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 11-01-2021 , and ending 10-31-2022
Name of foundation
THE ANDREW ALLEN CHARITABLE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)CO THOMAS N LONG PO BOX 87
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHEYENNE, WY82003
A Employer identification number

23-7862257
B Telephone number (see instructions)

(215) 751-2185
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$24,685,383J 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 89,955 89,955  
4 Dividends and interest from securities... 522,241 522,241  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,196,661
b Gross sales price for all assets on line 6a 6,735,374
7 Capital gain net income (from Part IV, line 2)... 1,196,661
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)....... Click to see attachment 22,213 22,213  
12 Total. Add lines 1 through 11........ 1,831,070 1,831,070  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 241,220 241,220   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment 19,041 19,041   0
b Accounting fees (attach schedule)....... Click to see attachment 8,995 8,995   0
c Other professional fees (attach schedule).... Click to see attachment 204,179 204,179   0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 13,300 8,300   0
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 75,318 75,318   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 562,053 557,053   0
25 Contributions, gifts, grants paid....... 1,406,751 1,406,751
26 Total expenses and disbursements. Add lines 24 and 25 1,968,804 557,053   1,406,751
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -137,734
b Net investment income (if negative, enter -0-) 1,274,017
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............. 559,880 405,204 405,204
2 Savings and temporary cash investments.........      
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).......      
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).......... 21,986,599 Click to see attachment22,003,541 24,280,179
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) 22,546,479 22,408,745 24,685,383
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 0 0
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 22,546,479 22,408,745
29 Total net assets or fund balances (see instructions)..... 22,546,479 22,408,745
30 Total liabilities and net assets/fund balances (see instructions). 22,546,479 22,408,745
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
22,546,479
2
Enter amount from Part I, line 27a .....................
2
-137,734
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
22,408,745
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
22,408,745
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 PUBLICALY TRADED SECURITIES-JP MORGAN P    
b PUBLICALY TRADED SECURITIES- WELLS FARGO P    
c CAPITAL GAINS DIVIDENDS P    
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 3,003,952   2,656,319 347,633
b 3,638,676   2,882,394 756,282
c 92,746     92,746
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       347,633
b       756,282
c       92,746
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 1,196,661
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 17,709
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 17,709
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 26,394
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 26,394
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 8,685
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet8,685 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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    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 ofbulletTHOMAS N LONG Telephone no.bullet (307) 635-0710

    Located atbulletPO BOX 87CHEYENNEWY ZIP+4bullet82003
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    THOMAS N LONG CO-TRUSTEE
    1.00     		77,340 0 0
    PO BOX 87
    CHEYENNE,WY82001
    NANCY VERBRUGGE CO-TRUSTEE
    1.00     		81,940 0 0
    1737 JACKPOT LOOP
    CHEYENNE,WY82009
    CAROL KIRSHNER CO-TRUSTEE
    1.00     		81,940 0 0
    4616 CHALMERS DRIVE
    NASHVILLE,TN37215
    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 N/A 0
    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 0
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    27,189,114
    b
    Average of monthly cash balances.......................
    1b
    703,376
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    27,892,490
    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
    27,892,490
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    418,387
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    27,474,103
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,373,705
    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
    1,373,705
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    17,709
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    17,709
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,355,996
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,355,996
    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
    1,355,996
    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 1,355,996
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 1,406,751
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 1,406,751
    a Applied to 2020, but not more than line 2a 1,406,751
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 0
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		1,355,996
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or 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
    ACCESS FUND
    PO BOX 17010
    BOULDER,CO80308     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    ACTEC FOUNDATION
    901 15TH STREET NW SUITE 525
    WASHINGTON,DC20005     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    ADVENTURE WEST COUNCIL BSA
    2215 23RD AVE
    GREELEY,CO80634     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    AFS-USA INC
    120 WALL STREET 4TH FLOOR
    NEW YORK,NY10005     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    ALZHEIMER'S ASSOCIATION
    2232 DELL RANGE BLVD SUITE 101
    CHEYENNE,WY82009     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    ALZHEIMER'S ASSOCIATION
    2232 DELL RANGE BLVD SUITE 101
    CHEYENNE,WY82009     		NONE PUBLIC CHARITY GENERAL SUPPORT 86,416
    AMELIA ISLAND ART ASSOCIATION
    18 N 2ND ST
    FERNANDINA BEACH,FL32034     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    AMELIA ISLAND CHAMBER MUSIC FESTIVAL
    1405 PARK AVE SUITE 101
    FERNANDINA BEACH,FL32034     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    AMELIA ISLAND JAZZ FESTIVAL
    PO BOX 16684
    FERNANDINA BEACH,FL32035     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    AMELIA ISLAND MUSEUM OF HISTORY
    233 S 3RD ST
    FERNANDINA BEACH,FL32034     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    AMERICAN HEART ASSOCIATION
    7272 GREENVILLE AVE
    DALLAS,TX75231     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    ANGELS AMONG US
    PO BOX 472
    EVANSTON,WY82931     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,150
    BELCOURT THEATRE INC
    2102 BELCOURT AVE
    NASHVILLE,TN37212     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,500
    BLACK DOG ANIMAL RESCUE
    2407 EAST 9TH STREET
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    BLOOMING LOTUS
    3311 OLD FAITHFUL RD STE 200
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 7,500
    BOYS & GIRLS CLUB OF CHEYENNE
    515 W JEFFERSON ROAD
    CHEYENNE,WY82007     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    BOYS & GIRLS CLUB OF CHEYENNE
    515 W JEFFERSON ROAD
    CHEYENNE,WY82007     		NONE PUBLIC CHARITY GENERAL SUPPORT 40,000
    BRYN MAWR COLLEGE
    101 NORTH MERION AVENUE
    BRYN MAWR,PA19010     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    CFD OLD WEST MUSEUM
    4606 CAREY AVENUE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    CFD OLD WEST MUSEUM
    4606 CAREY AVENUE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    CFD OLD WEST MUSEUM
    4606 CAREY AVENUE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 750
    CHEEKWOOD BOTANICAL GARDEN & MUSEUM
    1200 FORREST PARK DR
    NASHVILLE,TN37205     		NONE PUBLIC CHARITY GENERAL SUPPORT 15,000
    CHEEKWOOD BOTANICAL GARDEN & MUSEUM
    1200 FORREST PARK DR
    NASHVILLE,TN37205     		NONE PUBLIC CHARITY GENERAL SUPPORT 12,500
    CHEEKWOOD BOTANICAL GARDEN & MUSEUM
    1200 FORREST PARK DR
    NASHVILLE,TN37205     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,446
    CHEYENNE AMERICAN LEGION POST 6 BASEBALL
    PO BOX 2815
    CHEYENNE,WY82003     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,500
    CHEYENNE ANIMAL SHELTER
    800 SOUTHWEST DRIVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    CHEYENNE MASONIC TEMPLE ENDOWMENT
    1820 CAPITOL AVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 3,000
    CHEYENNE ROTARY CLUB FOUNDATION
    PO BOX 511
    CHEYENNE,WY82003     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,500
    CHEYENNE SYMPHONY ORCHESTRA
    PO BOX 851
    CHEYENNE,WY82003     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,500
    CHEYENNE YOUTH BASEBALL LEAGUE
    PO BOX 1401
    CHEYENNE,WY82003     		NONE PUBLIC CHARITY GENERAL SUPPORT 400
    CHILDREN'S JUSTICE CENTER
    PO BOX 683564
    PARK CITY,UT84068     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    CHRISTIAN CENTER OF PARK CITY
    PO BOX 683480
    PARK CITY,UT84068     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    CLIMB WYOMING
    1001 WEST 31ST
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    COMEA INC
    1504 STINSON AVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    COMMUNITY FOUNDATION OF JACKSON
    PO BOX 574
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    COMMUNITY FOUNDATION OF JACKSON
    PO BOX 574
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,700
    CRMC FOUNDATION
    408 E 23RD STREET
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    CRMC FOUNDATION
    408 E 23RD STREET
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 300
    CS FOUNDATION MASSACHUSETTS CHAPTER
    220 NORTH MAIN STREET
    NATICK,MA01760     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    CYSTIC FIBROSIS FOUNDATION
    4550 MONTGOMERY AVE SUITE 1100N
    BETHESDA,MD20814     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    DANA-FARBER CANCER INSTITUTE
    450 BROOKLINE AVE
    BOSTON,MA02215     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    DAVIS HOSPICE CENTER
    6000 SYCAMORE ROAD
    CHEYENNE,WY82009     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    DENVER FOUNDATION
    1009 GRANT STREET
    DENVER,CO80203     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    DENVER FOUNDATION
    1009 GRANT STREET
    DENVER,CO80203     		NONE PUBLIC CHARITY GENERAL SUPPORT 6,450
    DISABLE SPORTS USATETON ADAPTIVE SPORTS
    PO BOX 903
    TETON VILLAGE,WY83025     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    EQUAL JUSTICE WYOMING FOUNDATION
    2300 CAPITOL AVENUE 1ST FLOOR
    CHEYENNE,WY82002     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    EVANSTON YOUTH CLUB FOR BOYS & GIRLS
    603 6TH STREET
    EVANSTON,WY82930     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    FAMILY PROMISE OF CHEYENNE
    2950 SPRUCE DRIVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    FOOD BANK WYOMING
    PO BOX 1540
    EVANSVILLE,WY82636     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    FREE LIBRARY OF PHILADELPHIA FOUNDATION
    1901 VINE STREET
    PHILADELPHIA,PA19103     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    FRIDAY FOOD BAG FOUNDATION
    PO BOX 1186
    CHEYENNE,WY82003     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,015
    FRIENDS OF RADNOR LAKE
    1160 OTTER CREEK ROAD
    NASHVILLE,TN37220     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    FRIST ART MUSEUM
    919 BROADWAY
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    FRIST ART MUSEUM
    919 BROADWAY
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    FRIST ART MUSEUM
    919 BROADWAY
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    GILDA'S CLUB MIDDLE TENNESSEE
    1707 DIVISION STREET
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    GOVERNOR'S EARLY LITERACY FOUNDATION
    PO BOX 331338
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    GOVERNOR'S EARLY LITERACY FOUNDATION
    PO BOX 331338
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,446
    HABITAT FOR HUMANITY NASHVILLE
    414 HARDING PL SUITE 100
    NASHVILLE,TN37211     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    HARVARD COLLEGE FUND
    124 MOUNT AUBURN STREET
    CAMBRIDGE,MA02138     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    HARVARD MAGAZINE
    PO BOX 414946
    BOSTON,MA02241     		NONE PUBLIC CHARITY GENERAL SUPPORT 150
    HARVARD MEDICAL SCHOOL
    25 SHATTUCK ST
    BOSTON,MA02115     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    HARVARD MEDICAL SCHOOL
    25 SHATTUCK ST
    BOSTON,MA02115     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    HAVERFORD SCHOOL
    450 US-30
    HAVERFORD,PA19041     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    HEARTS AND HORSES INC
    163 N CR 29
    LOVELAND,CO80537     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    HIGHLANDS PRESBYTARIAN CHURCH
    2390 PATTISON AVE
    CHEYENNE,WY82009     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    HISPANOS UNIDOS
    PO BOX 462016
    ESCONDIDO,CA92046     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,500
    HISTORIC NASHVILLE
    PO BOX 190516
    NASHVILLE,TN37219     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    IMMIGRATION HOPE-WYOMINGIDAHO
    PO BOX 492
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 4,300
    INTERNATIONAL RETT SYNDROME FOUNDATION
    4500 COOPER ROAD SUITE 204
    CINCINNATI,OH45242     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    JACKSON CUPBOARD
    PO BOX 1622
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    JACKSON HOLE JUGERNAUTS
    PO BOX 7794
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    JACKSON HOLE LAND TRUST
    PO BOX 2897
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    JESSUP PTO
    6113 EVERS BLVD
    CHEYENNE,WY82009     		NONE PUBLIC CHARITY GENERAL SUPPORT 250
    LAND TRUST FOR TENNESSEE
    4000 FRANKLIN PIKE
    NASHVILLE,TN37204     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    LARAMIE COUNTY LIBRARY FOUNDATION
    2200 PIONEER AVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    LEGACY PHILANTHROPY WORKS
    521 SANTA BARBARA ST
    SANTA BARBARA,CA93101     		NONE PUBLIC CHARITY GENERAL SUPPORT 12,150
    LIFECHIOCE PREGNANCY CARE CENTER
    PO BOX 873
    CHEYENNE,WY82003     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    LONGS PEAK COUNCIL BOY SCOUTS
    PO BOX 116
    GREELEY,CO80632     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    MAKE-A-WISH FOUNDATION
    236 WEST FIRST STREET
    CASPER,WY82601     		NONE PUBLIC CHARITY GENERAL SUPPORT 20,000
    MEALS ON WHEELS OF CHEYENNE
    2015 S GREELEY HEW
    CHEYENNE,WY82007     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    MENTAL HEALTH ASSOCIATION MIDDLE TENNESSEE
    446 METROPLEX DRIVE SUITE A-224
    NASHVILLE,TN37211     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    NASHVILLE BALLET
    3630 REDMON ST
    NASHVILLE,TN37209     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    NASHVILLE CHILDREN'S THEATRE
    25 MIDDLETON ST
    NASHVILLE,TN37210     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    NASHVILLE HUMANE SOCIETY CORP
    213 OCEOLA AVE
    NASHVILLE,TN37209     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    NASHVILLE PUBLIC LIBRARY FOUNDATION
    615 CHURCH STREET
    NASHVILLE,TN37219     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    NASHVILLE PUBLIC RADIO
    630 MAINSTREAM DR
    NASHVILLE,TN37228     		NONE PUBLIC CHARITY GENERAL SUPPORT 11,500
    NASHVILLE PUBLIC RADIO
    630 MAINSTREAM DR
    NASHVILLE,TN37201     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    NASHVILLE PUBLIC RADIO
    630 MAINSTREAM DR
    NASHVILLE,TN37201     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    NASHVILLE PUBLIC TELEVISION
    161 RAINS AVE
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NASHVILLE PUBLIC TELEVISION
    161 RAINS AVE
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    NASHVILLE RESCUE MISSION
    639 LAFAYETTE STREET
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    NASHVILLE SYMPHONY
    1 SYMPHONY PLACE
    NASHVILLE,TN73201     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    NASHVILLE SYMPHONY
    1 SYMPHONY PLACE
    NASHVILLE,TN37201     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    NASSAU COUNTY HUMANE SOCIETY
    639 AIRPORT ROAD
    FERNANDINA BEACH,FL32034     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    NATIONAL APHASIA ASSOCIATION
    PO BOX 87
    SCARSDALE,NY10583     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NATIONAL APHASIA ASSOCIATION
    PO BOX 87
    SCARSDALE,NY10583     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NATIONAL APHASIA ASSOCIATION
    PO BOX 87
    SCARSDALE,NY10583     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NATIONAL CONSTITUTION CENTER
    525 ARCH ST
    PHILADELPHIA,PA19106     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    NATIONAL MS SOCIETY
    PO BOX 4594
    NEW YORK,NY10163     		NONE PUBLIC CHARITY GENERAL SUPPORT 100,000
    NATIONAL MUSEUM OF WILDLIFE ART
    2820 RUNGIUS ROAD
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NATIONAL PARKS CONSERVATION ASSOCIATION
    777 6TH STREET NW SUITE 700
    WASHINGTON,DC20001     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NATIONAL PARKS CONSERVATION ASSOCIATION
    777 6TH STREET NW SUITE 700
    WASHINGTON,DC20001     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    NATIONAL WOMEN'S LAW CENTER
    11 DUPONT CIRCLE NW 800
    WASHINGTON,DC20036     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    NATURE CONSERVATORY OF TENNESSEE
    2 MARYLAND FARMS 150
    BRENTWOOD,TN37027     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    NATURE CONSERVATORY OF TENNESSEE
    2 MARYLAND FARMS 150
    BRENTWOOD,TN37027     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    NATURE CONSERVATORY OF TENNESSEE
    2 MARYLAND FARMS 150
    BRENTWOOD,TN37205     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,445
    NEW YORK UNIVERSITY
    25 WEST FOURTH STREET 4TH FLOOR
    NEW YORK,NY10012     		NONE PUBLIC CHARITY GENERAL SUPPORT 25,000
    ONE22 INC
    PO BOX 1232
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    OUR KIDS NASHVILLE
    1804 HAYES ST
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    PCRM
    5100 WINSCONSIN AVE SW SUITE 400
    WASHINGTON,DC20016     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    PHI BETA KAPPA SOCIETY
    1606 NEW HAMPSHIRE AVE NW
    WASHINGTON,DC20009     		NONE PUBLIC CHARITY GENERAL SUPPORT 135
    PHI BETA KAPPA SOCIETY
    1606 NEW HAMPSHIRE AVE NW
    WASHINGTON,DC20009     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    PHILADELPHIA ORCHESTRA ASSOCIATION
    ONE SOUTH BORAD STREET 14TH FLOOR
    PHILADELPHIA,PA19107     		NONE PUBLIC CHARITY GENERAL SUPPORT 3,500
    PINE BLUFFS SENIOR CENTER INC
    PO BOX 532
    PINE BLUFFS,WY82082     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    RADCLIFFE INSTITUTE FOR ADVANCED STUDY
    10 GARDEN STREET
    CAMBRIDGE,MA02138     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    ROCKY MOUNTAIN INNOCENCE CENTER
    358 700 E B235
    SALT LAKE CITY,UT84102     		NONE PUBLIC CHARITY GENERAL SUPPORT 3,225
    RONALD MCDONALD HOUSE CHARITIES
    2144 FAIRFAX AVE
    NASHVILLE,TN37212     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    RONALD MCDONALD HOUSE CHARITIES DENVER
    1300 EAST 21ST AVENUE
    DENVER,CO80205     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    SALVATION ARMY CHEYENNE CORPS
    601 E 20TH ST
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    SCOTTISH RITE FOUNDATION OF WYOMING
    PO BOX 86
    CHEYENNE,WY82210     		NONE PUBLIC CHARITY GENERAL SUPPORT 16,500
    SECOND HARVEST FOOD BANK
    500-B SPRATT STREET
    CHARLOTTE,NC28206     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    SECOND HARVEST FOOD BANK
    500-B SPRATT STREET
    CHARLOTTE,NC28206     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    SENIOR CENTER OF JACKSON HOLE INC
    PO BOX 4677
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    SOUTHERN WORD
    1704 CHARLOTTE AVE SUITE 200
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    SPASTIC PARAPLEGIA FOUNDATION
    1605 GOULARTE PLACE
    FREMONT,CA94539     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    SPREAD THE LOVE COMMISSION
    PO BOX 13743
    JACKSON,WY83002     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    SPRINGSIDE CHESTNUT HILL ACADEMY
    500 W WILLOW GROVE AVE
    PHILADELPHIA,PA19118     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    ST JOSEPH'S CATHOLIC CHURCH
    206 VAN LENNEN AVE
    CHEYENNE,WY82007     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,030
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		NONE PUBLIC CHARITY GENERAL SUPPORT 75,000
    ST MARY'S CATHOLIC SCHOOL FOUNDATION
    2200 ONEIL AVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 75,000
    ST MARY'S CATHOLIC SCHOOL FOUNDATION
    2200 ONEIL AVE
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    SUSQUEHANNA UNIVERSITY
    514 UNIVERSITY AVENUE
    SELINSGROVE,PA17870     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    TEMPLE UNIVERSITY
    1801 N BROAD ST
    PHILADELPHIA,PA19122     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,500
    TENNESSEE CRAFT
    PO BOX 120066
    NASHVILLE,TN37212     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    TENNESSEE STATE MUSEUM FOUNDATION
    1000 ROSA L PARKS BLVD
    NASHVILLE,TN37243     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    TETON COUNTY LIBRARY FOUNDATION
    PO BOX 1629
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 6,750
    TETON COUNTY LIBRARY FOUNDATION
    PO BOX 1629
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 300
    TETON YOUTH & FAMILY SERVICES
    PO BOX 2631
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    TETON YOUTH & FAMILY SERVICES
    PO BOX 2631
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    THE DENVER INSTITUTE
    600 GRANT STREET SUITE 722
    DENVER,CO80203     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    TIP TOP SEARCH AND RESCUE
    PO BOX 400
    PINEDALE,WY82941     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    TRAVELLERS REST MUSEUM FOUNDATION
    650 FARRELL PKWY
    NASHVILLE,TN37220     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    TRUST FOR PUBLIC LANDS
    PO BOX 917
    JACKSON,WY83001     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    UINTA RECYCLING INC
    PO BOX 1022
    EVANSTON,WY82930     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    UNITED WAY NASHVILLE
    250 VENTURE CIR
    NASHVILLE,TN37228     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    UNITED WAY WORLDWIDE
    701 NORTH FAIRFAX STREET
    ALEXANDRIA,VA22314     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    UNIVERSITY OF WYOMING
    1000 E UNIVERSITY AVE
    LARAMIE,WY82071     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    UNIVERSITY OF WYOMING FOUNDATION
    222 S 22ND STREET
    LARAMIE,WY82070     		NONE PUBLIC CHARITY GENERAL SUPPORT 3,000
    UNIVERSITY OF WYOMING FOUNDATION
    222 S 22ND STREET
    LARAMIE,WY82070     		NONE PUBLIC CHARITY GENERAL SUPPORT 134,708
    UNIVERSITY OF WYOMING FOUNDATION
    222 S 22ND STREET
    LARAMIE,WY82070     		NONE PUBLIC CHARITY GENERAL SUPPORT 70,000
    UNIVERSITY OF WYOMING FOUNDATION
    222 S 22ND STREET
    LARAMIE,WY82070     		NONE PUBLIC CHARITY GENERAL SUPPORT 50,000
    UNIVERSITY OF WYOMING FOUNDATION
    222 S 22ND STREET
    LARAMIE,WY82070     		NONE PUBLIC CHARITY GENERAL SUPPORT 77,000
    UNIVERSITY SCHOOL OF NASHVILLE
    2000 EDGEHILL AVE
    NASHVILLE,TN37212     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    UNIVERSITY SCHOOL OF NASHVILLE
    2000 EDGEHILL AVE
    NASHVILLE,TN37212     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,000
    VANDERBILT CHILDREN'S HOSPITAL
    2200 CHILDRENS WAY
    NASHVILLE,TN37232     		NONE PUBLIC CHARITY GENERAL SUPPORT 25,000
    VANDERBILT CHILDREN'S HOSPITAL
    2200 CHILDRENS WAY
    NASHVILLE,TN37232     		NONE PUBLIC CHARITY GENERAL SUPPORT 75,000
    VANDERBILT UNIVERSITY MEDICAL
    3322 WEST END AVE SUITE 900
    NASHVILLE,TN37203     		NONE PUBLIC CHARITY GENERAL SUPPORT 25,000
    VETERAN'S ROCK
    605 S GREELEY HIGHWAY SUITE 1
    CHEYENNE,WY82007     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    VFW AUXILLARY POST #4280
    PO BOX 245
    EVANSTON,WY82931     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    WELLESLEY COLLEGE
    106 CENTRAL ST
    WELLESLEY,MA02481     		NONE PUBLIC CHARITY GENERAL SUPPORT 20,000
    WESTON COUNTY HEALTH SERVICES FOUNDATION
    PO BOX 821
    NEW CASTLE,WY82701     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    WHYY
    150 N SIXTH STREET
    PHILADELPHIA,PA19106     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    WILLIAMS COLLEGE
    75 PARK STREET
    WILLIAMSTOWN,MA01267     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    WILLIAMS COLLEGE
    75 PARK STREET
    WILLIAMSTOWN,MA01267     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,445
    WOUNDED WARRIOR PROJECT
    4899 BELFORT ROAD SUITE 300
    JACKSONVILLE,FL32256     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,075
    WYCO - SHERMAN
    315 SIOUX DRIVE
    CHEYENNE,WY82009     		NONE PUBLIC CHARITY GENERAL SUPPORT 2,150
    WYOFILE
    PO BOX 1099
    LANDER,WY82520     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    WYOMING CARES
    341 EAST E STREET 125
    CASPER,WY82601     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,015
    WYOMING CHILDREN'S LAW CENTER
    710 E GARFIELD STREET SUITE 249
    LARAMIE,WY82070     		NONE PUBLIC CHARITY GENERAL SUPPORT 1,000
    WYOMING OUTDOOR COUNCIL
    262 LINCOLN STREET
    LANDER,WY82520     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    WYOMING PUBLIC MEDIA
    1000 E UNIVERSITY AVE DEPT 3984
    LARAMIE,WY82071     		NONE PUBLIC CHARITY GENERAL SUPPORT 10,000
    YOLA AND BOOGY FUND
    3562 BLUE BELL TRAIL
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    YOLA AND BOOGY FUND
    3562 BLUE BELL TRAIL
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 500
    YOLA AND BOOGY FUND
    3562 BLUE BELL TRAIL
    CHEYENNE,WY82001     		NONE PUBLIC CHARITY GENERAL SUPPORT 5,000
    Total .................................bullet 3a 1,406,751
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 89,955  
    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 1,196,661  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 1,831,070 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,831,070
    (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:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 8,995 8,995   0

    TY 2021 InvestmentsOtherSchedule2
    Name:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    WELLS FARGO AT COST 9,854,980 11,831,973
    VANGUARD AT COST 362,936 1,025,289
    JP MORGAN AT COST 11,785,625 11,422,917

    TY 2021 LegalFeesSchedule
    Name:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 19,041 19,041   0


    TY 2021 OtherExpensesSchedule
    Name:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OTHER EXPENSES 75,318 75,318   0


    TY 2021 OtherIncomeSchedule2
    Name:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    OTHER INCOME OR LOSS 22,213 22,213 22,213


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT FEES 204,179 204,179   0
      0 0   0


    TY 2021 TaxesSchedule
    Name:
    THE ANDREW ALLEN CHARITABLE FOUNDATION
    EIN:
    23-7862257
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES PAID 8,300 8,300   0
    FEDERAL INCOME TAX PAID 5,000 0   0