TY 2021 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
bullet

Go to www.irs.gov/Form990PF for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

For calendar year 2021, or tax year beginning 07-01-2021 , and ending 06-30-2022

Name of foundation
The Bob and Patti Antin Family 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

82-0722416

B Telephone number (see instructions)

(800) 839-1754

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$9,942,110J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)	0
2	Check .............
3	Interest on savings and temporary cash investments	7,831		7,831
4	Dividends and interest from securities...	165,859		165,859
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		-49,580
b	Gross sales price for all assets on line 6a 2,369,486
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........	124,110		173,690
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).......
c	Other professional fees (attach schedule)....		46,356	46,356
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		1,390	90
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		33,804		33,804
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	81,550		46,446	33,804
25	Contributions, gifts, grants paid.......	509,100			509,100
26	Total expenses and disbursements. Add lines 24 and 25	590,650		46,446	542,904
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-466,540
b	Net investment income (if negative, enter -0-)			127,244
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	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............
	2	Savings and temporary cash investments.........	4,141,215	3,480,131	3,480,131
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	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)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)	50,342	98,215	92,520
	b	Investments—corporate stock (attach schedule).......	5,702,500	5,882,536	5,543,795
	c	Investments—corporate bonds (attach schedule).......	969,887	936,522	825,664
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	10,863,944	10,397,404	9,942,110
	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 )
	23	Total liabilities (add lines 17 through 22).........	0	0
		Foundations that follow FASB ASC 958, check here
		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
		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	10,863,944	10,397,404
	29	Total net assets or fund balances (see instructions).....	10,863,944	10,397,404
	30	Total liabilities and net assets/fund balances (see instructions).	10,863,944	10,397,404

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

10,863,944

Enter amount from Part I, line 27a .....................

-466,540

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

10,397,404

Decreases not included in line 2 (itemize) bullet

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

10,397,404

Form 990-PF (2021)

Page 3

Part IV

Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kind(s) of property sold (e.g., real estate, 2-story brick warehouse; or common stock, 200 shs. MLC Co.)		(b) How acquired P—Purchase D—Donation	(c) Date acquired (mo., day, yr.)	(d) Date sold (mo., day, yr.)
1 a	Publicly-traded Securities
b
c
d
e

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	2,369,486	2,419,066	-49,580
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			-49,580
b
c
d
e

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	-49,580
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 ...................		3

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 and enter “N/A" on line 1.
	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	1,769
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	1,769
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a	3,900
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c
d	Backup withholding erroneously withheld ...........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7	3,900
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.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	2,131
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax2,131	Refunded	11

Part VI-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?.........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2021)

Page 5

Part VI-A

Statements Regarding Activities (continued)

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 .............

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 Click to see attachment

.................

Yes

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

The books are in care of bullet

Foundation Source Telephone no. bullet

(800) 839-1754

Located at bullet

501 Silverside Road Suite 123WilmingtonDE ZIP+4 bullet

198091377

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

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

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)

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? ..............................

1a(2)

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........

1a(3)

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............

1a(4)

(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)

(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)

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 ..........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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? .............

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)):

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?....................

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year? ..............................

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.) .....................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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? ..

Form 990-PF (2021)

Page 6

Part VI-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........

5a(1)

(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)

(3) Provide a grant to an individual for travel, study, or other similar purposes? .............

5a(3)

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions ........................

5a(4)

(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)

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 ........

Organizations relying on a current notice regarding disaster assistance check here ......... bullet

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? .................

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? .............................

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....

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? .........................

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
Devin Antin	Dir, VP 20.0	0	0	0
Foundation Source 501 Silverside Rd Wilmington,DE198091377	Dir, VP 20.0	0	0	0
Elyse Antin	Dir, VP 25.0	0	0	0
Foundation Source 501 Silverside Rd Wilmington,DE198091377	Dir, VP 25.0	0	0	0
Paige Antin	Dir 20.0	0	0	0
Foundation Source 501 Silverside Rd Wilmington,DE198091377	Dir 20.0	0	0	0
Patricia W Antin	Dir, CFO, SEC 10.0	0	0	0
Foundation Source 501 Silverside Rd Wilmington,DE198091377	Dir, CFO, SEC 10.0	0	0	0
Robert L Antin	Dir, Pres 10.0	0	0	0
Foundation Source 501 Silverside Rd Wilmington,DE198091377	Dir, Pres 10.0	0	0	0

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...................

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

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)

Page 8

Part IX

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

7,540,546

Average of monthly cash balances.......................

4,000,114

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

11,540,660

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

11,540,660

Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see

instructions) .............................

173,110

Net value of noncharitable-use assets. Subtract line 4 from line 3. .......

11,367,550

Minimum investment return. Enter 5% (0.05) of line 5................

568,378

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.)

Minimum investment return from Part IX, line 6..................

568,378

Tax on investment income for 2021 from Part V, line 5.......

1,769

Income tax for 2021. (This does not include the tax from Part V.) ...

Add lines 2a and 2b............................

1,769

Distributable amount before adjustments. Subtract line 2c from line 1............

566,609

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

566,609

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...

566,609

Part XI

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

Program-related investments—total from Part VIII-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.

Form 990-PF (2021)

Page 9

Part XII

Undistributed Income (see instructions)

		(a) Corpus	(c) 2020	(d) 2021
1 Distributable amount for 2021 from Part X, line 7				566,609
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......			542,822
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......
f Total of lines 3a through e ........
4Qualifying distributions for 2021 from Part
XI, line 4: $ 542,904
a Applied to 2020, but not more than line 2a			542,822
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.....				82
e Remaining amount distributed out of corpus		0
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		0
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 ..........				566,527
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 ......		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....	0

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 4942(j)(3) or4942(j)(5)

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	(e) Total

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).)

ROBERT L ANTIN

PATRICIA W ANTIN

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

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions

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)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
BEIT TSHUVAH 8831 VENICE BLVD LOS ANGELES,CA90034	N/A	PC	General & Unrestricted	20,000
BIGVISION FOUNDATION 34 W 27TH ST NEW YORK,NY10001	N/A	PC	General & Unrestricted	5,000
BRENTWOOD COUNTRY CLUB EMPLOYEE SCHOLARSHIP FUND 590 S BURLINGAME AVE LOS ANGELES,CA90049	N/A	PC	General & Unrestricted	2,000
FRIENDS FOR GOLF 78060 CALLE ESTADO STE 12 LA QUINTA,CA92253	N/A	PC	General & Unrestricted	70,000
FRIENDS OF ST LAWRENCE-WATTS YOUTH CENTER 10122 COMPTON AVE LOS ANGELES,CA90002	N/A	PC	General & Unrestricted	5,000
HAROLD PUMP FOUNDATION 20189 VIA GALILEO NORTHRIDGE,CA91326	N/A	PC	General & Unrestricted	35,000
JEWISH BIG BROTHERS BIG SISTERS ASSOCIATION OF LOS 11150 W OLYMPIC BLVD STE 900 LOS ANGELES,CA90064	N/A	PC	General & Unrestricted	8,500
JEWISH FEDERATION COUNCIL OF GREATER LOS ANGELES 6505 WILSHIRE BLVD STE 800 LOS ANGELES,CA90048	N/A	PC	General & Unrestricted	10,000
JEWISH NATIONAL FUND 7120 HAYVENHURST AVE STE 200 VAN NUYS,CA91406	N/A	PC	General & Unrestricted	15,000
JEWISH NATIONAL FUND-USA INC 42 E 69TH ST NEW YORK,NY10021	N/A	PC	General & Unrestricted	15,000
MAY I PRAY FOR YOU MINISTRY 2544 RAMBLEWOOD RD AIKEN,SC29803	N/A	PC	Wells for Zambia	17,500
MORGAN STANLEY GLOBAL IMPACT FUNDING TRUST INC CO RENPSG 8910 PURDUE RD NO 500 INDIANAPOLIS,IN46268	N/A	PC	General & Unrestricted	122,000
NATIONAL JEWISH HEALTH 1400 JACKSON ST DENVER,CO80206	N/A	PC	General & Unrestricted	10,000
SAINT JOHNS HEALTH CENTER FOUNDATION 2121 SANTA MONICA BLVD SANTA MONICA,CA90404	N/A	PC	General & Unrestricted	174,100
Total ................................. 3a				509,100

bApproved for future payment

Total ................................. 3b

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	(e) Related or exempt function income (See instructions.)
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	7,831
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	-49,580
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) ..				124,110

13Total. Add line 12, columns (b), (d), and (e)..................

124,110

(See worksheet in line 13 instructions to verify calculations.)

Part XV-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	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)

Page 13

Part XVI

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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? ...........Yes No

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.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name				Firm's EIN
	Firm's address				Phone no.

Form 990-PF (2021)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

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

TY 2021 DepreciationSchedule

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

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

- TIN:

TY 2021 InvestmentsCorpBondsSchedule

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

Name of Bond	End of Year Book Value	End of Year Fair Market Value
AT&T INC - 2.300% - 06/01/2027	2,096	1,826
AT&T INC - 4.300% - 02/15/2030	49,539	40,988
BALL CORP BOND - 5.250% - 07/0	36,512	31,976
BANK AMER CORP BOND - 3.248% -	19,190	16,989
BANK AMER CORP FR - 4.200% - 0	49,313	44,084
BANK NOVA SCOTIA B CNOTE CALL	37,675	34,029
BP CAP MKTS P L C NOTE CALL MA	37,474	32,994
BROADCOM INC SER B NOTE - 4.11	13,260	11,406
CANADIAN IMPERIAL BANK OF COMM	50,628	48,606
CHARTER COMMUNCATIONS - 2.800%	41,550	32,118
CHARTER COMMUNICATIONS - 4.200	4,552	3,767
CHENIERE CORPUS CHRISTI HLDGS	41,017	36,882
CITIGROUP INC BND - 3.300% - 0	51,106	45,149
COMCAST CORP - 3.700% - 04/15/	50,829	46,138
COMCAST CORP NT - 3.150% - 02/	19,392	17,158
GENERAL MTRS FINL COINC NOTE -	41,972	36,502
GOLDMAN SACHS GROUP INC - 3.85	15,848	13,555
HCA INC - 5.250% - 06/15/2026	42,124	35,817
MPLX LP - 4.875% - 12/01/2024	49,587	44,340
NETFLIX INC - 5.875% - 02/15/2	4,666	4,060
PACIFIC GAS &ELEC CO - 2.100%	41,189	35,263
SOUTHWEST AIRLS CO - 5.250% -	2,249	2,039
STATOIL ASA - 0.025% - 01/17/2	50,188	47,957
T MOBILE USA INC NOTE - 2.250%	24,125	21,770
VERIZON COMMUNICATIONS INC - 2	51,011	42,865
WALT DISNEY COMPANY - 1.750% -	50,041	46,262
WELLS FARGO & CO - 3.000% - 10	50,537	43,491
WESTERN DIGITAL CORP - 4.750%	8,852	7,633

- TIN:

TY 2021 InvestmentsCorpStockSchedule

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

Name of Stock	End of Year Book Value	End of Year Fair Market Value
ABBOTT LABS	19,193	18,362
ABBVIE INC	34,538	50,849
ADOBE SYSTEMS, INC	53,181	41,365
ADVANCE AUTO PARTS INC	8,924	10,212
ADVANCED MICRO DEVICES INC	21,781	17,970
AECOM TECHNOLOGY CORPORATION	14,484	13,957
ALEXANDRIA REAL ESTATE EQUITIE	13,292	11,167
ALPHABET INC CL A	101,276	104,604
AMAZON COM	151,416	99,837
AMERICAN EXPRESS CO	13,283	19,268
AMERICAN TOWER REIT INC	15,850	16,613
AMERICAN WATER WORKS COMPANY I	14,664	14,133
AMERIPRISE FINANCIAL INC	15,191	21,391
AMETEK INC	10,969	11,209
ANALOG DEVICES INC	13,577	13,148
AON PLC CL A	31,556	30,474
APPLE INC	178,961	158,458
APPLIED MATERIALS INC	21,756	16,467
ASML HOLDING NV NY REG SHS	28,205	28,077
AUTODESK, INC	26,009	18,572
AVATAR HOLDINGS INC.	14,005	12,969
BECTON DICKINSON & CO	28,050	29,091
BOOKING HOLDINGS INC	11,326	8,745
BOOZ ALLEN HAMILTON HOLDING CO	15,447	16,897
BOSTON SCIENTIFIC	17,700	16,660
BROADCOM INC	22,790	30,606
BURLINGTON STORES, INC	9,670	6,130
CIENA CORP	35,853	23,216
CISCO SYSTEMS INC	21,456	24,689
CITIZENS FINANCIAL GROUP, INC	7,647	8,601
CME GROUP, INC	22,210	24,564
COMCAST CORP	54,127	40,574
CONOCOPHILLIPS	13,553	36,193
CONSTELLATION BRANDS INC	32,534	32,628
COSTCO WHOLESALE CORPORATION	34,687	35,467
CROWN CASTLE INTL	20,332	20,879
CSX CORP	39,437	31,966
CURTISS WRIGHT CP	11,247	12,414
CVS CAREMARK CORP	33,215	32,060
DANAHER CORP	49,627	49,943
DARDEN RESTAURANTS INC	8,822	9,389
DEXCOM, INC	28,786	23,850
DOLLAR GENERAL CORP	9,153	10,554
DOMINOS PIZZA INC	29,359	25,331
EASTMAN CHEMICAL CO	9,088	7,361
EDWARDS LIFESCIENCES	24,152	26,625
EMERSON ELECTRIC CO	29,380	27,521
ENTEGRIS INC	8,244	7,094
EOG RESOURCES INC	30,164	30,261
EPAM SYSTEMS INC	10,844	11,202
ESTEE LAUDER COMPANIES INC	10,733	11,205
EXXON MOBIL CORP	32,124	32,372
F M C CP	10,129	10,273
FIDELITY NATIONAL INFORMATION	21,733	14,851
FIRST REPUBLIC BANK	11,374	12,257
FORTINET INC	4,117	9,336
FREEPORT-MCMORAN COPPER & GOLD	29,939	21,301
GENERAC HOLDING INC	8,675	5,896
GOLDMAN SACHS GROUP	17,427	25,247
HESS CORP	11,752	11,124
HOME DEPOT INC	55,302	44,157
HONEYWELL INTL	13,826	13,731
HOULIHAN LOKEY INC	9,399	11,445
IDEXX CORP	26,332	19,290
INGERSOLL-RAND INC	11,554	9,931
INTEL CORP	33,538	25,701
INTERCONTINENTAL EXCHANGE, INC	9,097	8,746
INTUIT	16,291	16,574
INTUITIVE SURGICAL	43,092	28,300
ISHARE SP SMALL CAP 600 INDEX	198,247	242,853
ISHARES CORE MSCI EAFE ETF	1,039,337	1,008,160
ISHARES IBOXX $ HIGH YIELD COR	111,190	98,564
ISHARES JP MORGAN USD EM MKTS	179,253	138,645
ISHARES MSCI EMERGING MARKETS	466,833	409,581
JAZZ PHARMACEUTICALS INC	11,053	11,077
JP MORGAN CHASE	90,843	74,435
KEYSIGHT TECHNOLOGIES INC	41,447	41,355
LABORATORY CORP AMER HLDGS	12,325	12,655
LINDE PLC COM	24,301	30,766
LOCKHEED MARTIN CORP	14,472	17,198
LOGITECH INTERNATIONAL	8,639	5,466
LOWES COMPANIES INC	12,229	12,052
MARRIOTT INTERNATIONAL INC. CL	25,791	19,857
MASIMO CORPORATION	28,961	15,027
MATCH GROUP INC	11,513	6,133
MCCORMICK & CO	9,905	8,242
MCDONALD'S CORP	32,656	35,551
MEDTRONIC PLC	45,476	34,913
MICROSOFT CORP	164,664	166,426
MONSTER BEVERAGE CORP	16,757	17,891
MORGAN STANLEY	17,057	26,393
NETFLIX INC	18,844	7,345
NEXTERA ENERGY, INC	70,966	70,566
NIKE INC-CL B	17,638	12,673
NORFOLK SOUTHERN CORP	21,611	23,865
NVIDIA CORP	26,620	30,318
O'REILLY AUTOMOTIVE INC	9,328	13,267
ON SEMICONDUCTOR	6,656	7,144
PALO ALTO NETWORKS INC	14,109	19,758
PARKER HANNIFIN CP	11,503	11,072
PIONEER NAT RES CO	12,731	17,623
PROCTER GAMBLE CO	49,885	48,457
PROLOGIS	16,466	19,295
RAYTHEON TECHNOLOGIES CORP	19,726	31,044
ROCKWELL AUTOMATION INC	7,016	5,979
RPM INTERNATIONAL INC	13,680	12,438
S&P GLOBAL INC COM	13,904	12,471
SALESFORCE.COM	26,903	19,310
SERVICE CP INTL	9,650	14,377
SHERWIN-WILLIAMS CO	12,073	12,091
STARWOOD PROPERTY TRUST INC	222,294	208,900
SYSCO CORP	24,783	26,599
TAKE-TWO INTERACTIVE SOFTWARE	16,736	13,111
TAPESTRY INC	25,234	19,380
TARGET CORPORATION	22,820	19,490
TELEFLEX INC	14,097	9,834
TEXAS INSTRUMENTS INC	18,121	15,519
THERMO FISHER SCIENTIFIC INC	8,766	9,779
TIMKEN CO COM	10,038	6,897
TJX COMPANIES INC	15,181	14,744
TRADEWEB MARKETS INC	41,673	40,199
TRAVELERS COMPANIES INC	16,301	22,833
TYLER TECHNOLOGIES, INC	10,343	6,982
UBER	19,615	10,946
UBS ULTRA SHORT INCOME FUND CL	264,373	260,408
UNION PACIFIC	56,119	49,694
UNITED PARCEL SERVICE	27,003	25,738
UNITEDHEALTH GROUP INC	21,408	26,195
V F CORP	24,796	15,194
VAIL RESORTS INC	12,368	8,722
VISA INC	73,668	69,699
VOYA FINANCIAL INC	8,289	8,275
WAL-MART STORES INC	37,756	32,827
WELLS FARGO & CO	39,556	27,811
ZEBRA TECHNOLOGIES CORP	27,826	21,458
ZOETIS INC	33,669	28,878

- TIN:

TY 2021 InvestmentsGovtObligationsSch

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

US Government Securities - End of Year Book Value:

98,215

US Government Securities - End of Year Fair Market Value:

92,520

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

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

- TIN:

TY 2021 OtherExpensesSchedule

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

Description	Revenue and Expenses per Books	Disbursements for Charitable Purposes
Administrative Fees	33,615	33,615
Postage/Delivery Service	114	114
State or Local Filing Fees	75	75

- TIN:

TY 2021 OtherProfessionalFeesSchedule

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
Investment Management Services	46,356	46,356

- TIN:

TY 2021 TaxesSchedule

Name:

The Bob and Patti Antin Family Foundation

EIN:

82-0722416

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
990-PF Estimated Tax for 2022	1,300
Foreign Tax Paid	90	90