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 12-01-2021 , and ending 11-30-2022
Name of foundation
ETHA ELEANOR ROSE CHARITABLE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 0634
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MILWAUKEE, WI532010634
A Employer identification number

43-6858210
B Telephone number (see instructions)

(314) 418-2643
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$515,386
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 12,174 12,174  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 8,902
b Gross sales price for all assets on line 6a 146,838
7 Capital gain net income (from Part IV, line 2)... 8,902
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... 8 8  
12 Total. Add lines 1 through 11........ 21,084 21,084  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 8,947 8,052   895
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... 1,500 0 0 1,500
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... 714 321   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 11,161 8,373 0 2,395
25 Contributions, gifts, grants paid....... 24,020 24,020
26 Total expenses and disbursements. Add lines 24 and 25 35,181 8,373 0 26,415
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -14,097
b Net investment income (if negative, enter -0-) 12,711
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 9,871 5,637 5,637
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 338,616 Click to see attachment101,324 139,810
c Investments—corporate bonds (attach schedule)....... 92,354    
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 49,067 Click to see attachment368,844 369,939
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) 489,908 475,805 515,386
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 489,908 475,805
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)..... 489,908 475,805
30 Total liabilities and net assets/fund balances (see instructions). 489,908 475,805
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
489,908
2
Enter amount from Part I, line 27a .....................
2
-14,097
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
475,811
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
6
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
475,805
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 2. AIRBNB INC CL A   2021-09-16 2022-02-14
b 4. ALBEMARLE CORP   2020-01-21 2022-02-14
c 1. ALPHABET INC CL A   2020-04-29 2022-02-14
d 1. AMAZON COM INC COM   2020-01-21 2022-02-14
e 2. AMERICAN TOWER CORP   2017-04-24 2022-02-14
22. APPLE COMPUTER INC COM     2022-02-14
40. BANK OF AMERICA CORP   2020-07-06 2022-02-14
1. CENTENE CORP COM   2020-07-06 2022-02-14
5. COPART INC COM   2020-07-07 2022-02-14
4. COSTCO WHOLESALE CORP COM   2017-09-21 2022-02-14
2. ECOLAB INC COM   2020-01-21 2022-02-14
9. EDWARDS LIFESCIENCES CORP COM   2017-11-16 2022-02-14
3. FACEBOOK INC A   2020-01-21 2022-02-14
4. HOME DEPOT INC COM   2021-09-16 2022-02-14
3. INTUIT INC COMMON STOCK   2020-07-06 2022-02-14
48. ISHARES CORE U.S. AGGREGATE BOND ETF     2022-02-14
25. ISHARES CORE U.S. AGGREGATE BOND ETF     2022-02-14
23. ISHARES RUSSELL MIDCAP VALUE ETF   2021-01-05 2022-02-14
10. ISHARES MIDCAP INDEX FD   2021-01-05 2022-02-14
35. ISHARES MSCI EAFE VALUE ETF   2018-10-01 2022-02-14
4. JP MORGAN CHASE & CO COM   2020-07-06 2022-02-14
34. MARATHON PETROLEUM CORP     2022-02-14
6. MATCH GROUP INC NEW   2020-04-29 2022-02-14
6. MICROSOFT CORP COM   2018-07-17 2022-02-14
2. NVIDIA CORP   2021-09-16 2022-02-14
251.98 PGIM TOTAL RETURN BOND CL R6   2021-02-18 2022-02-14
14. RINGCENTRAL INC   2021-09-16 2022-02-14
2. SALESFORCE COM INC   2021-09-16 2022-02-14
9. SCHWAB CHARLES CORP COM NEW   2015-07-22 2022-02-14
24. SCHWAB US REIT ETF   2019-05-22 2022-02-14
3. TARGET CORP   2020-01-21 2022-02-14
28. TELADOC INC   2021-09-16 2022-02-14
13. TELADOC INC     2022-02-14
2. TRANSDIGM GROUP INC   2020-07-06 2022-02-14
4. TRANSUNION   2019-06-26 2022-02-14
1. UNITEDHEALTH GRP INC COM   2019-05-22 2022-02-14
42. VIATRIS INC     2022-02-14
5. WAL MART STORES INC COM   2020-07-07 2022-02-14
1. APTIV PLC   2018-11-21 2022-02-14
1. CHUBB LTD   2015-07-22 2022-02-14
22. COUPA SOFTWARE INC     2022-05-26
3. TYLER TECHNOLOGIES INC   2018-12-17 2022-05-26
3. AIRBNB INC CL A   2021-09-16 2022-08-03
3. ALBEMARLE CORP   2020-01-21 2022-08-03
6. AMAZON COM INC COM   2018-11-21 2022-08-03
2. AMERICAN TOWER CORP     2022-08-03
9. APPLE COMPUTER INC COM   2020-04-29 2022-08-03
126. ARTISAN HIGH INCOME FUND   2021-09-16 2022-08-03
33. BANK OF AMERICA CORP   2020-07-06 2022-08-03
57. CENTENE CORP COM     2022-08-03
4. COPART INC COM     2022-08-03
1. COSTCO WHOLESALE CORP COM   2017-08-15 2022-08-03
2. ECOLAB INC COM   2020-01-21 2022-08-03
2. ETSY INC   2022-02-14 2022-08-03
28. EXACT SCIENCES CORPORATION   2021-09-16 2022-08-03
4. FACEBOOK INC A     2022-08-03
3. GILEAD SCIENCES INC COM   2022-02-14 2022-08-03
1. GILEAD SCIENCES INC COM   2019-11-08 2022-08-03
1. HOME DEPOT INC COM   2021-09-16 2022-08-03
1. INTUIT INC COMMON STOCK   2020-07-06 2022-08-03
13. ISHARES RUSSELL MIDCAP VALUE ETF   2021-01-05 2022-08-03
28. ISHARES MIDCAP INDEX FD   2021-01-05 2022-08-03
8. ISHARES RUSSELL 2000 INDEX FUND     2022-08-03
170. ISHARES CORE MSCI EAFE ETF   2022-02-14 2022-08-03
74. ISHARES CORE MSCI EAFE ETF   2021-01-05 2022-08-03
4. JP MORGAN CHASE & CO COM   2020-07-06 2022-08-03
40.757 MAINSTAY CBRE GLOBAL INFRASTRUCTURE   2022-02-16 2022-08-03
8. MARATHON PETROLEUM CORP   2020-01-21 2022-08-03
2. MASTERCARD INC   2022-02-14 2022-08-03
21. MATCH GROUP INC NEW   2020-04-29 2022-08-03
5. MICROSOFT CORP COM   2017-11-16 2022-08-03
9. MICRON TECHNOLOGY INC   2022-02-14 2022-08-03
16. MICRON TECHNOLOGY INC     2022-08-03
4. PAYPAL HOLDINGS INC   2021-09-16 2022-08-03
1. RINGCENTRAL INC   2021-09-16 2022-08-03
10. RINGCENTRAL INC     2022-08-03
9. ROPER INDS INC     2022-08-03
3. SALESFORCE COM INC   2021-09-16 2022-08-03
18. SCHWAB CHARLES CORP COM NEW   2015-07-22 2022-08-03
92. SCHWAB US REIT ETF   2019-05-22 2022-08-03
2. SQUARE INC A   2022-02-14 2022-08-03
2. TARGET CORP   2020-01-21 2022-08-03
4. TRADE DESK INC THE CLASS A   2022-02-14 2022-08-03
3. TRANSDIGM GROUP INC     2022-08-03
248. VIATRIS INC     2022-08-03
4. WAL MART STORES INC COM     2022-08-03
4. ZILLOW GROUP INC   2022-02-14 2022-08-03
5. MEDTRONIC PLC   2022-02-14 2022-08-03
2. APTIV PLC   2018-11-21 2022-08-03
1. CHUBB LTD   2015-07-22 2022-08-03
7. ECOLAB INC COM   2020-01-21 2022-08-12
101. ISHARES CORE U.S. AGGREGATE BOND ETF   2022-08-03 2022-08-12
2. ISHARES RUSSELL 2000 INDEX FUND   2022-02-14 2022-08-12
2. ISHARES RUSSELL 2000 INDEX FUND   2020-10-15 2022-08-12
2. MAINSTAY CBRE GLOBAL INFRASTRUCTURE   2022-02-16 2022-08-12
16. MARATHON PETROLEUM CORP     2022-08-12
2. MASTERCARD INC   2022-02-14 2022-08-12
2. MASTERCARD INC   2020-07-06 2022-08-12
23. MICRON TECHNOLOGY INC     2022-08-12
17. NEXTERA ENERGY INC     2022-08-12
8. MEDTRONIC PLC   2022-02-14 2022-08-12
114. ARTISAN HIGH INCOME FUND   2022-02-14 2022-11-01
22. ISHARES CORE U.S. AGGREGATE BOND ETF   2022-08-03 2022-11-01
16. ISHARES 1 3 YEAR TREASURY BOND ETF   2022-08-03 2022-11-01
9. ISHARES RUSSELL MIDCAP VALUE ETF     2022-11-01
21. ISHARES MIDCAP INDEX FD   2021-01-05 2022-11-01
5. ISHARES RUSSELL 2000 INDEX FUND   2020-09-18 2022-11-01
16. ISHARES MSCI EAFE VALUE ETF   2022-08-03 2022-11-01
1. PALO ALTO NETWORKS INC   2022-08-03 2022-11-01
43. PGIM TOTAL RETURN BOND CL R6   2022-08-03 2022-11-01
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
CAPITAL GAIN DIVIDENDS P    
(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 338   336 2
b 910   325 585
c 2,699   1,347 1,352
d 3,103   1,865 1,238
e 469   250 219
3,706   1,662 2,044
1,885   947 938
82   67 15
613   428 185
2,016   646 1,370
367   392 -25
972   323 649
650   664 -14
1,405   1,337 68
1,582   933 649
5,257   5,579 -322
2,738   2,797 -59
2,672   2,224 448
761   683 78
1,819   1,820 -1
607   377 230
2,680   2,076 604
683   461 222
1,766   631 1,135
483   441 42
3,477   3,727 -250
2,356   3,081 -725
413   512 -99
782   314 468
1,117   1,077 40
624   342 282
1,992   3,826 -1,834
925   2,724 -1,799
1,262   876 386
402   287 115
473   250 223
626   662 -36
668   637 31
136   74 62
201   106 95
1,519   4,589 -3,070
1,049   547 502
341   504 -163
720   244 476
839   459 380
538   213 325
1,495   646 849
1,144   1,295 -151
1,104   781 323
5,298   3,536 1,762
520   340 180
545   157 388
334   392 -58
219   287 -68
1,337   2,865 -1,528
676   810 -134
190   184 6
63   65 -2
306   334 -28
464   311 153
1,432   1,257 175
1,999   1,912 87
1,517   1,725 -208
10,451   12,062 -1,611
4,549   5,212 -663
453   377 76
535   528 7
738   448 290
712   746 -34
1,329   1,615 -286
1,413   417 996
578   803 -225
1,027   805 222
391   1,131 -740
54   220 -166
537   1,528 -991
3,862   3,443 419
571   768 -197
1,244   627 617
2,081   2,065 16
174   225 -51
337   228 109
201   310 -109
1,894   1,180 714
2,409   3,907 -1,498
527   474 53
153   233 -80
469   512 -43
219   148 71
185   106 79
1,209   1,374 -165
10,390   10,430 -40
398   402 -4
398   323 75
27   26 1
1,553   880 673
704   746 -42
704   611 93
1,478   1,048 430
1,528   1,460 68
752   820 -68
984   1,108 -124
2,085   2,272 -187
1,292   1,322 -30
950   813 137
1,427   1,434 -7
922   763 159
667   704 -37
170   176 -6
498   547 -49
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
      2,243
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       2
b       585
c       1,352
d       1,238
e       219
      2,044
      938
      15
      185
      1,370
      -25
      649
      -14
      68
      649
      -322
      -59
      448
      78
      -1
      230
      604
      222
      1,135
      42
      -250
      -725
      -99
      468
      40
      282
      -1,834
      -1,799
      386
      115
      223
      -36
      31
      62
      95
      -3,070
      502
      -163
      476
      380
      325
      849
      -151
      323
      1,762
      180
      388
      -58
      -68
      -1,528
      -134
      6
      -2
      -28
      153
      175
      87
      -208
      -1,611
      -663
      76
      7
      290
      -34
      -286
      996
      -225
      222
      -740
      -166
      -991
      419
      -197
      617
      16
      -51
      109
      -109
      714
      -1,498
      53
      -80
      -43
      71
      79
      -165
      -40
      -4
      75
      1
      673
      -42
      93
      430
      68
      -68
      -124
      -187
      -30
      137
      -7
      159
      -37
      -6
      -49
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 8,902
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........................... 3 177
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- ..... 5 177
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 464
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  
7 Total credits and payments. Add lines 6a through 6d.............. 7 464
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 10 287
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet180 RefundedBullet 11 107
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)
    bulletMO
    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 ofbulletUS BANK NA Telephone no.bullet (417) 888-2223

    Located atbulletPO BOX 0634MILWAUKEEWI ZIP+4bullet532010634
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    U S BANK NA TRUSTEE
    1
    8,947    
    PO BOX 387
    ST LOUIS,MO63166
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    541,865
    b
    Average of monthly cash balances.......................
    1b
    9,160
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    551,025
    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
    551,025
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    8,265
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    542,760
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    27,138
    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
    27,138
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    177
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    177
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    26,961
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    26,961
    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
    26,961
    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 26,961
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 6,520
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 0
    b From 2017...... 0
    c From 2018...... 0
    d From 2019...... 0
    e From 2020...... 0
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 26,415
    a Applied to 2020, but not more than line 2a 6,520
    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..... 19,895
    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 ..........
    7,066
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
    0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...
    0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......
    0
    10 Analysis of line 9:
    a Excess from 2017.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 0
    d Excess from 2020.... 0
    e Excess from 2021.... 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..
             
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    NONE
    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.
    NONE
    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
    SOUTHWEST MISSOURI HUMANE SOCIETY
    ATTN GARY BAUMGARTNER
    3161 W NORTON RD
    SPRINGFIELD,MO65803
    NONE PC GENERAL OPERATING 24,020
    Total .................................bullet 3a 24,020
    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 8,902  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aOTHER INCOME
        1 8  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   21,084  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    21,084
    (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:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,500     1,500

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Name of Bond End of Year Book Value End of Year Fair Market Value
    72369L107 PIONEER ILS INTERVAL    
    024932154 AMERICAN CENTURY HIG    
    74440B884 PGIM TOTAL RETURN BO    
    464287226 ISHARES CORE U.S. AG    

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Name of Stock End of Year Book Value End of Year Fair Market Value
    594918104 MICROSOFT CORP 2,122 10,206
    H1467J104 CHUBB LTD 425 878
    81762P102 SERVICENOW INC 2,462 2,498
    56585A102 MARATHON PETROLEUM C 2,724 6,212
    127097103 CABOT OIL GAS CORP C    
    46625H100 J P MORGAN CHASE CO 2,707 4,007
    023135106 AMAZON.COM INC 2,843 5,310
    03027X100 AMERICAN TOWER CORP 926 2,434
    931142103 WAL MART STORES INC 2,167 4,115
    037833100 APPLE INC 5,735 10,066
    848637104 SPLUNK INC    
    060505104 BANK OF AMERICA CORP 1,722 2,763
    91324P102 UNITED HEALTH GROUP 1,092 3,287
    28176E108 EDWARDS LIFESCIENCES 2,087 2,009
    30303M102 FACEBOOK INC A 1,623 1,535
    808513105 SCHWAB CHARLES CORP 1,555 3,714
    893641100 TRANSDIGM GROUP INC 1,102 2,514
    22160K105 COSTCO WHSL CORP 786 2,696
    464288877 ISHARES MSCI EAFE VA    
    15135B101 CENTENE CORP COM 1,126 1,741
    G6095L109 APTIV PLC 812 1,173
    89400J107 TRANSUNION 2,532 2,334
    70450Y103 PAYPAL HOLDINGS INC 3,172 2,274
    76680R206 RINGCENTRAL INC    
    595112103 MICRON TECHNOLOGY IN    
    902252105 TYLER TECHNOLOGIES I    
    012653101 ALBEMARLE CORP 1,463 5,004
    524686524 CLEARBRIDGE INTERNAT    
    464287499 ISHARES RUSSELL MID    
    02079K305 ALPHABET INC CL A 1,386 4,747
    78409V104 S P GLOBAL INC 1,505 2,470
    46434G103 ISHARES CORE MSCI EM    
    46432F842 ISHARES CORE MSCI EA    
    88339J105 TRADE DESK INC THE C 904 1,773
    375558103 GILEAD SCIENCES INC 3,171 4,392
    464287473 ISHARES RUSSELL MIDC    
    024524217 AMERICAN BEACON STEP    
    285512109 ELECTRONIC ARTS INC    
    808524847 SCHWAB US REIT ETF    
    097023105 BOEING CO    
    57636Q104 MASTERCARD INC 691 1,782
    87612E106 TARGET CORP 2,432 3,174
    278865100 ECOLAB INC 1,766 1,348
    57667L107 MATCH GROUP INC NEW 1,846 1,213
    87918A105 TELADOC INC    
    G5960L103 MEDTRONIC PLC 3,745 3,004
    79466L302 SALESFORCE COM INC 3,198 2,724
    92556V106 VIATRIS INC    
    776696106 ROPER INDS INC    
    217204106 COPART INC COM 2,008 3,195
    461202103 INTUIT INC 816 1,223
    22266L106 COUPA SOFTWARE INC    
    009066101 AIRBNB INC CL A 3,357 2,043
    437076102 HOME DEPOT INC 1,746 1,944
    30063P105 EXACT SCIENCES CORPO 1,801 854
    67066G104 NVIDIA CORP 5,344 4,400
    09247X101 BLACKROCK INC 2,739 2,864
    29444U700 EQUINIX INC 1,399 1,381
    007903107 ADVANCED MICRO DEVIC 1,510 1,164
    90353T100 UBER TECHNOLOGIES IN 3,039 2,768
    550021109 LULULEMON ATHLETICA 1,601 1,902
    620076307 MOTOROLA SOLUTIONS I 1,684 1,905
    00724F101 ADOBE SYS INC 3,592 2,759
    29786A106 ETSY INC 1,578 1,453
    65339F101 NEXTERA ENERGY INC 1,873 2,118
    852234103 SQUARE INC A 848 542
    697435105 PALO ALTO NETWORKS I 2,986 2,888
    98954M101 ZILLOW GROUP INC 1,576 1,010

    TY 2021 InvestmentsOtherSchedule2
    Name:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    464287655 ISHARES RUSSELL 2000 AT COST 20,443 25,108
    46090E103 INVESCO QQQ TRUST ET      
    04314H568 ARTISAN HIGH INCOME AT COST 29,155 24,652
    524686524 CLEARBRIDGE INTERNAT AT COST 21,950 21,980
    74440B884 PGIM TOTAL RETURN BO AT COST 24,718 20,399
    46432F842 ISHARES CORE MSCI EA AT COST 26,711 27,679
    464287499 ISHARES RUSSELL MID AT COST 28,789 36,398
    72369L107 PIONEER ILS INTERVAL AT COST 17,501 15,795
    464287226 ISHARES CORE U.S. AG AT COST 47,435 43,051
    808524847 SCHWAB US REIT ETF AT COST 21,499 20,910
    46434G103 ISHARES CORE MSCI EM AT COST 40,967 38,799
    56064L298 MAINSTAY CBRE GLOBAL AT COST 15,946 15,786
    464287457 ISHARES 1 3 YEAR TRE AT COST 15,196 14,981
    024524217 AMERICAN BEACON STEP AT COST 18,338 21,114
    464288877 ISHARES MSCI EAFE VA AT COST 23,477 21,990
    464287473 ISHARES RUSSELL MIDC AT COST 16,291 20,869
    CASH CASH AT COST 428 428

    TY 2021 OtherDecreasesSchedule
    Name:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Description Amount
    ROUNDING ADJUSTMENT 6


    TY 2021 OtherIncomeSchedule2
    Name:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    OTHER INCOME 8 8  


    TY 2021 TaxesSchedule
    Name:
    ETHA ELEANOR ROSE CHARITABLE FOUNDATION
    EIN:
    43-6858210
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 238 238   0
    FEDERAL ESTIMATES - PRINCIPAL 393 0   0
    FOREIGN TAXES ON NONQUALIFIED 83 83   0