchase Holiday Meals 2,000
    TEXAS RURAL HEALTH ASSOCIATION INC
    3702 LOOP 322
    ABILENE,TX79602     		N/A PC High School Telemedicine Technical Certificate Course fund 75,000
    THE FOOD BANK OF WESTERN MASSACHUSETTS INC
    97 N HATFIELD RD
    HATFIELD,MA01038     		N/A PC Brown Bag Food for Elders 12,500
    THE GREATER BOSTON FOOD BANK INC
    70 S BAY AVE
    BOSTON,MA02118     		N/A PC Community Food Bank 12,500
    THE PEER AND FAMILY CAREER ACADEMY LTD
    7431 S SUNDOWN CT
    BUCKEYE,AZ85326     		N/A PC Seed funding for new non-profit 100,000
    THE SALVATION ARMY
    440 W NYACK ROAD
    WEST NYACK,NY10994     		N/A PC Holiday Giving Program 3,000
    THE SALVATION ARMY
    111 QUEEN ANNE AVE N STE 300
    SEATTLE,WA98109     		N/A PC to purchase Back to School Supplies 1,000
    THE SALVATION ARMY
    440 W NYACK ROAD
    WEST NYACK,NY10994     		N/A PC General & Unrestricted 5,000
    THE SALVATION ARMY - ATHENS GA UNIT
    PO BOX 367
    ATHENS,GA30603     		N/A PC Operation Save Christmas 5,000
    THE SALVATION ARMY - WOOSTER CHAPTER
    437 SOUTH MARKET ST
    WOOSTER,OH44691     		N/A PC Red Kettle Annual Campaign and Christmas Outreach program 5,000
    THE SKAGIT VALLEY FAMILY YMCA
    1901 HOAG RD
    MOUNT VERNON,WA98273     		N/A PC PAX Good Behavior Game 2,500
    THE YOUNG WOMENS CHRISTIAN ASSOCIATION OF NORTHWES
    1018 JEFFERSON ST
    TOLEDO,OH43604     		N/A PC Breast Cancer Awareness 2,000
    TIDES FOUNDATION
    PO BOX 889389
    LOS ANGELES,CA90088     		N/A PC NAACP PV Fiscal Sponsorship - COVID-19 Efforts fund 10,000
    TODEC LEGAL CENTER PERRIS
    PO BOX 1235
    MORENO VALLEY,CA92556     		N/A PC COVID-19 Outreach and Education program 20,000
    TORCH FOUNDATION
    3309 FOREST CREEK DR UNIT 305
    ROUND ROCK,TX78664     		N/A PC Advancing Rural Health; Clinical Integration, Telehealth and data analytics 250,000
    TRANSITIONS
    3128 N HEMLOCK
    SPOKANE,WA99205     		N/A PC Cold Weather program 3,200
    TRIDENT UNITED WAY INC
    PO BOX 63305
    N CHARLESTON,SC29419     		N/A PC Utility Fund Project 2,000
    UNION OF PAN ASIAN COMMUNITIES
    1031 25TH ST
    SAN DIEGO,CA92102     		N/A PC Charitable Event 5,000
    UNITED MINISTRIES
    606 PENDLETON ST
    GREENVILLE,SC29601     		N/A PC Financial Workshop 1,000
    UNITED TERRITORIES OF PACIFIC ISLANDERS WASHINGTON
    841 CENTRAL AVE N STE C-106
    KENT,WA98032     		N/A PC Charitable Event 1,000
    UNITED WAY OF GREATER RICHMOND
    7814 CAROUSEL LN STE 400
    RICHMOND,VA23294     		N/A PC WomenRise fund 20,000
    UNITED WAY OF RHODE ISLAND INC
    50 VALLEY ST
    PROVIDENCE,RI02909     		N/A PC UWRI Non-Profit Innovation Lab 50,000
    UNITED WAY OF SALT LAKE
    257 E 200 S STE 300
    SALT LAKE CITY,UT84111     		N/A PC Season of Service 1,000
    UNITY UNITED METHODIST CHURCH
    1910 E BROADWAY ST
    NORTHWOOD,OH43619     		N/A PC to purchase meals, hats and gloves for at-risk youths 2,000
    UNIVERSITY OF ARIZONA FOUNDATION
    1111 N CHERRY AVE
    TUCSON,AZ85721     		N/A PC General & Unrestricted 25,000
    UNIVERSITY OF ROCHESTER
    300 E RIVER RD PO BOX 270032
    ROCHESTER,NY14627     		N/A PC ROC with WISH and the Diabetes Prevention Program 10,000
    UNIVERSITY OF WASHINGTON FOUNDATION
    PO BOX 359505
    SEATTLE,WA98195     		N/A PC Reinforcing the Safety Net Program 200,000
    Upper Valley Career Center
    8811 CAREER DR
    Piqua,OH45356     		N/A GOV Student Assistance Center 2,500
    UPSTATE FATHER HOOD COALITION
    730 S PLEASANTBURG DR STE 205
    GREENVILLE,SC29607     		N/A PC Fueling Fathers 1,500
    UTAH STATE UNIVERSITY
    2400 OLD MAIN HL
    LOGAN,UT84322     		N/A PC 4-H winter programming 5,000
    VALLEY LEADERSHIP CORPORATION
    7000 N 16TH ST SUITE 120-439
    PHOENIX,AZ85020     		N/A PC Impact Maker Team 100,000
    VIA VISUALLY IMPAIRED ADVANCEMENT
    1170 MAIN ST
    BUFFALO,NY14209     		N/A PC Sprint for Sight 2021 1,500
    VINEYARD FARMS INC
    PO BOX 30259
    ROCHESTER,NY14603     		N/A PC The Vineyard Surround Care Program & The Mobile Wellness initiative 10,000
    VISIONS MULTI MEDIA INSTITUTE INC
    143 BROADWAY ST
    BUFFALO,NY14203     		N/A PC Charitable Programming Series 25,000
    VISIONS-MEDICAL WORKFORCE TRAINING CENTER
    PO BOX 4580
    GREENVILLE,MS38704     		N/A PC Increasing Access to Healthy Foods in MS 50,000
    VOLUNTEER FLORIDA FOUNDATION INC
    1545 RAYMOND DIEHL RD STE 250
    TALLAHASSEE,FL32308     		N/A SO I Healthy Minds Summit 25,000
    VOLUNTEERS OF AMERICA INC
    525 W 2ND AVE
    SPOKANE,WA99201     		N/A PC General & Unrestricted 4,000
    VOLUNTEERS OF AMERICA INC - WESTERN WASHINGTON
    2802 BROADWAY
    EVERETT,WA98201     		N/A PC VOA Free Showers Program 3,200
    Walnut Grove Elementary
    14181 GROVE ST
    Walnut Grove,CA95690     		N/A GOV Meal Program 10,000
    Walnut Grove Elementary
    14181 GROVE ST
    Walnut Grove,CA95690     		N/A GOV MolinaCares Champions - Sacramento 5,000
    WASHINGTON RURAL HEALTH COLLABORATIVE
    365 COOPER POINT RD NW STE 102
    OLYMPIA,WA98502     		N/A SO I Rural Quality Initiative 25,000
    WASHINGTON WEST AFRICAN CENTER
    525 112TH ST SE APT F324
    EVERETT,WA98208     		N/A PC COVID Vaccine Education & Accessibility 1,750
    WEST SEATTLE FOOD BANK
    3419 SW MORGAN ST
    SEATTLE,WA98126     		N/A PC Charitable Event 500
    WESTERN NEW YORK COALITION FOR THE HOMELESS INC
    66 ENGLEWOOD AVE
    BUFFALO,NY14214     		N/A PC Project Homeless 2,000
    WESTERN WAYNE FAMILY HEALTH CENTERS
    2700 HAMLIN BLVD
    INKSTER,MI48141     		N/A PC COVID-19 Vaccination Health Outreach Program 10,000
    WILKINSON CENTER
    PO BOX 720248
    DALLAS,TX75372     		N/A PC Job Training & Workforce Development 5,000
    WIN MINISTRIES - WOMEN IN NEED
    7665 MENTOR AVE SUITE 135
    MENTOR,OH44060     		N/A PC General & Unrestricted 575
    WORCESTER COUNTY FOOD BANK INC
    474 BOSTON TPKE
    SHREWSBURY,MA01545     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 571
    WORCESTER COUNTY FOOD BANK INC
    474 BOSTON TPKE
    SHREWSBURY,MA01545     		N/A PC General & Unrestricted 12,500
    YOUNG DREAMS COMMUNITY OUTREACH
    13846 SW 274TH TER
    HOMESTEAD,FL33032     		N/A PC Holiday Drives - Meals and Toys fund 2,500
    YOUNG SCHOLARS FOR ACADEMIC EMPOWERMENT
    4175 BROCKTON AVE
    RIVERSIDE,CA92501     		N/A PC Project Legacy - Health & Wellness Program 20,000
    YOUNGSTOWN COMMUNITY CENTER INC
    1413 BELMONT AVE
    YOUNGSTOWN,OH44504     		N/A PC Thanksgiving Take-Out Dinner 1,220
    YOUNGSTOWN COMMUNITY CENTER INC
    1413 BELMONT AVE
    YOUNGSTOWN,OH44504     		N/A PC Technology for Community Rooms 1,000
    YOUNGSTOWN METROPOLITAN HOUSING AUTHORITY
    131 W BOARDMAN ST
    YOUNGSTOWN,OH44503     		N/A GOV Community and Workforce Development 1,000
    YOUTH EASTSIDE SERVICES
    999 164TH AVE NE
    BELLEVUE,WA98008     		N/A PC Charitable Event 2,500
    YOUTH ERA
    PO BOX 583
    EUGENE,OR97440     		N/A PC General & Unrestricted 10,000
    YWCA GREAT LAKES BAY REGION
    909 WASHINGTON AVE STE 5
    BAY CITY,MI48708     		N/A PC I Support the Girls Project 2,000
    YWCA NORTH CENTRAL WASHINGTON
    212 1ST ST
    WENATCHEE,WA98801     		N/A PC YWCA Low Barrier Shelter fund 3,500
    ZEPF CENTER
    2005 ASHLAND AVE
    TOLEDO,OH43620     		N/A PC Rocking for Recovery 1,000
    SALVATION ARMY
    16130 NORTHLAND DR
    SOUTHFIELD,MI48075     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 1,270
    UNITED WAY OF SALT LAKE
    257 E 200 S STE 300
    SALT LAKE CITY,UT84111     		N/A PC General & Unrestricted (SEE GENERAL EXPLANATION) 787
    Total .................................bullet 3a 6,817,916
    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 ...........     		    14 17,408  
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   17,408  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    17,408
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


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

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

    85-1496438
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    The Molina Healthcare Charitable Foundation
          		Employer identification number
    85-1496438
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    Molina Healthcare Inc
    200 Oceangate Suite 100
     
    Long Beach, CA90802

    		$ 91,677


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

    		$  


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

    		$  


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

    		$  


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

    		$  


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

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    The Molina Healthcare Charitable Foundation
          		Employer identification number

    85-1496438
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    The Molina Healthcare Charitable Foundation
          		Employer identification number

    85-1496438
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Audit Fees 15,000     15,000

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

    TY 2021 DepreciationSchedule
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included

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

    TY 2021 ExpenditureResponsibilityStmt
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Grantee's Name Grantee's Address Grant Date Grant Amount Grant Purpose Amount Expended By Grantee Any Diversion By Grantee? Dates of Reports By Grantee Date of Verification Results of Verification
    IOWA ASSOCIATION OF COMMUNITY PROVIDERS
          		7025 HICKMAN RD SUITE 5
    URBANDALE,IA50322     		2021-02-04 10,000 SUPPORTIVE EMPLOYMENT FOR THE DISABILITY COMMUNITY 10,000 NO 01/31/2022   None Necessary

    TY 2021 GeneralExplanationAttachment
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Identifier Return Reference Explanation
    FORM 990-PF, PARTS I AND XIV FORM 990-PF, PARTS I AND XIV TOTAL Part I, Line 25, Column (a) and Part XIV, Line 3a: $6,817,916 Less amount counted as a qualifying distribution on Part XI, Line 2: $18,741 TOTAL Part I, Line 25, Column (d): $6,799,175
    PART I LINE 25 AND PART XIV LINE 3A PART I LINE 25 AND PART XIV LINE 3A DISTRIBUTIONS OF PROPERTY VALUE AT FAIR MARKET VALUE AT DATE OF DISTRIBUTION METHOD FOR DETERMINING VALUE OF DONATED ITEMS: PURCHASE PRICE TOTAL FAIR MARKET VALUE OF PROPERTY: $18,741 TOTAL BOOK VALUE OF PROPERTY: $18,741 TOTAL CASH PORTION OF GRANTS: $- TOTAL AMOUNT OF GRANTS: $18,741 FORM 990-PF, PART III, LINE 3 - OTHER INCREASES/DECREASES: $- DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Sweet Pea Diaper Bag UNITS: 150 DATE OF DISTRIBUTION: 8/14/2021 GRANT RECIPIENT: AFRICAN AMERICAN BREASTFEEDING NETWORK INC FMV OF PROPERTY: $2,854 BOOK VALUE OF PROPERTY: $2,854 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $2,854 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Rabbit Skins Infant Onesies UNITS: 200 DATE OF DISTRIBUTION: 8/14/2021 GRANT RECIPIENT: AFRICAN AMERICAN BREASTFEEDING NETWORK INC FMV OF PROPERTY: $1,443 BOOK VALUE OF PROPERTY: $1,443 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $1,443 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Therm-O Super Square Insulated Tote UNITS: 225 DATE OF DISTRIBUTION: 6/25/2021 GRANT RECIPIENT: BRENTWOOD CHURCH OF CHRIST FMV OF PROPERTY: $965 BOOK VALUE OF PROPERTY: $965 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $965 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Protector Hand Sanitizer UNITS: 500 DATE OF DISTRIBUTION: 12/12/2021 GRANT RECIPIENT: HARRY CHAPIN FOOD BANK OF SOUTHWEST FLORIDA INC FMV OF PROPERTY: $502 BOOK VALUE OF PROPERTY: $502 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $502 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Payson Mini Tote UNITS: 200 DATE OF DISTRIBUTION: 9/27/2021 GRANT RECIPIENT: HURLEY FOUNDATION FMV OF PROPERTY: $275 BOOK VALUE OF PROPERTY: $275 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $275 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Spree Shopping Tote UNITS: 1,000 DATE OF DISTRIBUTION: 11/30/2021 GRANT RECIPIENT: IDAHO FOODBANK WAREHOUSE FMV OF PROPERTY: $1,544 BOOK VALUE OF PROPERTY: $1,544 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $1,544 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Holiday Cards UNITS: 1,000 DATE OF DISTRIBUTION: 12/31/2021 GRANT RECIPIENT: IDAHO FOODBANK WAREHOUSE FMV OF PROPERTY: $1,418 BOOK VALUE OF PROPERTY: $1,418 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $1,418 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Crossland Heather Pom Beanie UNITS: 1,000 DATE OF DISTRIBUTION: 12/15/2021 GRANT RECIPIENT: OPERATION WARM INC FMV OF PROPERTY: $4,429 BOOK VALUE OF PROPERTY: $4,429 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $4,429 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Payson Mini Tote UNITS: 300 DATE OF DISTRIBUTION: 1/25/2022 GRANT RECIPIENT: OPERATION WARM INC FMV OF PROPERTY: $366 BOOK VALUE OF PROPERTY: $366 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $366 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Plastic Convention Bag UNITS: 3,000 DATE OF DISTRIBUTION: 12/8/2021 GRANT RECIPIENT: SALVATION ARMY FMV OF PROPERTY: $1,270 BOOK VALUE OF PROPERTY: $1,270 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $1,270
    PART I LINE 25 AND PART XIV LINE 3A PART I LINE 25 AND PART XIV LINE 3A DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Greystone Cooler Bag UNITS: 300 DATE OF DISTRIBUTION: 8/25/2021 GRANT RECIPIENT: SHALOM CENTER OF INTERFAITH NETWORK OF KENOSHA COUNTY INC FMV OF PROPERTY: $1,751 BOOK VALUE OF PROPERTY: $1,751 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $1,751 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Holiday Cards UNITS: 1,000 DATE OF DISTRIBUTION: 12/8/2021 GRANT RECIPIENT: SOUTH EASTERN IDAHO COMMUNITY FMV OF PROPERTY: $566 BOOK VALUE OF PROPERTY: $566 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $566 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Holiday Cards UNITS: 3,000 DATE OF DISTRIBUTION: 12/3/2021 GRANT RECIPIENT: UNITED WAY OF SALT LAKE FMV OF PROPERTY: $787 BOOK VALUE OF PROPERTY: $787 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $787 DETAILS OF ITEMS GRANTED: DESCRIPTION OF PROPERTY: Payson Mini Tote, Hand Sanitizer and Sport Bottle UNITS: 500 DATE OF DISTRIBUTION: 9/21/2021 GRANT RECIPIENT: WORCESTER COUNTY FOOD BANK INC FMV OF PROPERTY: $571 BOOK VALUE OF PROPERTY: $571 CASH PORTION OF GRANT: $- TOTAL AMOUNT OF GRANT: $571

    TY 2021 LiquidationExplanationStmt
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Statement:
    As explained below, the Foundation has no plans for dissolution. This statement is submitted to report the distribution of certain assets during the year. The distributions resulted in a substantial contraction of assets. The following information is submitted in accordance with Treasury Regulation Section 1.6043-3(a)(1) and the Form 990-PF instructions: During the taxable year ending May 31, 2022, the Foundation made distributions from assets from sources other than current income. Collectively, the distributions in excess of current income totaled $6,817,916. This amount represents 25% or more of the Foundation's net assets of $12,910,406 (as measured by fair market value) at the beginning of the Foundation's taxable year ending May 31, 2022. Although the Foundation technically experienced a substantial contraction, it will continue in existence and has no plans for dissolution. The Foundation made distributions of cash to the grantees listed in the attachment to Part XiV, Line 3a; each such grant was made solely for the charitable purpose specified therein.


    TY 2021 OtherAssetsSchedule
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    TOTE BAGS   3,846 3,846


    TY 2021 OtherExpensesSchedule
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 85,236     85,236
    POSTAGE/DELIVERY SERVICE 799     799
    FOUNDATION EVENTS 72,768     72,768
    COMMUNITY CHAMPIONS EVENT 1,401     1,401


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    VIDEOGRAPHER SERVICES 2,060     2,060


    TY 2021 TaxesSchedule
    Name:
    The Molina Healthcare Charitable Foundation
    EIN:
    85-1496438
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    990-PF Extension for 2021 150