Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 05-01-2022 , and ending 06-30-2022
Name of foundation
ANNMARIE FOUNDATION INC
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 44
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MEDFORD, WI54451
A Employer identification number

23-7301323
B Telephone number (see instructions)

(651) 303-2246
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$8,768,070J 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) 50,000
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 19,913 19,913  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 -56,964
b Gross sales price for all assets on line 6a 186,000
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........ 12,949 19,913  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 6,708 3,665   3,043
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 684 0   684
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 3,045 0   3,045
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 10,437 3,665   6,772
25 Contributions, gifts, grants paid....... 113,264 113,264
26 Total expenses and disbursements. Add lines 24 and 25 123,701 3,665   120,036
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -110,752
b Net investment income (if negative, enter -0-) 16,248
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............. 1,744 1,438 1,438
2 Savings and temporary cash investments......... 446,366 203,299 203,299
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 116,086 Click to see attachment365,569 365,569
b Investments—corporate stock (attach schedule)....... 6,534,128 Click to see attachment5,956,021 5,956,021
c Investments—corporate bonds (attach schedule)....... 2,236,352 Click to see attachment2,241,743 2,241,743
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)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 9,334,676 8,768,070 8,768,070
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........ 1,103,122 1,103,122
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 8,231,554 7,664,948
29 Total net assets or fund balances (see instructions)..... 9,334,676 8,768,070
30 Total liabilities and net assets/fund balances (see instructions). 9,334,676 8,768,070
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
9,334,676
2
Enter amount from Part I, line 27a .....................
2
-110,752
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
9,223,924
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
455,854
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
8,768,070
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a PUBLICLY TRADED SECURITIES P    
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 186,000   242,964 -56,964
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       -56,964
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 -56,964
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 226
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 226
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 0
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 0
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 226
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    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)
    bulletWI
    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 addressbulletHTTP://ANNMARIEFOUNDATION.ORG/
    14
    The books are in care ofbulletJIM SOLINSKY Telephone no.bullet (651) 303-2246

    Located atbulletPO BOX 44MEDFORDWI ZIP+4bullet54451
    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
    KRISTI DEBRUYNE PRESIDENT
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    JOELLYN DECESARE VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    RON BAKKEN VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    DAVID FLESSERT SECRETARY/TREASURER
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    VICKI GJOVIK MEMBER
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    MELISA HANSEN MEMBER
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    SUZY OCKER MEMBER
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    JAMES UHLIR MEMBER
    1.00     		0 0 0
    PO BOX 44
    MEDFORD,WI54451
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    8,912,230
    b
    Average of monthly cash balances.......................
    1b
    360,332
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    9,272,562
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    9,272,562
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    139,088
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    9,133,474
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    76,319
    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
    76,319
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    226
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    226
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    76,093
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    76,093
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    76,093
    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 76,093
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 188,547
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 188,547
    a Applied to 2020, but not more than line 2a 188,547
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 0
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		76,093
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    ANNMARIE FOUNDATION
    PO BOX 44
    MEDFORD,WI55451
    (651) 303-2246
    INFO@ANNMARIEFOUNDATION.ORG
    bThe form in which applications should be submitted and information and materials they should include:
    PLEASE RETURN THE FOLLOWING TO THE FOUNDATION. EMAIL PREFERRED. NAME OF HIGH SCHOOL STUDENT'S NAME MAILING ADDRESS CITY, STATE, ZIP PHONE NUMBER EMAIL
    cAny submission deadlines:
    MAY 15TH
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    1) IF A STUDENT IS RECEIVING SCHOLARSHIPS FROM OTHER SOURCES, ONLY THOSE STUDENTS RECEIVING LESS THAN $1,000 SHOULD BE CONSIDERED FOR THE ANNMARIE SCHOLARSHIP. 2) WHILE WE RECOGNIZE THAT GOOD GRADES ARE AN INTEGRAL PART OF SELECTING A SCHOLARSHIP WINNER, WE DO NOT WANT TO RESTRICT THE SELECTION PROCESS TO ONLY THE TOP TEN OR TWENTY STUDENTS. IF THERE IS A STUDENT WHO HAS A GOOD ACADEMIC RECORD BUT HAS NOT BEEN IN THE "TOP TEN", WE WISH HIM/HER TO BE CONSIDERED ALONG WITH THE "TOP TEN". 3) EXTRA-CURRICULAR AND COMMUNITY ACTIVITIES SHOULD BE CONSIDERED ALONG WITH ACADEMICS.
    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
    HANNAH WALKER
    PO BOX 70
    PHILLIPS,WI54555     		NONE I SCHOLARSHIP 2,000
    SOPHIA TIBAYAN
    1220 ST CROIX
    PRESCOTT,WI54021     		NONE I SCHOLARSHIP 2,000
    EMILY DRESS
    1501 VINE STREET
    HUDSON,WI54016     		NONE I SCHOLARSHIP 2,000
    BRYNN BERGESON
    601 UNIVERSITY
    COLFAX,WI54730     		NONE I SCHOLARSHIP 2,000
    JAZLYNN LUDWIG
    PO BOX 70
    PHILLIPS,WI54555     		NONE I SCHOLARSHIP 2,000
    JESSICA LUDWIG
    PO BOX 70
    PHILLIPS,WI54555     		NONE I SCHOLARSHIP 2,000
    MEDFORD SCHOOL DISTRICT
    124 STATE STREET
    MEDFORD,WI54451     		N/A PC CPR MANIKIN, CANNON CAMERA, CAMCORDER, QBALL AND COVER 5,039
    MENOMONIE SCHOOL DISTRICT
    215 PINE AVE NE
    MENOMONIE,WI54751     		N/A PC TI 30XS CLASSROOM KIT, YAMAHA DIGITAL PIANO, KILN, CLAY, AIR FILTER SYSTEM 5,725
    SOMERSET SCHOOL DISTRICT
    PO BOX 100
    SOMERSET,WI54025     		N/A PC MATERIAL FOR CHAIRS 1,800
    NEW RICHMOND SCHOOL DISTRICT
    701 EAST ELEVENTH ST
    NEW RICHMOND,WI54017     		N/A PC SETS READER WHOLE PHONICS, MATH MANIPULATIVES, SENSORY PAD, ACTIVITY PLAY CENTER, LEVELED LITERACY SYSTEM 6,778
    HUDSON SCHOOL DISTRICT
    644 BRAKKE DR
    HUDSON,WI54016     		N/A PC PLANTING BOXES, AUDIO BOOKS, HEARTRATE MONITORS, STEM LAB EQUIPMENT, WORLD LANGUAGE CLASSROOM SEATING 6,748
    ST CROIX CENTRAL SCHOOL DISTRICT
    1751 BROADWAY ST
    HAMMOND,WI54015     		N/A PC 10 CANOE PADDLES 1,000
    BOYCEVILLE SCHOOL DISTRICT
    1003 TIFFANY STREET
    BOYCEVILLE,WI54725     		N/A PC REAL CARE BABY EXPERIENCE 5,455
    EAU CLAIRE SCHOOL DISTRICT
    500 MAIN STREET
    EAU CLAIRE,WI54701     		N/A PC 3D PRINTERS, SOCIAL-EMOTIONAL RESOURCES, 776
    RIB LAKE SCHOOL DISTRICT
    1236 KENNEDY ST PO BOX 278
    RIB LAKE,WI54470     		N/A PC MICROBIT PROCESSORS, LANGUAGE TRANSLATOR, MIG WELDER 3,604
    PRENTICE SCHOOL DISTRICT
    PO BOX 110
    PRENTICE,WI54556     		N/A PC MULTIMATIC TIG, MIG AND STICK WELDER 3,839
    PHILLIPS SCHOOL DISTRICT
    PO BOX 70
    PHILLIPS,WI54555     		N/A PC PHANTOM 4PRO DRONE, IPADS, 5,500
    REGIS CATHOLIC SCHOOLS
    2728 MALL DRIVE
    EAU CLAIRE,WI54701     		N/A PC SAMSUNG LED TV, BEE BOTS, FLEXIBLE SEATING, HUMMINGBIRD ROBOT KITS, WINDOW GROWING KIT, KINETIC SAND, SOCIAL DETECTIVES, 3,601
    HOLY ROSARY CATHOLIC SCHOOL
    215 S WASHINGTON AVE
    MEDFORD,WI54451     		N/A PC STEREO HEADPHONES, DOOR ORGANIZERS 580
    ABBOTSFORD CHRISTIAN ACADEMY
    4868 CEMETERY AVE
    ABBOTSFORD,WI54405     		N/A PC KINETIC SAND, MATH GAME LIBRARY, TAKE APART HUMAN MODEL, ALPHABET LEARNING LOCKS 939
    MCDONELL AREA CATHOLIC SCHOOLS
    1316 BEL AIR BLVD
    CHIPPEWA FALLS,WI54729     		N/A PC ASSEMBLY ROBOT KITS, MOTOR ELECTRONIC ASSEMBLY KITS 244
    ST ANNE SCHOOL
    140 CHURCH HILL ROAD
    SOMERSET,WI54025     		N/A PC LITTLEBITS STEAM CODING CLASS KIT 4,200
    IMMANUEL LUTHERAN SCHOOL
    420 E LINCOLN STREET
    MEDFORD,WI54451     		N/A PC LEGO MINDSTORM KITS 1,800
    NEW HOPE BAPTIST ACADEMY
    PO BOX 107
    KENNAN,WI54537     		N/A PC IPS UHD IR MULTI-TOUCH 3,000
    CHIPPEWA COUNTY 4-H (PARTNER DUNNEC COUNTY 4-H)
    711 N BRIDGE STREET RM13
    CHIPPEWA FALLS,WI54739     		N/A PC PLANNED ACTIVITIES 2,000
    ELK MOUND LIBRARY AND COMMUNITY CENTER
    PO BOX 188
    ELK MOUND,WI54739     		N/A PC COMPUTER WORKSTATION, MONITOR AND STANDS 2,655
    LE PHILLIPS MEMORIAL PUBLIC LIBRARY
    2725 MALL DRIVE
    EAU CLAIRE,WI54701     		N/A PC LAPTOPS AND DIGITAL PEN 7,960
    FRANCES L SIMEK MEMORIAL LIBRARY
    400 N MAIN STREET
    MEDFORD,WI54451     		N/A PC PHONICS SETS AND EASY READER BOOKS 750
    WESTBORO PUBLIC LIBRARY
    N8855 SECOND ST
    WESTBORO,WI54490     		N/A PC WOODEN TABLES, CHAIRS, EXTENSION CORDS, MOUSEPADS, CHILDREN MIC 774
    COLFAX PUBLIC LIBRARY
    613 MAIN STREET PO BOX 525
    COLFAX,WI54730     		N/A PC SPANISH-ENGLISH BOOKS 750
    JR ACHIEVEMENT - UPPER MIDWEST (JAUM)
    PO BOX 120478
    ST PAUL,MN55112     		N/A PC CLASSROOM MATERIALS 450
    JR ACIEVEMENT - NW DISTRICT
    2004 HIGHLAND AVE SUITE 2C
    EAU CLAIRE,WI54701     		N/A PC TRAINING MATERIALS AND ONLINE RESOURCES 5,000
    MOMS AND DADS AGAINST METH
    PO BOX 172
    ST CROIX FALLS,WI54024     		N/A PC VOLLEYBALL NET, POLES, BALLS, GARDEN SUPPLIES, FOOD PRESERVATION SUPPLIES, TWIN MATTRESS PROTECTORS 807
    LEGACY COMMUNITY CENTER
    26 W GRAND AVE
    CHIPPEWA FALLS,WI54729     		N/A PC HEAVY DUTY WHEEL CARTS 1,000
    BASICS FOR LOCAL KIDS
    PO BOX 61 W7173 450TH AVE
    ELLSWORTH,WI54011     		N/A PC SNOWPANTS, BOOTS, GLOVES 1,000
    MEDFORD PERFORMING ARTS
    PO BOX 13
    MEDFORD,WI54451     		N/A PC CONCERT PROGRAM COSTS 750
    FOREST SPRINGS CAMP AND CONVERENCE CENTER
    N8890 FOREST LANE
    WESTBORO,WI54470     		N/A PC REPLACEMENT XC SKIS 2,000
    OUTDOORMORE INC
    10614 24TH AVE
    EAU CLAIRE,WI54701     		N/A PC DISC GOLF TEE PADS, BASKETS, MAP SIGNS 1,600
    THE BRIDGE TO HOPE
    2110 4TH AVE NE PO BOX 700
    MENOMONIE,WI54751     		N/A PC SHOWER BAGS, COLORING BOOKS, FACE/EYE MASKS, FACE WASH, ETC 1,375
    NEW RICHMOND HERITAGE CENTER
    1100 HERITAGE DRIVE
    NEW RICHMOND,WI54017     		N/A PC DISPLAY CASE, INFORMATIONAL SIGNS, LARGE DISPLAY CASE 900
    THUG LIFE MINISTRY FOR HOMELESS YOUTH
    424 CHURCH HILL RD
    SOMERSET,WI54025     		N/A PC TWIN MATTRESSES, TOILET, LAPTOP COMPUTERS, 2 DOOR CABINETS 3,560
    COLFAX RAILROAD MUSEUM INC
    500 E RAILROAD AVE PO BOX 383
    COLFAX,WI54730     		N/A PC FOLDING TABLES 3,060
    CATAWBA HARMONY FIRE DEPARTMENT
    N4508 HIGH STPO BOX 136
    CATAWBA,WI54515     		N/A PC THERMAL IMAGING CAMERA 3,245
    HEALING PLAY INC
    1524 RIVER TERRACE
    PRESCOTT,WI54021     		N/A PC PLAYGROUND EQUIPMENT 1,000
    Total .................................bullet 3a 113,264
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 -56,964  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 -37,051 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    -37,051
    (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
    ANNMARIE FOUNDATION INC
     
    Employer identification number

    23-7301323
    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
    ANNMARIE FOUNDATION INC
          		Employer identification number
    23-7301323
    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
    LOUIS VOKURKA
    W7009 RASKIE ROAD
     
    PHILLIPS, WI54555

    		$ 50,000


    (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
    ANNMARIE FOUNDATION INC
          		Employer identification number

    23-7301323
    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
    ANNMARIE FOUNDATION INC
          		Employer identification number

    23-7301323
    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 CashDistributionExplnStmt
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    Explanation:
    THE FOUNDATION MADE THE DECISION TO MOVE THE FISCAL YEAR END FROM APRIL 30TH TO JUNE 30TH FOR OPERATIONAL REASONS. THE FOUNDATION'S MISSION IS TO PROVIDE EDUCATIONAL SCHOLARSHIPS TO STUDENTS PURSUING HIGHER EDUCATION AND SUPPORT TO SCHOOLS AND SCHOOL DISTRICTS AT ALL LEVELS OF EDUCATION. GIVING, SPECIFICALLY FOR SCHOLARSHIPS, CAN BE VERY CHALLENGING WHEN NOT IN OR NEAR THE TRADITIONAL SCHOOL YEAR. KNOWING THAT THIS SHORT PERIOD RETURN WOULD NOT BE SUFFICIENT TIME TO MEET THE 12-MONTH CHARITABLE DISTRIBUTION REQUIREMENT IN 2 MONTHS, THE BOARD RESOLVED TO SET ASIDE $68,511 (THE DIFFERENCE BETWEEN WHAT THEY COULD GRANT IN THOSE TWO MONTHS AND THE DISTRIBUTION REQUIREMENT ON THEIR PRIOR PERIOD 990-PF). THIS AMOUNT WILL BE DISTRIBUTED BY THE END OF CALENDAR YEAR 2022. HISTORICALLY, THE FOUNDATION HAS ALWAYS MET DISTRIBUTION REQUIREMENTS AND HAS AVERAGED APPROXIMATELY $375,000 IN ANNUAL DISTRIBUTION THE PAST 5 FULL 12-MONTH TAX YEARS, THE NEED FOR THIS SET ASIDE IS VERY UNIQUE AND WILL BE MET WITHING 180 DAYS OF THE YEAR END IN ADDITION TO MEETING THE SHORT PERIOD DISTRIBUTION REQUIREMENTS SHOWN ON PART XII LINE 6F. BY SETTING ASIDE, THE FOUNDATION IS ENSURING THE USE OF THESE FUNDS WILL BE ALIGNED WITH THEIR MISSION AND BETTER SERVE THE RECIPIENTS BY DISBURSING IN JULY THROUGH DECEMBER.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    Name of Bond End of Year Book Value End of Year Fair Market Value
    AFLAC INC 3.625% 15 NOV 2024 105,242 105,242
    AMEREN ILLINOIS CO 3.25% 01 MAR 2025 49,428 49,428
    BANK OF AMERICA CORP 4.183% 25 NOV 2027 48,669 48,669
    BP CAPITAL MARKETS AMERICA INC 3.79% 06 FEB 2024 25,118 25,118
    BURLINGTON NORTHERN SANTA FE LLC 3.25% 15 JUN 2027 97,826 97,826
    CHUBB INA HOLDINGS INC 3.35% 03 MAY 2026 97,911 97,911
    CITIGROUP INC 3.75% 16 JUN 2024 50,234 50,234
    COMCAST CORP 2.35% 15 JAN 2027 46,608 46,608
    COMMONWEALTH EDISON CO 2.55% 15 JUN 2026 47,943 47,943
    DUKE ENERGY PROGRESS LLC 3.7% 01 SEP 2028 121,266 121,266
    GENERAL DYNAMICS CORP 3.25% 01 APR 2025 99,256 99,256
    GEORGIA POWER CO 3.25% 01 APR 2026 24,301 24,301
    GLAXOSMITHKLINE CAPITAL INC 3.875% 15 MAY 2028 29,888 29,888
    INTEL CORP 2.45% 15 NOV 2029 26,768 26,768
    INTERCONTINENTAL EXCHANGE INC 3.75% 01 DEC 2025 98,961 98,961
    MARSH & MCLENNAN COS INC 3.75% 14 MAR 2026 49,538 49,538
    MCKESSON CORP 3.95% 16 FEB 2028 48,621 48,621
    MICROSOFT CORP 2% 08 AUG 2023 49,507 49,507
    NORTHERN TRUST CORP 3.65% 03 AUG 2028 73,442 73,442
    PACCAR FINANCIAL CORP 2.15% 15 AUG 2024 48,610 48,610
    PAYPAL HOLDINGS 2.65% 01 OCT 2026 94,951 94,951
    PHILLIPS 66 3.9% 15 MAR 2028 48,649 48,649
    RAYTHEON TECHNOLOGIES CORP 3.125% 04 MAY 2027 47,889 47,889
    SCHLUMBERGER INVESTMENT SA 3.65% 01 DEC 2023 100,387 100,387
    STATE STREET CORP 2.65% 19 MAY 2026 47,876 47,876
    TARGET CORP 3.5% 01 JUL 2024 25,094 25,094
    UNITEDHEALTH GROUP INC 3.75% 15 JUL 2025 49,980 49,980
    VISA INC 2.75% 15 SEP 2027 143,582 143,582
    VISA INC 3.15% 14 DEC 2025 98,874 98,874
    WALT DISNEY CO/THE 4% 01 OCT 2023 126,369 126,369
    WELLS FARGO & CO 3% 23 OCT 2026 118,183 118,183
    WELLS FARGO & CO 4.125% 15 AUG 2023 100,772 100,772

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    Name of Stock End of Year Book Value End of Year Fair Market Value
    DODGE & COX INTERNATIONAL STOCK FUND 637,055 637,055
    FMI COMMON STOCK FUND 869,221 869,221
    FMI INTERNATIONALFUND 625,270 625,270
    FMI LARGE CAP FUND 3,008,554 3,008,554
    T ROWE PRICE BLUE CHIP GROWTH FUND INC 815,921 815,921

    TY 2021 InvestmentsGovtObligationsSch
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    US Government Securities - End of Year Book Value:

    250,899
    US Government Securities - End of Year Fair Market Value:

    250,899
    State & Local Government Securities - End of Year Book Value:


    114,670
    State & Local Government Securities - End of Year Fair Market Value:


    114,670


    TY 2021 OtherDecreasesSchedule
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    Description Amount
    CURRENT YEAR UNREALIZED LOSS 455,854


    TY 2021 OtherExpensesSchedule
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    WEBSITE 3,045 0   3,045


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    ANNMARIE FOUNDATION INC
    EIN:
    23-7301323
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADMIN SERVICES 2,636 0   2,636
    INVESTMENT MANAGEMENT FEES 4,072 3,665   407