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 09-01-2021 , and ending 08-31-2022
Name of foundation
George W Mergens Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)PO Box 633
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Milton, VT05468
A Employer identification number

03-0345055
B Telephone number (see instructions)

(802) 893-4854
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$20,688,248J 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) 250,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 1,092 1,092  
4 Dividends and interest from securities... 361,141 361,141  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment 1,010,114
b Gross sales price for all assets on line 6a 4,111,540
7 Capital gain net income (from Part IV, line 2)... 1,010,114
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)..... 0  
11 Other income (attach schedule)....... 0    
12 Total. Add lines 1 through 11........ 1,622,347 1,372,347  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 348,400 106,422   241,978
14 Other employee salaries and wages...... 0 0   0
15 Pension plans, employee benefits....... 40,517 13,343   27,174
16a Legal fees (attach schedule)......... 0      
b Accounting fees (attach schedule)....... Click to see attachment 1,940 970   970
c Other professional fees (attach schedule).... 0      
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 60,264 8,047   18,159
19 Depreciation (attach schedule) and depletion... 166 51  
20 Occupancy.............. 27,661 8,449   19,212
21 Travel, conferences, and meetings....... 2,298 919   1,379
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment -61,955 -18,947   -43,031
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 419,291 119,254   265,841
25 Contributions, gifts, grants paid....... 836,555 836,555
26 Total expenses and disbursements. Add lines 24 and 25 1,255,846 119,254   1,102,396
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 366,501
b Net investment income (if negative, enter -0-) 1,253,093
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............. 82,542 40,040 40,040
2 Savings and temporary cash investments......... 118,698 3,629,410 3,629,410
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).....   0  
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet     0  
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)....... 15,119,707 Click to see attachment12,018,281 14,428,702
c Investments—corporate bonds (attach schedule)....... 2,841,935 Click to see attachment2,841,935 2,589,919
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet     0  
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........   0  
14 Land, buildings, and equipment: basis bullet11,198
Less: accumulated depreciation (attach schedule) bullet11,021 344 Click to see attachment177 177
15 Other assets (describe bullet) 0 0 0
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 18,163,226 18,529,843 20,688,248
Liabilities 17 Accounts payable and accrued expenses.......... 0 0
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons   0
21 Mortgages and other notes payable (attach schedule)......   0
22 Other liabilities (describe bullet) Click to see attachment0 Click to see attachment116
23 Total liabilities (add lines 17 through 22)......... 0 116
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 18,163,226 18,529,727
29 Total net assets or fund balances (see instructions)..... 18,163,226 18,529,727
30 Total liabilities and net assets/fund balances (see instructions). 18,163,226 18,529,843
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
18,163,226
2
Enter amount from Part I, line 27a .....................
2
366,501
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
18,529,727
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
18,529,727
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 Publicly Traded Securities P    
b
c
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 4,111,540 0 3,101,426 1,010,114
b
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 0 0 0 1,010,114
b
c
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 1,010,114
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 17,418
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 17,418
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 18,500
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. Part VI Line 7 - Original Return Overpayment: -18500 7 18,500
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
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 1,082
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet1,082 RefundedBullet 11  
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 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)
    bulletVT
    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 addressbulletwww.mergensfoundation.org
    14
    The books are in care ofbulletPaul G Mergens Telephone no.bullet (802) 862-6770

    Located atbulletPO Box 633MiltonVT ZIP+4bullet05468
    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)
    Yes
     
    (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
    Paul G Mergens President & Treasurer
    40.00     		135,900 20,774 0
    PO Box 633
    Milton,VT05468
    Mary E Mergens-Loughran Vice-President
    5.00     		0 0 0
    PO Box 633
    Milton,VT05468
    Lenora A Mergens Director
    5.00     		0 0 0
    PO Box 633
    Milton,VT05468
    William H Wiltshire V-P; Director of Operations
    32.00     		150,000 12,234 0
    PO Box 633
    Milton,VT05468
    Rachel Mergens V-P; Director of Finance
    30.00     		62,500 7,509 0
    PO Box 633
    Milton,VT05468
    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
    21,254,811
    b
    Average of monthly cash balances.......................
    1b
    1,949,874
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    23,204,685
    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
    23,204,685
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    348,070
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    22,856,615
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,142,831
    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
    1,142,831
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    17,418
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
    0
    c
    Add lines 2a and 2b............................
    2c
    17,418
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,125,413
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,125,413
    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
    1,125,413
    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 1,125,413
    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  
    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...... 49,266
    f Total of lines 3a through e ........ 49,266
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 1,102,396
    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..... 1,102,396
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021. 23,017 23,017
    (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 26,249
    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......     		 
    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) .......     		 
    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 ......     		26,249
    10 Analysis of line 9:
    a Excess from 2017.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 0
    d Excess from 2020.... 26,249
    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).)
    Paul G Mergens
    Mary Mergens-Loughran
    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 e-mail address of the person to whom applications should be addressed:
    Paul G Mergens
    PO Box 633
    Milton,VT05468
    (802) 862-6770
    bThe form in which applications should be submitted and information and materials they should include:
    Any form of application is acceptable. Include organizational information and intended charitable use of funds.
    cAny submission deadlines:
    None
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    None
    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
    Audubon Vermont
    255 Sherman Hollow Road
    Huntington,VT05462     		  PC Green MountainCenter EducationPrograms 15,000
    Azimuth Counseling & Therapeutics Service
    8 Essex Way
    Essex Junction,VT05452     		  PC Elevation Academy:Counseling Services 10,000
    BarnArts Center for the Arts
    PO Box 41
    Barnard,VT05031     		  PC Youth SummerCamp 2022 5,000
    Bennington Museum
    75 Main Street
    Bennington,VT05201     		  PC Community EngagementCoordinatorPosition 15,000
    Birds of Vermont Museum
    900 Sherman Hollow Road
    Huntington,VT05462     		  PC General OperatingSupport 3,000
    Bishop John A Marshall School
    680 LaPorte Road
    Morrisville,VT05661     		  PC Early EducationProgram / PlaygroundRenovation 40,000
    Bradford Teen Center
    PO Box 247
    Bradford,VT05033     		  PC General OperatingSupport 7,500
    Brattleboro Development Credit Corporation
    76 Cotton Mill Hill
    Brattleboro,VT05301     		  PC Pipeline andPathwaysProgram (P3) 10,000
    Brattleboro Museum & Art Center
    10 Vernon Street
    Brattleboro,VT05301     		  PC Youth & EducationPrograms 10,000
    BSA Green Mountain Council
    PO Box 557
    Waterbury,VT05676     		  PC General OperatingSupport 20,000
    BSA Green Mountain Council
    PO Box 557
    Waterbury,VT05676     		  PC OutreachInitiative 15,000
    Cancer Patient Support Foundation
    PO Box 1804
    Williston,VT05495     		  PC General OperatingSupport 5,000
    Care Net of Mid-Coast ME
    PO Box 969
    Brunswick,ME04011     		  PC General OperatingSupport 20,000
    Changing Perspectives
    PO Box 694
    Bradford,VT05033     		  PC General OperatingSupport 8,000
    Children's Literacy Foundation
    1536 Loomis Hill Road
    Waterbury Center,VT05677     		  PC Building CapitalCampaign 25,000
    Circus Smirkus
    1 Circus Road
    Greensboro,VT05841     		  PC School Artist-in-Residency Program 8,000
    City of Montpelier
    39 Main Street
    Montpelier,VT05602     		  Gov FeastFarm 10,000
    Common Ground Center
    473 Tatro Road
    Starksboro,VT05487     		  PC Adventure CampSeries 2022 10,000
    Community Sailing Center
    505 Lake Street
    Burlington,VT05401     		  PC CapitalCampaign 50,000
    Community Sailing Center
    505 Lake Street
    Burlington,VT05401     		  PC YouthPrograms 15,000
    ECHO Leahy Center for Lake Champlain
    1 College Street
    Burlington,VT05401     		  PC SciExcelProgram 10,000
    Essex CHIPS
    2 Lincoln Street 2nd Floor
    Essex Junction,VT05452     		  PC Matching Fundsfor AmericorpsPositions 10,000
    Fairbanks Museum & Planetarium
    1302 Main Street
    St Johnsbury,VT05819     		  PC Science AnnexChallenge Fundraiser 25,000
    FEJ - USA
    1464 West Webster Avenue
    Chicago,IL60614     		  PC Youth HealthProgram 5,000
    Friar Suppliers
    583 South 7th Street
    Lindenhurst,NY11757     		  PC HaitiMission 2,500
    Future Genius Inc
    283 Stone Drive
    Colchester,VT05446     		  PC TeamElektra 5,000
    Generator Inc
    40 Sears Lane
    Burlington,VT05404     		  PC Maker MentorProgram 10,000
    Governor's Institute of Vermont
    20 West Canal Street C5
    Winooski,VT05404     		  PC General OperatingSupport 10,000
    Greater Rutland County Supervisory Union
    16 Evelyn Street
    Rutland,VT05701     		  Gov Healthy Foodsfrom A-Z 5,000
    Green Mountain Farm to School
    115 2nd Street
    Newport,VT05855     		  PC General OperatingSupport 10,000
    Hunger Free Vermont
    38 Eastwood Drive
    South Burlington,VT05403     		  PC Child NutritionInitiatives 5,000
    In Tandem Arts
    208 Flynn Avenue
    Burlington,VT05401     		  PC High SchoolProgramming 3,000
    Intervale Center
    180 Intervale Road
    Burlington,VT05401     		  PC Gleaning and FoodRescue Programs 10,000
    Kids on the Ball Inc
    19 Lindenwood Drive
    South Burlington,VT05403     		  PC General OperatingSupport 5,000
    King Street Center
    PO Box 1615
    Burlington,VT05402     		  PC After SchoolExcellence Program 15,000
    Lake Champlain Museum Maritime
    4472 Basin Harbor Road
    Vergennes,VT05491     		  PC High School LongboatRowing Program 10,000
    Lake Paran Recreation
    PO Box 393
    Bennington,VT05257     		  PC SummerCamp 4,000
    Lund Family Center
    76 Glen Road
    Burlington,VT05404     		  PC General OperatingSupport 10,000
    Milton Community Youth Coalition
    164 Route 7 South
    Milton,VT05468     		  PC Annual FundraiserMatching Grant 14,355
    Milton Family Community Center
    23 Villemaire Lane
    Milton,VT05468     		  PC ConnectionsProgramming 5,000
    New England Youth Theatre
    100 Flat Street
    Brattleboro,VT05301     		  PC Town SchoolsTheatre Program 5,000
    Northwest Vermont Regional Foundation
    75 Fairfield Street
    St Albans City,VT05478     		  PC Healthy RootsCollaborative 5,000
    Old Stone House Museum
    109 Old Stone House Road
    Brownington,VT05860     		  PC Hands-on-HistoryProgram 2022 5,000
    Prevent Child Abuse Vermont
    203 Country Club Road
    Montpelier,VT05602     		  PC General OperatingSupport 15,000
    Pure Water for the World
    PO Box 55
    Rutland,VT05702     		  PC General OperatingSupport 20,000
    Reinbow Riding Center
    PO Box 395
    Shrewsbury,VT05738     		  PC General OperatingSupport 5,000
    ReSource
    266 Pine Street
    Burlington,VT05401     		  PC YouthBuild& LEAP Programs 15,000
    Rice Memorial High School
    99 Proctor Avenue
    South Burlington,VT05403     		  PC AnnualCampaign 2,500
    Rice Memorial High School
    99 Proctor Avenue
    South Burlington,VT05403     		  PC TuitionAssistance 50,000
    Saint Paul's Catholic School
    54 Eastern Avenue
    Barton,VT05822     		  PC General OperatingSupport 17,000
    Slate Valley Unified School District
    33 Mechanic Street
    Fair Haven,VT05743     		  Gov Snack SackProgram 5,000
    South Hero Library Foundation
    28 Community Lane
    South Hero,VT05486     		  PC Worthen LibraryMakerspace Equipment 15,000
    Southern Vermont Arts Center
    PO Box 617
    Manchester,VT05254     		  PC Arts EducationProgram & Scholarships 5,000
    Special Needs Support Center
    129 South Main Street
    White River Junction,VT05001     		  PC ASPIRE Afterschool & Summer Camp 10,000
    Spectrum Youth & Family Services
    31 Elmwood Avenue
    Burlington,VT05401     		  PC General OperatingSupport 20,000
    Steps to End Domestic Violence
    PO Box 1535
    Burlington,VT05402     		  PC General OperatingSupport 10,000
    UP for Learning
    155 Elm Street 1
    Montpelier,VT05602     		  PC Milton InnovationCenter 14,000
    United States Committee for Refugees and Immigrants
    101 462 Hegeman Avenue
    Colchester,VT05446     		  PC Youth Leadership CaseManager Position 5,000
    VABVI
    37 Elmwood Avenue
    Burlington,VT05401     		  PC HAPIProgram 2022 3,000
    Vermont Adaptive Ski and Sports
    77 Alpine Drive
    Killington,VT05751     		  PC YouthPrograms 10,000
    Vermont Historical Society
    60 Washington Street
    Barre,VT05641     		  PC VermontHistory Day 10,000
    Vermont Institute of Natural Science
    PO Box 1281
    Quechee,VT05059     		  PC General OperatingSupport 10,000
    Vermont Patriots
    201 Juniper Drive
    South Burlington,VT05403     		  PC General OperatingSupport 10,000
    Vermont State Mathematics Coalition
    PO Box 211
    Underhill Center,VT05490     		  PC General OperatingSupport 10,200
    Vermont Symphony Orchestra
    2 Church Street 3B
    Burlington,VT05401     		  PC YouthPrograms 10,000
    Vermont Youth Conservation Corps
    1949 East Main Street
    Richmond,VT05477     		  PC FarmProgram 25,000
    Vermont Youth Orchestra Association
    223 Ethan Allen Avenue
    Colchester,VT05446     		  PC General OperatingSupport 12,000
    Windsor County Mentors
    PO Box 101
    Windsor,VT05089     		  PC General OperatingSupport 5,000
    Wuku Kawoq - Maya Health Alliance
    PO Box 91
    Bethel,VT05302     		  PC Complex PediatricCases Program 20,000
    Young Writers Project
    47 Maple Street Suite 216
    Burlington,VT05401     		  PC 13th AnthologyEdition 7,500
    Youth Safety Council of Vermont
    PO Box 428
    Burlington,VT05402     		  PC Turn of TextingProgram 5,000
    Total .................................bullet 3a 836,555
    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 ...........     		    14 1,092  
    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 1,010,114  
    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) ..   1,372,347  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,372,347
    (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:  
    Part VI Line 7 -Original Return Overpayment: -18,500


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

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    George W Mergens Foundation
     
    Employer identification number

    03-0345055
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    George W Mergens Foundation
          		Employer identification number
    03-0345055
    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
    Paul G Mergens
    PO Box 718
     
    Milton, VT05468

    		$ 250,000


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

    		$  


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

    		$  


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

    		$  


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

    		$  


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

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    George W Mergens Foundation
          		Employer identification number

    03-0345055
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    George W Mergens Foundation
          		Employer identification number

    03-0345055
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Vermont CPA Firm Accounting & Tax Preparation 1,940 970   970

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    TY 2021 GainLossSaleOtherAssetsSch
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    Publicly Traded Securities (including Capital Gain Dividends)   Purchased   Unrelated Third Parties 4,111,540 3,101,426 Cost 0 1,010,114 0

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Name of Bond End of Year Book Value End of Year Fair Market Value
    24,055 Vanguard Short Term Investment Grade Bond Fund 249,929 241,991
    82,572 Vanguard Total Bond Market Index Admiral Fund 887,935 810,856
    88,107 Schwab Short-Term Bond Index Fund 904,071 841,420
    133,779 Vanguard High-Yield Corporate Bond Fund 800,000 695,652

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Name of Stock End of Year Book Value End of Year Fair Market Value
    2,737sh Vanguard Energy ETF 199,965 310,622
    2,355sh Vanguard Financials ETF IV 199,940 191,532
    3,470sh Vanguard Growth ETF 892,553 830,579
    590sh Vanguard Health Care ETF 100,058 136,620
    2,467sh Vanguard Information Tech ETF 889,469 861,674
    2,784sh Vanguard S&P SC 600 499,656 446,247
    3,850sh Vanguard Value ETF IV 499,715 519,134
    9,765sh Baron Emerging Markets Institutional Fund 112,318 130,654
    23,519sh Champlain Mid Cap Growth Fund 399,154 503,314
    2,941sh Harbor Capital Appreciation Fund 174,143 206,252
    7,117sh Lazard International Strategic Equity Inst. 69,961 93,020
    36,687sh Touchstone Institutional Funds Sand Cap Fund 408,535 384,843
    9,323sh Vanguard Growth Index Admiral Fund 536,918 1,148,634
    6,833sh Vanguard Small Cap Index Admiral Fund 503,534 621,083
    7,216sh Vanguard Total International Stock Index Admiral Fund 180,491 198,295
    12,815sh Vanguard Total Stock Market Admiral Fund 712,572 1,238,463
    14,753sh Vanguard Value Index Admiral Fund 473,174 775,857
    1,260sh Vanguard 500 Index Admiral Fund 267,535 461,062
    3,744sh IShares Global Materials ETF 224,887 275,633
    1,922sh Vanguard Growth ETF 494,338 460,050
    2,687sh Vanguard Health Care ETF 481,673 622,202
    1,365sh Vanguard Information Technology ETF 492,629 476,767
    2,072sh Vanguard S&P Mid Cap 400 329,717 318,404
    1,811sh Vanguard S&P SC 600 329,700 290,285
    4,359sh Vanguard S&P 500 Growth ETF 774,462 1,012,116
    2,408sh Vanguard S&P 500 Value ETF IV 329,920 328,861
    4,112sh Vanguard Small Cap ETF 620,367 780,088
    20,477sh MFS International Intrinsic Value Fund 820,897 806,411

    TY 2021 LandEtcSchedule2
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Leasehold Improvements 3,623 3,623 0  
    Office Equipment 7,575 7,398 177  


    TY 2021 OtherExpensesSchedule
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Computer Services 1,668 510   1,158
    Office & Other Supplies 922 281   641
    Postage 343 105   238
    Telephone 3,865 1,181   2,684
    Meals & Entertainment 150 23   104
    Insurance 997 305   692
    Payroll Service 578 177   401
    Benefits Consultant 715 218   497
    Bank Charges 72 22   50
    State Filing Fee 20 6   14
    Operating Cost Reimbursement from A.A. Mergens Foundation -71,285 -21,775   -49,510


    TY 2021 OtherLiabilitiesSchedule
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Description Beginning of Year - Book Value End of Year - Book Value
    Credit Card Payable 0 116


    TY 2021 TaxesSchedule
    Name:
    George W Mergens Foundation
    EIN:
    03-0345055
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Payroll Taxes 26,206 8,047   18,159
    Federal Excise Taxes 34,058 0   0