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 01-01-2021 , and ending 12-31-2021
Name of foundation
MAURICE J LEZELL CHARITABLE TRUST
 
Number and street (or P.O. box number if mail is not delivered to street address)6325 S RAINBOW BLVD STE 300
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS, NV89118
A Employer identification number

82-3739202
B Telephone number (see instructions)

(888) 730-4933
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$1,169,958J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 25,587 25,453  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 39,241
b Gross sales price for all assets on line 6a 409,372
7 Capital gain net income (from Part IV, line 2)... 39,241
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 64,828 64,694  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 17,509 15,758   1,751
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule)......... Click to see attachment 794 0 0 794
b Accounting fees (attach schedule)....... Click to see attachment 1,011 0 0 1,011
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 722 602   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... Click to see attachment 7 7    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 20,043 16,367 0 3,556
25 Contributions, gifts, grants paid....... 54,774 54,774
26 Total expenses and disbursements. Add lines 24 and 25 74,817 16,367 0 58,330
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -9,989
b Net investment income (if negative, enter -0-) 48,327
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. -26,445    
2 Savings and temporary cash investments......... 15,714 55,314 55,314
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 266,335 Click to see attachment844,580 1,114,644
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 654,249   0
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) 909,853 899,894 1,169,958
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 909,853 899,894
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 909,853 899,894
30 Total liabilities and net assets/fund balances (see instructions). 909,853 899,894
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
909,853
2
Enter amount from Part I, line 27a .....................
2
-9,989
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
236
4
Add lines 1, 2, and 3 ..........................
4
900,100
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
206
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
899,894
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 24. AT & T INC   2019-08-07 2021-01-05
b 3. ABBVIE INC   2020-12-10 2021-01-05
c 1. AMGEN INC   2020-09-14 2021-01-05
d 10. BLACKSTONE INC   2020-05-29 2021-01-05
e 1. BOEING CO   2018-05-22 2021-01-05
1. BROADCOM INC   2019-09-10 2021-01-05
2. CVS HEALTH CORPORATION   2018-05-22 2021-01-05
1. CELANESE CORP   2019-12-20 2021-01-05
5. CISCO SYSTEMS INC   2019-08-07 2021-01-05
5. CITIGROUP INC.   2019-12-20 2021-01-05
3. COGNIZANT TECH SOLUTIONS CRP COM   2018-05-22 2021-01-05
1. DIAGEO PLC - ADR   2019-12-20 2021-01-05
2. WALT DISNEY CO   2020-12-10 2021-01-05
4. ELECTRONIC ARTS INC   2020-04-03 2021-01-05
1. ELECTRONIC ARTS INC   2019-02-15 2021-01-05
4. FIDELITY NATL INFORMATION SVCS INC   2020-03-04 2021-01-05
66.805 FIDELITY NEW MRKTS INC-Z #3323   2018-05-23 2021-01-05
11. HAIN CELESTIAL GROUP INC   2018-05-22 2021-01-05
18. INTERPUBLIC GROUP COS INC   2020-12-21 2021-01-05
108. INVESCO OPTIMUM YIELD DIVERSIF ETF   2020-04-03 2021-01-05
44. ISHARES CORE U.S. AGGREGATE ETF   2020-12-09 2021-01-05
14. ISHARES RUSSELL 2000 ETF   2020-12-09 2021-01-05
79. ISHARES CORE MSCI EMERGING ETF   2020-12-09 2021-01-05
2. JPMORGAN CHASE & CO   2019-12-20 2021-01-05
4. LAS VEGAS SANDS CORP   2018-05-22 2021-01-05
3. ELI LILLY & CO COM   2020-07-20 2021-01-05
16. MANULIFE FINANCIAL CORP   2018-05-22 2021-01-05
7. MERCK & CO INC NEW   2019-12-20 2021-01-05
3. MICROSOFT CORP   2019-12-20 2021-01-05
3. MONDELEZ INTERNATIONAL INC   2019-08-07 2021-01-05
2. NIKE INC CL B   2019-08-07 2021-01-05
733.605 PGIM HIGH YIELD-Q 1067   2020-12-09 2021-01-05
2. RAYTHEON TECHNOLOGIES CORP   2020-01-07 2021-01-05
23. SUNCOR ENERGY INC NEW F   2018-05-22 2021-01-05
7. SYSCO CORP   2020-08-25 2021-01-05
218.325 TCW EMRG MKTS INCM-I 4721   2020-12-09 2021-01-05
1. TARGET CORP   2020-04-03 2021-01-05
3. TARGET CORP   2019-12-20 2021-01-05
1. THERMO FISHER SCIENTIFIC INC   2019-08-07 2021-01-05
5. TORONTO DOMINION BK ONT COM NEW   2020-12-10 2021-01-05
7. TORONTO DOMINION BK ONT COM NEW   2019-07-31 2021-01-05
14. TOTAL S.A. - ADR   2018-05-22 2021-01-05
12. UNILEVER PLC - ADR   2020-02-04 2021-01-05
1. UNITED PARCEL SERVICE-CL B   2018-05-22 2021-01-05
1. UNITEDHEALTH GROUP INC   2019-12-20 2021-01-05
52. VANGUARD FTSE DEVELOPED ETF   2018-05-22 2021-01-05
24. VANGUARD MIDCAP VIPER   2020-02-12 2021-01-05
3. VISA INC-CLASS A SHRS   2020-03-17 2021-01-05
2. WASTE MANAGEMENT INC   2020-03-04 2021-01-05
2. EATON CORP PLC   2020-11-30 2021-01-05
1. MEDTRONIC PLC   2019-12-20 2021-01-05
3. GARMIN LTD   2020-10-21 2021-01-05
4. TE CONNECTIVITY LTD   2018-05-22 2021-01-05
25. FLEXTRONICS INTL LTD   2019-08-07 2021-01-05
6. APPLE INC   2020-04-03 2021-02-11
2. BROADCOM INC   2019-07-03 2021-02-11
1. LAM RESEARCH CORP COM   2019-08-07 2021-02-11
96. MANULIFE FINANCIAL CORP   2018-05-22 2021-02-11
20. AT & T INC   2019-08-07 2021-02-23
1. ALPHABET INC CL C   2019-12-20 2021-02-23
9. APPLE INC   2020-04-03 2021-02-23
20. APPLE INC   2019-08-07 2021-02-23
1. BLACKROCK INC   2021-02-11 2021-02-23
9. BLACKSTONE INC   2021-02-11 2021-02-23
3. BOEING CO   2018-05-22 2021-02-23
2. BROADCOM INC   2019-07-03 2021-02-23
8. CVS HEALTH CORPORATION   2018-05-22 2021-02-23
6. CELANESE CORP   2018-05-22 2021-02-23
18. CISCO SYSTEMS INC   2019-07-23 2021-02-23
17. CITIGROUP INC.   2018-05-22 2021-02-23
8. COGNIZANT TECH SOLUTIONS CRP COM   2018-05-22 2021-02-23
5. DIAGEO PLC - ADR   2019-08-07 2021-02-23
5. WALT DISNEY CO   2020-12-10 2021-02-23
3. ELECTRONIC ARTS INC   2020-04-03 2021-02-23
2. ELECTRONIC ARTS INC   2019-11-06 2021-02-23
103. INVESCO OPTIMUM YIELD DIVERSIF ETF   2020-04-03 2021-02-23
25. ISHARES CORE U.S. AGGREGATE ETF   2020-12-09 2021-02-23
281. ISHARES CORE U.S. AGGREGATE ETF   2019-08-07 2021-02-23
10. JPMORGAN CHASE & CO   2019-09-26 2021-02-23
2. LAM RESEARCH CORP COM   2018-10-01 2021-02-23
11. LAS VEGAS SANDS CORP   2018-05-22 2021-02-23
2. ELI LILLY & CO COM   2020-04-03 2021-02-23
2. ELI LILLY & CO COM   2019-12-20 2021-02-23
43. MANULIFE FINANCIAL CORP   2019-10-18 2021-02-23
8. MICROSOFT CORP   2020-04-03 2021-02-23
4. MICROSOFT CORP   2019-12-20 2021-02-23
12. MONDELEZ INTERNATIONAL INC   2019-08-07 2021-02-23
5. NIKE INC CL B   2020-04-03 2021-02-23
8. RAYTHEON TECHNOLOGIES CORP   2019-12-20 2021-02-23
9. SYSCO CORP   2020-08-25 2021-02-23
3. TARGET CORP   2020-04-03 2021-02-23
1. TARGET CORP   2019-08-07 2021-02-23
2. THERMO FISHER SCIENTIFIC INC   2018-05-22 2021-02-23
4. TORONTO DOMINION BK ONT COM NEW   2020-12-10 2021-02-23
9. TORONTO DOMINION BK ONT COM NEW   2019-07-05 2021-02-23
3. UNION PACIFIC CORP   2019-08-07 2021-02-23
5. UNITED PARCEL SERVICE-CL B   2018-05-22 2021-02-23
3. UNITEDHEALTH GROUP INC   2019-12-20 2021-02-23
905. VANGUARD FTSE DEVELOPED ETF   2018-05-22 2021-02-23
6. WASTE MANAGEMENT INC   2020-03-04 2021-02-23
5. EATON CORP PLC   2021-02-11 2021-02-23
5. MEDTRONIC PLC   2019-07-19 2021-02-23
5. GARMIN LTD   2020-10-21 2021-02-23
5. TE CONNECTIVITY LTD   2018-05-22 2021-02-23
5. APPLE INC   2019-08-07 2021-03-25
1. BLACKROCK INC   2019-12-20 2021-03-25
2. BROADCOM INC   2019-07-03 2021-03-25
13. HAIN CELESTIAL GROUP INC   2018-05-22 2021-03-25
26. INTERPUBLIC GROUP COS INC   2020-11-02 2021-03-25
9. MERCK & CO INC NEW   2019-08-07 2021-03-25
3. MICROSOFT CORP   2019-08-07 2021-03-25
8126.012 PGIM HIGH YIELD-Q 1067   2020-09-28 2021-03-25
15. TOTAL S.A. - ADR   2018-05-22 2021-03-25
10. UNILEVER PLC - ADR   2020-02-04 2021-03-25
3. VISA INC-CLASS A SHRS   2020-03-17 2021-03-25
7. TE CONNECTIVITY LTD   2018-05-22 2021-03-25
168. AT & T INC   2018-05-22 2021-04-08
1. LAM RESEARCH CORP COM   2018-10-01 2021-04-08
11. SYSCO CORP   2020-05-19 2021-04-08
.2 ORGANON & CO   2020-07-20 2021-06-14
4.8 ORGANON & CO   2018-05-22 2021-06-14
3. TARGET CORP   2019-08-07 2021-06-14
.5 ORGANON & CO   2020-07-20 2021-06-28
3. ELI LILLY & CO COM   2019-08-07 2021-07-06
4. UNITEDHEALTH GROUP INC   2018-05-22 2021-07-06
1. ABBVIE INC   2021-07-06 2021-07-29
1. AMGEN INC   2020-09-14 2021-07-29
96.374 EV GL MACR ABS RTRN ADV-R6 #1072   2021-02-23 2021-07-29
2030.651 EV GL MACR ABS RTRN ADV-R6 #1072   2018-02-02 2021-07-29
1. FIDELITY NATL INFORMATION SVCS INC   2019-12-20 2021-07-29
1. HASBRO INC   2021-04-08 2021-07-29
1311. INVESCO OPTIMUM YIELD DIVERSIF ETF   2020-04-03 2021-07-29
170. ISHARES CORE U.S. AGGREGATE ETF   2019-12-20 2021-07-29
87. ISHARES RUSSELL 2000 ETF   2021-02-23 2021-07-29
14. SUNCOR ENERGY INC NEW F   2018-05-22 2021-07-29
10. VANGUARD MIDCAP VIPER   2021-02-23 2021-07-29
64. VANGUARD MIDCAP VIPER   2020-02-12 2021-07-29
16. FLEXTRONICS INTL LTD   2019-08-07 2021-07-29
7. BLACKSTONE INC   2021-02-11 2021-08-30
5. CISCO SYSTEMS INC   2021-07-29 2021-08-30
13. CISCO SYSTEMS INC   2019-12-20 2021-08-30
2. GARMIN LTD   2021-07-29 2021-08-30
4. GARMIN LTD   2020-05-29 2021-08-30
6. AMGEN INC   2020-10-21 2021-10-12
12. AMGEN INC   2020-08-22 2021-10-12
12. BLACKSTONE INC   2020-05-12 2021-10-21
2. DIAGEO PLC - ADR   2021-07-29 2021-10-21
1. DIAGEO PLC - ADR   2019-08-07 2021-10-21
194. FLEXTRONICS INTL LTD   2019-02-15 2021-11-19
12. ISHARES CORE S&P SMALL-CAP E   2021-03-25 2021-12-10
627. ISHARES CORE MSCI EMERGING ETF   2021-02-23 2021-12-10
35.536 PGIM HIGH YIELD-Q 1067   2021-07-30 2021-12-10
22. ISHARES CORE U.S. AGGREGATE ETF   2019-12-20 2021-12-15
18. ISHARES RUSSELL 2000 ETF   2021-02-23 2021-12-15
1. ISHARES CORE S&P SMALL-CAP E   2021-03-25 2021-12-15
123. ISHARES CORE MSCI EMERGING ETF   2021-03-25 2021-12-15
24. ISHARES CORE TOTAL BOND ETF   2021-07-29 2021-12-15
456.236 PGIM HIGH YIELD-Q 1067   2021-07-30 2021-12-15
10. VANGUARD MIDCAP VIPER   2020-02-12 2021-12-15
1. BLACKROCK INC   2021-07-29 2021-12-17
9. BLACKSTONE INC   2020-05-12 2021-12-17
5. MICROSOFT CORP   2021-07-29 2021-12-17
2. NIKE INC CL B   2021-07-29 2021-12-17
4. NIKE INC CL B   2020-04-03 2021-12-17
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(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 706   902 -196
b 319   323 -4
c 228   246 -18
d 626   560 66
e 213   358 -145
427   293 134
142   132 10
131   123 8
220   259 -39
309   394 -85
240   226 14
160   166 -6
358   308 50
565   411 154
141   107 34
551   596 -45
1,006   1,017 -11
442   287 155
422   420 2
1,688   1,285 403
5,182   5,175 7
2,763   2,691 72
5,041   4,816 225
252   276 -24
238   316 -78
498   500 -2
287   319 -32
566   640 -74
652   471 181
174   158 16
282   162 120
4,042   4,035 7
139   195 -56
422   953 -531
515   406 109
1,858   1,843 15
181   94 87
544   389 155
477   273 204
285   284 1
399   408 -9
617   895 -278
724   705 19
163   116 47
347   295 52
2,499   2,370 129
4,939   4,444 495
645   474 171
230   240 -10
241   242 -1
117   114 3
356   296 60
491   381 110
452   261 191
805   364 441
951   578 373
574   194 380
1,883   1,882 1
595   679 -84
2,025   1,352 673
1,103   546 557
2,451   976 1,475
700   720 -20
621   634 -13
644   1,074 -430
931   569 362
558   527 31
819   720 99
815   902 -87
1,116   1,252 -136
582   603 -21
828   826 2
970   771 199
415   309 106
276   197 79
1,800   1,225 575
2,884   2,940 -56
32,415   31,677 738
1,516   1,338 178
1,113   300 813
693   870 -177
401   282 119
401   264 137
830   809 21
1,840   1,241 599
920   628 292
657   632 25
670   397 273
589   733 -144
708   522 186
564   281 283
188   82 106
908   491 417
246   227 19
553   520 33
622   496 126
800   572 228
988   885 103
44,430   40,041 4,389
670   720 -50
653   615 38
584   531 53
630   493 137
643   476 167
597   244 353
719   502 217
910   569 341
551   333 218
728   594 134
681   783 -102
705   406 299
44,693   43,390 1,303
681   959 -278
559   587 -28
623   474 149
872   667 205
5,041   5,298 -257
665   150 515
882   578 304
6   8 -2
146   149 -3
695   246 449
15   19 -4
703   352 351
1,631   976 655
119   116 3
245   246 -1
1,023   1,010 13
21,566   20,674 892
150   139 11
100   96 4
26,723   15,538 11,185
19,762   19,094 668
19,407   18,963 444
289   580 -291
2,409   2,164 245
15,421   11,851 3,570
278   167 111
877   624 253
295   275 20
767   622 145
356   314 42
713   363 350
1,207   1,424 -217
2,414   2,952 -538
1,587   637 950
398   394 4
199   164 35
3,440   1,841 1,599
1,355   1,289 66
38,542   40,576 -2,034
196   199 -3
2,515   2,471 44
3,816   3,923 -107
109   104 5
7,193   7,696 -503
1,269   1,294 -25
2,514   2,550 -36
2,463   1,852 611
921   866 55
1,110   474 636
1,617   1,433 184
325   332 -7
649   318 331
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
      160
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       -196
b       -4
c       -18
d       66
e       -145
      134
      10
      8
      -39
      -85
      14
      -6
      50
      154
      34
      -45
      -11
      155
      2
      403
      7
      72
      225
      -24
      -78
      -2
      -32
      -74
      181
      16
      120
      7
      -56
      -531
      109
      15
      87
      155
      204
      1
      -9
      -278
      19
      47
      52
      129
      495
      171
      -10
      -1
      3
      60
      110
      191
      441
      373
      380
      1
      -84
      673
      557
      1,475
      -20
      -13
      -430
      362
      31
      99
      -87
      -136
      -21
      2
      199
      106
      79
      575
      -56
      738
      178
      813
      -177
      119
      137
      21
      599
      292
      25
      273
      -144
      186
      283
      106
      417
      19
      33
      126
      228
      103
      4,389
      -50
      38
      53
      137
      167
      353
      217
      341
      218
      134
      -102
      299
      1,303
      -278
      -28
      149
      205
      -257
      515
      304
      -2
      -3
      449
      -4
      351
      655
      3
      -1
      13
      892
      11
      4
      11,185
      668
      444
      -291
      245
      3,570
      111
      253
      20
      145
      42
      350
      -217
      -538
      950
      4
      35
      1,599
      66
      -2,034
      -3
      44
      -107
      5
      -503
      -25
      -36
      611
      55
      636
      184
      -7
      331
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 39,241
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........................... 3 672
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- ..... 5 672
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 160
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 512
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 672
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet0 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNC
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletWELLS FARGO BANK NA Telephone no.bullet (888) 730-4933

    Located atbullet110 N MAIN ST D4001-117WINSTON SALEMNC ZIP+4bullet27101
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    WELLS FARGO BANK N A TRUSTEE
    1     		17,509    
    100 N MAIN ST MAC D4001-117
    WINSTON SALEM,NC27101
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,126,955
    b
    Average of monthly cash balances.......................
    1b
    41,208
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,168,163
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    1,168,163
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    17,522
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    1,150,641
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    57,532
    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
    57,532
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    672
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    672
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    56,860
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    56,860
    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
    56,860
    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 56,860
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 27,512
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 0
    b From 2017...... 0
    c From 2018...... 0
    d From 2019...... 0
    e From 2020...... 0
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 58,330
    a Applied to 2020, but not more than line 2a 27,512
    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..... 30,818
    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 ..........     		26,042
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 0
    d Excess from 2020.... 0
    e Excess from 2021.... 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    AMERICAN JEWISH JOINT COMMITTEE INC
    220 EAST 42ND STREET ROOM 400
    NEW YORK,NY10017     		NONE PC GENERAL SUPPORT 9,129
    THE SALVATION ARMY
    5550 PRAIRIE STONE PARKWAY
    HOFFMAN ESTATES,IL60192     		NONE PC GENERAL SUPPORT 9,129
    PROVINCE OF ST JOSEPH
    1100 NORTH BALLARD ROAD
    APPLETON,WI54911     		NONE PC GENERAL SUPPORT 9,129
    HOLOCAUST MEMORIAL CENTER
    28123 ORCHARD LAKE RD
    FARMINGTON HILLS,MI48334     		NONE PC GENERAL SUPPORT 9,129
    ST JUDE CHILDRENS RESEARCH HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		NONE PC GENERAL SUPPORT 9,129
    CITY OF HOPE
    1500 E DUARTE RD
    DUARTE,CA91010     		NONE PC GENERAL SUPPORT 9,129
    Total .................................bullet 3a 54,774
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 39,241  
    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) ..   64,828  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    64,828
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,011     1,011

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Name of Stock End of Year Book Value End of Year Fair Market Value
    H2906T109 GARMIN LTD 4,333 5,991
    17275R102 CISCO SYSTEMS INC 5,705 8,301
    172967424 CITIGROUP INC. 8,709 8,998
    Y2573F102 FLEX LTD    
    G29183103 EATON CORP PLC 7,238 9,851
    91324P102 UNITEDHEALTH GROUP I 6,487 13,056
    09857L108 BOOKING HOLDINGS INC 5,578 7,198
    037833100 APPLE INC 9,678 32,318
    58933Y105 MERCK & CO INC NEW 5,756 6,438
    02079K107 ALPHABET INC CL C 10,141 26,042
    285512109 ELECTRONIC ARTS INC 4,144 5,804
    25243Q205 DIAGEO PLC - ADR 5,033 7,705
    92826C839 VISA INC-CLASS A SHR 5,703 6,935
    G5960L103 MEDTRONIC PLC 4,010 4,241
    911312106 UNITED PARCEL SERVIC 3,951 7,931
    11135F101 BROADCOM INC 4,176 9,981
    254687106 WALT DISNEY CO 4,650 6,196
    94106L109 WASTE MANAGEMENT INC 5,949 8,679
    891160509 TORONTO DOMINION BK 5,798 8,205
    87612E106 TARGET CORP 2,306 6,480
    31620M106 FIDELITY NATL INFORM 6,519 5,785
    09260D107 BLACKSTONE INC 2,760 6,728
    609207105 MONDELEZ INTERNATION 4,397 6,498
    594918104 MICROSOFT CORP 10,526 32,623
    883556102 THERMO FISHER SCIENT 2,495 6,672
    75513E101 RAYTHEON TECHNOLOGIE 6,412 7,401
    517834107 LAS VEGAS SANDS CORP 6,928 4,705
    H84989104 TE CONNECTIVITY LTD 4,567 6,615
    871829107 SYSCO CORP 3,073 5,499
    907818108 UNION PACIFIC CORP 3,782 6,550
    00206R102 AT & T INC    
    89151E109 TOTALENERGIES SE -SP 6,263 6,084
    031162100 AMGEN INC    
    150870103 CELANESE CORP 5,795 8,739
    00287Y109 ABBVIE INC 5,757 7,176
    512807108 LAM RESEARCH CORP CO 1,502 7,192
    532457108 ELI LILLY & CO COM 3,461 8,563
    46625H100 JPMORGAN CHASE & CO 9,000 12,985
    126650100 CVS HEALTH CORPORATI 4,186 6,912
    867224107 SUNCOR ENERGY INC NE 7,270 6,583
    192446102 COGNIZANT TECH SOLUT 5,408 7,186
    097023105 BOEING CO 6,232 4,832
    654106103 NIKE INC CL B 2,857 6,667
    09247X101 BLACKROCK INC 4,397 9,156
    56501R106 MANULIFE FINANCIAL C 6,281 7,952
    460690100 INTERPUBLIC GROUP CO 3,566 6,704
    405217100 HAIN CELESTIAL GROUP 1,852 3,707
    904767704 UNILEVER PLC - ADR 3,919 3,819
    46434V613 ISHARES CORE TOTAL B 44,905 44,408
    381430107 GOLDMAN SACHS ACTIVE 23,554 23,384
    464287655 ISHARES RUSSELL 2000 48,968 67,180
    922908629 VANGUARD MIDCAP VIPE 117,037 196,173
    31641Q755 FIDELITY NEW MRKTS I 23,576 22,502
    464287226 ISHARES CORE U.S. AG 85,873 88,640
    74440Y884 PGIM HIGH YIELD-Q 10 82,028 88,623
    464287804 ISHARES CORE S&P SMA 20,929 23,131
    872365713 TCW EMRG MRKTS INC-P 45,636 43,827
    30303M102 META PLATFORMS INC 3,486 3,700
    418056107 HASBRO INC 5,556 5,903
    46434G103 ISHARES CORE MSCI EM 81,236 89,910
    722005667 PIMCO COMMODITY REAL 23,246 23,580

    TY 2021 InvestmentsOtherSchedule2
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    46090F100 INVESCO OPTIMUM YIEL      
    464287655 ISHARES RUSSELL 2000      
    87234N765 TCW EMRG MKTS INCM-I      
    46434G103 ISHARES CORE MSCI EM      
    921943858 VANGUARD FTSE DEVELO      
    31641Q755 FIDELITY NEW MRKTS I      
    922908629 VANGUARD MIDCAP VIPE      
    464287226 ISHARES CORE U.S. AG      
    27830W108 EV GL MACR ABS RTRN      
    74440Y884 PGIM HIGH YIELD-Q 10      

    TY 2021 LegalFeesSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES - PRINCIPAL (ALLOCA 397     397
    LEGAL FEES - INCOME (ALLOCABLE 397     397


    TY 2021 OtherDecreasesSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Description Amount
    PY RETURN OF CAPITAL ADJ 206


    TY 2021 OtherExpensesSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT EXPENSES - ADR FEES 7 7   0


    TY 2021 OtherIncreasesSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Description Amount
    MUTUAL FUND TIMING ADJ 82
    COST BASIS ADJUSTMENT 154


    TY 2021 TaxesSchedule
    Name:
    MAURICE J LEZELL CHARITABLE TRUST
    EIN:
    82-3739202
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 461 461   0
    FEDERAL ESTIMATES - PRINCIPAL 120 0   0
    FOREIGN TAXES ON NONQUALIFIED 141 141   0