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 06-01-2021 , and ending 05-31-2022
Name of foundation
ANNE & SCOTT NICKERSON FAMILY
FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 278
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BIG HORN, WY82833
A Employer identification number

84-1409098
B Telephone number (see instructions)

(307) 674-9875
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$3,929,667J 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) 233,000
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 47,117 47,117  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 109,978
b Gross sales price for all assets on line 6a 468,848
7 Capital gain net income (from Part IV, line 2)... 109,978
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........ 390,095 157,095  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 1,925 1,444   481
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 6,184 2,473    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 40,476 40,476    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 48,585 44,393   481
25 Contributions, gifts, grants paid....... 192,000 192,000
26 Total expenses and disbursements. Add lines 24 and 25 240,585 44,393   192,481
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 149,510
b Net investment income (if negative, enter -0-) 112,702
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 294,766 415,665 415,665
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 3,074,988 Click to see attachment3,004,352 3,004,352
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).......... 570,610 Click to see attachment509,650 509,650
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) 3,940,364 3,929,667 3,929,667
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........... 3,940,364 3,929,667
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 3,940,364 3,929,667
30 Total liabilities and net assets/fund balances (see instructions). 3,940,364 3,929,667
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
3,940,364
2
Enter amount from Part I, line 27a .....................
2
149,510
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
4,089,874
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
160,207
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
3,929,667
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 35-CHUBB LTD P 2021-03-22 2021-09-01
b 3932-ADRIATIC METALS PLC P 2020-07-14 2021-07-15
c 364-INTEGRA RESOURCES CORP P 2021-05-24 2022-05-25
d 145-ROCHE HLDG AG P 2021-03-22 2021-09-01
e 3546-ADRIATIC METALS PLC P 2020-07-15 2021-07-16
468-SUNCOR ENERGY INC P 2020-10-16 2021-10-15
275-CLARIVATE PLC P 2021-09-01 2022-03-08
10911-ADRIATIC METALS PLC P 2020-07-21 2021-07-22
1200-COTERRA ENERGY INC P 2020-10-21 2021-10-22
25-MASIMO CORP P 2021-03-22 2022-03-08
1726-SOLARIS RES INC P 2021-01-17 2022-01-18
741-HELMERICH & PAYNE INC P 2021-03-06 2022-03-07
80-PROGRESSIVE CO OHIO P 2021-03-22 2022-05-20
1226-INTEGRA RESOURCES CORP P 2021-02-13 2022-02-14
224-HELMERICH & PAYNE INC P 2021-03-07 2022-03-08
3019-SUNCOR ENERGY P 2020-10-16 2021-10-15
706-HELMERICH & PAYNE INC P 2021-03-06 2022-03-07
2738-BERRY CORPORATION P 2020-10-20 2021-10-19
214-HELMERICH & PAYNE INC P 2021-03-07 2022-03-08
9822-CODA MINERALS LTD P 2020-12-10 2021-12-09
5163-WHITECAP RESOURCES INC P 2021-03-07 2022-03-08
2819-CODA MINERALS LTD P 2021-01-05 2022-01-04
98656-METAL TIGER PLC P 2021-03-15 2022-03-16
2015-INTEGRA RESOURCES CORP P 2021-04-15 2022-04-14
4034-CODA MINERALS LTD P 2021-04-12 2022-04-13
1131-INTEGRA RESOURCES CORP P 2021-04-19 2022-04-18
9724-CODA MINERALS LTD P 2021-04-18 2022-04-19
2885-ARDEA RESOURCES LTD P 2020-06-03 2021-06-04
905-INTEGRA RESOURCES CORP P 2021-05-02 2022-05-03
9837-ARDEA RESOURCES LTD P 2020-06-09 2021-06-10
276-INTEGRA RESOURCES CORP P 2021-05-03 2022-05-04
15432-GOGOLD RESOURCES INC P 2020-06-09 2021-06-10
1372-INTEGRA RESOURCES CORP P 2021-05-04 2022-05-05
1568-MAG SILVER CORP P 2020-06-16 2021-06-17
488-INTEGRA RESOURCES CORP P 2021-05-08 2022-05-09
(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 6,386   5,568 818
b 7,317   3,281 4,036
c 349   905 -556
d 7,272   6,168 1,104
e 6,602   2,959 3,643
11,028   11,039 -11
3,312   7,151 -3,839
20,600   9,104 11,496
22,200   19,321 2,879
3,475   5,624 -2,149
20,927   3,481 17,446
31,719   24,381 7,338
8,833   7,282 1,551
2,059   3,049 -990
9,605   3,342 6,263
71,141   65,492 5,649
30,220   38,957 -8,737
26,828   10,296 16,532
9,176   11,808 -2,632
7,208   9,723 -2,515
40,685   20,283 20,402
2,084   2,791 -707
24,333   31,068 -6,735
2,763   5,012 -2,249
1,771   3,993 -2,222
1,549   2,813 -1,264
4,246   9,626 -5,380
1,107   1,807 -700
963   2,251 -1,288
3,919   6,154 -2,235
292   686 -394
41,789   7,122 34,667
1,458   3,413 -1,955
35,119   11,706 23,413
513   1,214 -701
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       818
b       4,036
c       -556
d       1,104
e       3,643
      -11
      -3,839
      11,496
      2,879
      -2,149
      17,446
      7,338
      1,551
      -990
      6,263
      5,649
      -8,737
      16,532
      -2,632
      -2,515
      20,402
      -707
      -6,735
      -2,249
      -2,222
      -1,264
      -5,380
      -700
      -1,288
      -2,235
      -394
      34,667
      -1,955
      23,413
      -701
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 2 109,978
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 11,369
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 1,567
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 1,567
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 1,500
b Exempt foreign organizations—tax withheld at source...... 6b  
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 1,500
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 17
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 84
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (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)
    bulletWY
    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 addressbulletN/A
    14
    The books are in care ofbulletMOHATT JOHNSON & GODWIN LLP Telephone no.bullet (307) 672-6494

    Located atbullet352 WHITNEY LANE STE 201SHERIDANWY ZIP+4bullet82801
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
     
    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
    SCOTT NICKERSON PRESIDENT
    10.00     		0 0 0
    PO BOX 278
    BIG HORN,WY82833
    ANNE NICKERSON SECY/TREAS
    10.00     		0 0 0
    PO BOX 278
    BIG HORN,WY82833
    DAVID NICKERSON DIRECTOR
    2.00     		0 0 0
    PO BOX 278
    BIG HORN,WY82833
    GREGORY NICKERSON DIRECTOR
    2.00     		0 0 0
    PO BOX 278
    BIG HORN,WY82833
    PHILLIP NICKERSON DIRECTOR
    2.00     		0 0 0
    PO BOX 278
    BIG HORN,WY82833
    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  
    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.............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 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    2,985,984
    b
    Average of monthly cash balances.......................
    1b
    348,087
    c
    Fair market value of all other assets (see instructions)................
    1c
    526,983
    d
    Total (add lines 1a, b, and c).........................
    1d
    3,861,054
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    3,861,054
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    57,916
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    3,803,138
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    190,157
    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
    190,157
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    1,567
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,567
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    188,590
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    188,590
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    188,590
    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 7 188,590
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 12,526
    b From 2017...... 5,099
    c From 2018......  
    d From 2019...... 2,560
    e From 2020...... 7,240
    f Total of lines 3a through e ........ 27,425
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 192,481
    a Applied to 2020, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount..... 188,590
    e Remaining amount distributed out of corpus 3,891
    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 31,316
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		12,526
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		18,790
    10 Analysis of line 9:
    a Excess from 2017.... 5,099
    b Excess from 2018....  
    c Excess from 2019.... 2,560
    d Excess from 2020.... 7,240
    e Excess from 2021.... 3,891
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    ANNE SCOTT NICKERSON FAMILY FOUND
    PO BOX 278
    BIG HORN,WY82833
    (307) 674-9875
    bThe form in which applications should be submitted and information and materials they should include:
    GRANT APPLICATION, INCLUDING: GENERAL APPLICANT INFORMATION, PROOF OF TAX EXEMPT STATUS UNDER SECTION 501(C)(3), MOST RECENT FINANCIAL REPORT IN THE FORM PROVIDED BY THE IRC OR TREASURY REGULATIONS, AMOUNT REQUESTED, AND PURPOSE (INCLUDING ANTICIPATED BUDGET AND OTHER FINANCIAL RESOURCES). ILLUSTRATIONS, EXHIBITS, OR OTHER WRITTEN EXPLANATORY INFORMATION TO OTHERWISE COMPLETE THE GRANT APPLICATION MAY ALSO BE ATTACHED.
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    FOR RELIGIOUS, CHARITABLE, OR SCIENTIFIC PURPOSES RELATED TO PUBLIC SAFETY, LITERARY CONCERNS, CHILDREN, AND/OR ANIMALS.
    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
    ANTELOPE BUTTE FOUNDATION
    PO BOX 6624
    SHERIDAN,WY82801     		N/A EXEMPT BUILDING CAMPAIGN 25,000
    BIG HORN EDUCATION FUND
    PO BOX 615
    BIG HORN,WY82833     		N/A EXEMPT SCHOLARSHIPS 2,500
    CENTER FOR VITAL COMMUNITY
    245 BROADWAY
    SHERIDAN,WY82801     		N/A EXEMPT CIVIC PROJECT 15,000
    DAMIEN HOUSE INC
    4407 NORTH ELSTON
    CHICAGO,IL60630     		N/A EXEMPT UNRESTRICTED 13,000
    EXTREMITY NERVE RESEARCH FOUNDATION
    201 STILLWATER SUITE 8
    WIMBERLY,TX78676     		N/A EXEMPT DURA RESEARCH PROJECT 5,000
    NICKERSON FAMILY ASSOCIATION
    PO BOX 296
    NORTH CHATHAM,MA026502296     		N/A EXEMPT BARN PROJECT 10,000
    PROJECT SCHOOLHOUSE
    PO BOX 609
    AUSTIN,TX78767     		N/A EXEMPT UNRESTRICTED 15,000
    SHERIDAN COMMUNITY LAND TRUST
    PO BOX 7185
    SHERIDAN,WY82801     		N/A EXEMPT HISTOR & TRAILS PROJECTS 10,000
    SHERIDAN MEMORIAL HOSPITAL FDN
    1401 WEST 5TH ST
    SHERIDAN,WY82801     		N/A EXEMPT URGENT CARE IMPROVEMENTS 13,000
    SHERIDAN PUBLIC ARTS COMMITTEE
    PO BOX 848
    SHERIDAN,WY82801     		N/A EXEMPT PUBLIC ARTS COLLECTION 3,000
    SHERIDAN COUNTY YMCA
    417 N JEFFERSON ST
    SHERIDAN,WY82801     		N/A EXEMPT RENOVATION CAPITAL CAMPAIGN 30,000
    STORY COMMUNITY LIBRARY
    PO BOX 646
    STORY,WY82842     		N/A EXEMPT EXPANSION CAMPAIGN 25,000
    THE HUB
    211 SMITH ST
    SHERIDAN,WY82801     		N/A EXEMPT DEMENTIA EDUCATION PROGAMMING 15,000
    THE STUDENT DIPLOMACY CORPS
    424 WEST 54TH STREET
    NEW YORK,NY10019     		N/A EXEMPT UNRESTRICTED 10,000
    TONGUE RIVER VALLEY COMMUNITY CENTE
    PO BOX 1100
    DAYTON,WY82836     		N/A EXEMPT MISSOULA CHILDRENS THEATER RESIDENCY 500
    Total .................................bullet 3a 192,000
    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 ............     		    18 109,978  
    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) ..   157,095  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    157,095
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


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

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    ANNE & SCOTT NICKERSON FAMILY
    FOUNDATION
    Employer identification number

    84-1409098
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    ANNE & SCOTT NICKERSON FAMILY
    FOUNDATION         		Employer identification number
    84-1409098
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    ANNE SCOTT NICKERSON
    PO BOX 278
     
    BIG HORN, WY82833

    		$ 233,000


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

    		$  


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

    		$  


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

    		$  


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

    		$  


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

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    ANNE & SCOTT NICKERSON FAMILY
    FOUNDATION         		Employer identification number

    84-1409098
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    ANNE & SCOTT NICKERSON FAMILY
    FOUNDATION         		Employer identification number

    84-1409098
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    ANNE & SCOTT NICKERSON FAMILY
     
    FOUNDATION
    EIN:
    84-1409098
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT ACCOUNTING FEES 1,925 1,444   481

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    ANNE & SCOTT NICKERSON FAMILY
     
    FOUNDATION
    EIN:
    84-1409098
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBOTT LABORATORIES 18,794 18,794
    ABBVIE INC 8,105 8,105
    ADOBE INC 10,412 10,412
    AIR PRODUCTS & CHEMICALS 16,000 16,000
    ALPHABET INC 34,212 34,212
    AMAZON.COM INC 36,063 36,063
    APPLE INC 29,768 29,768
    ASML HOLDINGS NV 5,763 5,763
    AUTO DATA PROCESSING 3,344 3,344
    BLACKROCK INC 13,382 13,382
    BROADRIDGE FINL SOLU 5,849 5,849
    CANADIAN PACIFIC RAILWAY 5,358 5,358
    CHEVRON CORP 26,199 26,199
    CHUBB LTD    
    COMCAST CORP 10,849 10,849
    EOG RESOURCES INC 6,848 6,848
    ESTEE LAUDER CO INC 10,186 10,186
    EXXON MOBIL CORP 16,800 16,800
    FACEBOOK INC    
    HESS CORP 17,230 17,230
    INTERCONTINENTAL EXC 10,751 10,751
    INTUIT INC 12,434 12,434
    INTUITIVE SURGICAL 13,658 13,658
    JPMORGAN CHASE & CO 10,578 10,578
    MARRIOTT INTL INC 12,869 12,869
    MASIMO CORP    
    MASTERCARD INC 12,525 12,525
    MCDONALDS CORP 15,133 15,133
    META PLATFORMS INC 26,141 26,141
    MICROSOFT CORP 51,655 51,655
    NESTLE SA 13,416 13,416
    NIKE INC 6,537 6,537
    NOVO-NORDISK 13,800 13,800
    OTIS WORLDWIDE CORP 3,348 3,348
    PEPSICO INC 12,581 12,581
    PHILIP MORRIS INTL 14,875 14,875
    PROGRESSIVE CO OHIO 6,566 6,566
    RAYTHEON TECHNOLOGIES CO 7,610 7,610
    ROCHE HLDG AG    
    S&P GLOBAL INC 15,727 15,727
    SHERWIN WILLIAMS CO 8,041 8,041
    TEXAS INSTRUMENTS 17,676 17,676
    THE COCA-COLA CO 15,211 15,211
    UNION PACIFIC CORP 19,780 19,780
    UNITEDHEALTH GRP INC 27,323 27,323
    VERISK ANALYTICS INC 6,122 6,122
    VISA INC 18,034 18,034
    ZOETIS INC 6,837 6,837
    BERRY CORPORATION 61,883 61,883
    FREEPORT-MCMORAN INC 117,240 117,240
    HELMERICH & PAYNE INC    
    NEWMONT MINING CORP 135,700 135,700
    ADRIATIC METALS PLC 95,878 95,878
    AFRICA OIL CORP 135,561 135,561
    AGNICO EAGLE MINES LTD 95,274 95,274
    ALTIUS MINERALS CORP 109,016 109,016
    ARDEA RESOURCES LTD NPV    
    CENTAURUS METALS LIMITED 111,167 111,167
    CES ENERGY SOLUTIONS CORP 57,501 57,501
    EMX RTY CORP 41,774 41,774
    ENDEAVOUR MINING CORPORATION 93,891 93,891
    ENTREE RES LTD 37,203 37,203
    ERO COPPER CORP 55,846 55,846
    GOGOLD RESOURCES INC 55,255 55,255
    INTEGRA RES CORP 3,498 3,498
    LARA EXPLORATION LTD 23,631 23,631
    MAG SILVER CORP 22,173 22,173
    METAL TIGER PLC    
    MUNDORO CAPITAL INC 6,656 6,656
    NTHN STAR RES LTD 35,679 35,679
    OZ MINERALS LTD 38,732 38,732
    PAN GLOBAL RESOURCES INC 30,371 30,371
    PERSEUS MINING LTD 84,700 84,700
    SANDSTORM GOLD LTD COM 93,337 93,337
    SOLARIS RES INC    
    SOVEREIGN METALS LIMITED 52,238 52,238
    SUNCOR ENERGY INC    
    TAMARACK VALLEY ENERGY LTD 106,127 106,127
    TRILOGY METALS INC NEW 20,653 20,653
    TURACO GOLD LTD 19,416 19,416
    WHITECAP RESOURCES INC 84,826 84,826
    VANECK VECTORS ETF TR GOLD MINERS 253,840 253,840
    BERRY COPORATION 28,816 28,816
    CABOT OIL AND GAS CORP    
    HALLIBURTON COMPANY 32,400 32,400
    HELMERICH & PAYNE INC    
    OCCIDENTAL PETE CORP 19,684 19,684
    ALTIUS MINERALS CORPORATION 36,042 36,042
    OZ MINERALS LTD 13,081 13,081
    RIO TINTO PLC 35,839 35,839
    SCHLUMBERGER LTD 27,024 27,024
    SPROTT INC 41,038 41,038
    SUNCOR ENERGY INC    
    WHITECAP RESOURCES INC 35,315 35,315
    WTS OCCIDENTAL PETROLEUM 1,657 1,657

    TY 2021 InvestmentsOtherSchedule2
    Name:
    ANNE & SCOTT NICKERSON FAMILY
     
    FOUNDATION
    EIN:
    84-1409098
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    14500 SPROTT PHYSICAL SILVER TR FMV 107,010 107,010
    28000 SPROTT PHYSICAL GOLD TRUST FMV 402,640 402,640

    TY 2021 OtherDecreasesSchedule
    Name:
    ANNE & SCOTT NICKERSON FAMILY
     
    FOUNDATION
    EIN:
    84-1409098
    Description Amount
    CHANGE IN UNREALIZED GAIN ON INVESTMENT 160,207


    TY 2021 OtherExpensesSchedule
    Name:
    ANNE & SCOTT NICKERSON FAMILY
     
    FOUNDATION
    EIN:
    84-1409098
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    INVESTMENT EXPENSES 40,451 40,451    
    SAFE DEPOSIT BOX 25 25    


    TY 2021 TaxesSchedule
    Name:
    ANNE & SCOTT NICKERSON FAMILY
     
    FOUNDATION
    EIN:
    84-1409098
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 2,473 2,473    
    EXCISE TAXES 3,711