TY 2021 Form 990PF

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	6,770	87,569	87,569
	2	Savings and temporary cash investments.........
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	249,506	259,017	259,017
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	256,276	346,586	346,586
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........	0	0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	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	256,276	346,586
	29	Total net assets or fund balances (see instructions).....	256,276	346,586
	30	Total liabilities and net assets/fund balances (see instructions).	256,276	346,586

Part III

Analysis of Changes in Net Assets or Fund Balances

Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............

256,276

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

93,247

Other increases not included in line 2 (itemize) bullet

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

349,523

Decreases not included in line 2 (itemize) bullet

2,937

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

346,586

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	11,555
3	Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
	If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 ...................	3

1a	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2	Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	2	0
3	Add lines 1 and 2...........................	3	173
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	173
6	Credits/Payments:

a	2021 estimated tax payments and 2020 overpayment credited to 2021	6a
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	0
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.	8	0
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......	9	173
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...	10
11	Enter the amount of line 10 to be: Credited to 2022 estimated tax	Refunded	11

(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
MARGARET D MCISAAC	PRESIDENT/DIRECTOR 2.00	0	0	0
38 HAZARD AVENUE PROVIDENCE,RI02906
MICHAEL BAKER	TREASURER 2.00	0	0	0
826 SOUTH STREET BRIDGEWATER,MA02324
KIMBERLY THOMAS	DIRECTOR 2.00	0	0	0
7 ELMWOOD COURT MANSFIELD,MA02048
PETER DELLO RUSSO	DIRECTOR 2.00	0	0	0
35 MAIN ENTRY ROAD NORTH FALMOUTH,MA02556
DEBRA CROWELL	DIRECTOR 2.00	0	0	0
31 LONGWOOD CIRCLE MANSFIELD,MA02048
DIANE PEREIRA	CLERK 2.00	0	0	0
880 LOUISE LANE DIGHTON,MA02715
STEVEN OBERLANDER	DIRECTOR 2.00	0	0	0
86 LEWIS AVENUE WALPOLE,MA02081
ROBERT PEIXOTO	DIRECTOR 2.00	0	0	0
1259 SOMERSET AVENUE DIGHTON,MA02715
JAMES WOOD	DIRECTOR 2.00	0	0	0
24 PINE TREE DRIVE BUZZARDS BAY,MA02532

		(a) Corpus	(b) Years prior to 2020	(c) 2020	(d) 2021
1 Distributable amount for 2021 from Part X, line 7					3,372
2 Undistributed income, if any, as of the end of 2021:
a Enter amount for 2020 only.......				0
b Total for prior years:20, 20, 20			0
3 Excess distributions carryover, if any, to 2021:
a From 2016......	38,638
b From 2017......	43,690
c From 2018......	27,312
d From 2019......	49,583
e From 2020......	50,042
f Total of lines 3a through e ........		209,265
4Qualifying distributions for 2021 from Part
XI, line 4: $ 70,500
a Applied to 2020, but not more than line 2a				0
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.....					3,372
e Remaining amount distributed out of corpus		67,128
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		276,393
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 ..........					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) .......		0
8 Excess distributions carryover from 2016 not applied on line 5 or line 7 (see instructions) ...		38,638
9 Excess distributions carryover to 2022. Subtract lines 7 and 8 from line 6a ......		237,755
10 Analysis of line 9:
a Excess from 2017....	43,690
b Excess from 2018....	27,312
c Excess from 2019....	49,583
d Excess from 2020....	50,042
e Excess from 2021....	67,128

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2021	(b) 2020	(c) 2019	(d) 2018	(e) Total

b 85% (0.85) of line 2a .........
c Qualifying distributions from Part XI, line 4 for each year listed .....
d Amounts included in line 2c not used directly for active conduct of exempt activities ..........
e Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c ....
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part IX, line 6 for each year listed ..
c “Support" alternative test—enter:
(1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:

DIANE PEREIRA
BLUESTONE BANK 756 ORCHARD STREET
RAYNHAM,MA02767
(508) 884-3326

bThe form in which applications should be submitted and information and materials they should include:

SEE ATTACHED GRANT APPLICATION; IN ADDITION, A COVER LETTER INTRODUCING THE ORGANIZATION AND A PROPOSAL DESCRIBING GOALS, CONSTITUENTS, COMMUNITY NEEDS TO BE MET, AND PROJECTED OUTCOMES SHOULD BE ATTACHED AS WELL AS A COPY OF THE ORGANIZATION'S IRS TAX DETERMINATION LETTER INDICATING 501(C)(3) STATUS, IF APPLICABLE.

cAny submission deadlines:

NONE

dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:

THE CHARITABLE FOUNDATION DOES NOT PROVIDE FUNDING FOR INDIVIDUALS, SPORTS, INDIVIDUAL SCHOOLS OR RELIGIOUS GROUPS. THE CHARITABLE FOUNDATION CONSIDERS GRANT PROPOSALS FROM ORGANIZATIONS INCLUDING NON-PROFITS AS DEFINED IN INTERNAL REVENUE CODE SECTION 501(C)(3). IT ALSO ACCEPTS APPLICATIONS FROM ORGANIZATIONS SERVING HOUSEHOLDS, ORGANIZATIONS THAT THE FOUNDATION HAS FINANCIALLY SUPPORTED IN THE PAST, ORGANIZATIONS THAT DIRECT SERVICES TO LOW-TO-MODERATE INCOME HOUSEHOLDS, ORGANIZATIONS THAT SUPPORT DEVELOPMENT AND MAINTENANCE OF HOUSING FOR LOW-TO-MODERATE INCOME HOUSEHOLDS, ORGANIZATIONS DEDICATED TO IMPROVING THE QUALITY OF COMMUNITY LIFE, AND TO OTHER ORGANIZATIONS WHOSE GOALS ARE DETERMINED TO BE CONSISTENT WITH THE FOUNDATION'S MISSION, ALL WITHIN A DEFINED MARKET AREA THAT INCLUDES THE COMMUNITIES SERVED BY BLUESTONE BANK.

3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient	If recipient is an individual, show any relationship to any foundation manager or substantial contributor	Foundation status of recipient	Purpose of grant or contribution	Amount
Name and address (home or business)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
ATTLEBORO AREA INTERFAITH COLLABORATIVE PO BOX 368 ATTLEBORO,MA02703	NONE		GENERAL PURPOSE GRANT	5,000
BOY SCOUTS OF AMERICA NARRAGANSETT COUNCIL 223 SCITUATE AVE CRANSTON,MA02921	NONE		GENERAL PURPOSE GRANT	5,000
BRIDGEWATER FOOD PANTRY 71 CENTRAL SQUARE BRIDGEWATER,MA02324	NONE		GENERAL PURPOSE GRANT	2,000
CUPBOARD OF KINDNESS PO BOX 874 NORTON,MA02766	NONE		GENERAL PURPOSE GRANT	2,000
FRANKLIN FOOD PANTRY 43 W CENTRAL STREET FRANKLIN,MA02038	NONE		GENERAL PURPOSE GRANT	2,000
GREATER ATTLEBORO AREA COUNCIL FOR CHILDREN 4 HODGES STREET ATTLEBORO,MA02703	NONE		GENERAL PURPOSE GRANT	7,500
LENORE'S PANTRY 43 S WASHINGTON STREET NORTH ATTLEBORO,MA02760	NONE		GENERAL PURPOSE GRANT	2,000
LIVING BREAD FOOD PANTRY 16 EAST BACON STREET PLAINVILLE,MA02762	NONE		GENERAL PURPOSE GRANT	2,000
MARSHFIELD FOOD PANTRY 1837 OCEAN STREET MARSHFIELD,MA02050	NONE		GENERAL PURPOSE GRANT	2,000
NORTON HISTORICAL SOCIETY 18 W MAIN STREET NORTON,MA02766	NONE		GENERAL PURPOSE GRANT	5,000
OLD BRIDGEWATER HISTORICAL SOCIETY 162 HOWARD ST WEST BRIDGEWATER,MA02379	NONE		GENERAL PURPOSE GRANT	5,000
OUR DAILY BREAD FOOD AND RESOURCE CENTER 111 HIGH STREET TAUNTON,MA02780	NONE		GENERAL PURPOSE GRANT	2,000
OUR DAILY BREAD FOOD PANTRY - MANSFIELD 15 WEST STREET MANSFIELD,MA02048	NONE		GENERAL PURPOSE GRANT	2,000
PEMBROKE FIREHOUSE FOOD PANTRY 144 CENTER STREET PEMBROKE,MA02359	NONE		GENERAL PURPOSE GRANT	2,000
RAYNHAM FOOD BASKET 494 CHURCH STREET RAYNHAM,MA02767	NONE		GENERAL PURPOSE GRANT	2,000
SCIENCE & ENGINEERING ED DEVELOPMENT INC 32 WISTERIA DRIVE PLAINVILLE,MA02762	NONE		GENERAL PURPOSE GRANT	1,000
SHARON COMMUNITY CHAMBER ORCHESTRA PO BOX 128 SHARON,MA02067	NONE		GENERAL PURPOSE GRANT	1,500
SPECIAL OLYMPICS MA 512 FOREST STREET MARLBOROUGH,MA01752	NONE		GENERAL PURPOSE GRANT	5,000
ST VINCENT DE PAUL SOCIETY - EAST BRIDGEWATER 210 CENTRAL STREET EAST BRIDGEWATER,MA02333	NONE		GENERAL PURPOSE GRANT	2,000
ST VINCENT DE PAUL SOCIETY - MIDDLEBORO 53 OAK STREET MIDDLEBORO,MA02346	NONE		GENERAL PURPOSE GRANT	2,000
ST VINCENT DE PAUL SOCIETY - WEST BRIDGEWATER 103 CENTER STREET BRIDGEWATER,MA02324	NONE		GENERAL PURPOSE GRANT	2,000
UNIQUE STEPS DANCE ACADEMY TWO 19 N WASHINGTON ST NORTH ATTLEBORO,MA02760	NONE		GENERAL PURPOSE GRANT	2,500
WEST BRIDGEWATER FOOD PANTRY 2 SPRING STREET WEST BRIDGEWATER,MA02379	NONE		GENERAL PURPOSE GRANT	2,000
WEST SIDE BENEVOLENT CIRCLE PO BOX 506 MANSFIELD,MA02048	NONE		GENERAL PURPOSE GRANT	5,000
Total ................................. 3a				70,500

	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)


1	Contributions, gifts, grants, etc., received (attach schedule)	150,000
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...	893		893
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		11,555
b	Gross sales price for all assets on line 6a 11,985
7	Capital gain net income (from Part IV, line 2)...			11,555
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).......		1,363	0	1,363
12	Total. Add lines 1 through 11........	163,811		12,448	1,363
13	Compensation of officers, directors, trustees, etc.	0		0	0	0
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......
c	Other professional fees (attach schedule)....
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		29	0	0	0
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		35	0	0	0
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	64		0	0	0
25	Contributions, gifts, grants paid.......	70,500				70,500
26	Total expenses and disbursements. Add lines 24 and 25	70,564		0	0	70,500
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	93,247
b	Net investment income (if negative, enter -0-)			12,448
c	Adjusted net income (if negative, enter -0-)...				1,363

(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	INVESTMENTS HELD IN BLUESTONE BANK	P	2001-01-01	2021-12-31
b	CAPITAL GAINS DIVIDENDS	P
c
d
e

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	500	430	70
b	11,485		11,485
c
d
e

Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69			(l) Gains (Col. (h) gain minus col. (k), but not less than -0-) or Losses (from col.(h))
(i) F.M.V. as of 12/31/69	(j) Adjusted basis as of 12/31/69	(k) Excess of col. (i) over col. (j), if any
a			70
b			11,485
c
d
e

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


(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...................				0

bApproved for future payment

Total ................................. 3b				0

Enter gross amounts unless otherwise indicated.	Unrelated business income		Excluded by section 512, 513, or 514		(e) Related or exempt function income (See instructions.)
1Program service revenue:	(a) Business code	(b) Amount	(c) Exclusion code	(d) Amount	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments ....
3 Interest on savings and temporary cash investments ...........
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	11,555
9 Net income or (loss) from special events:					1,363
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		12,448	1,363

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

Name of organization BLUESTONE BANK CHARITABLE FOUNDATION INC

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	BLUESTONE BANK 756 ORCHARD STREET RAYNHAM, MA02767	$ 150,000	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Name of organization BLUESTONE BANK CHARITABLE FOUNDATION INC		Employer identification number 11-3689271

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)


Name of organization BLUESTONE BANK CHARITABLE FOUNDATION INC			Employer identification number 11-3689271
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.) $ Use duplicate copies of Part III if additional space is needed.

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