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56-195562 <br />(Complete only if you checked the box on line 1O of Pad I or if the organization failed to qualify under Part ll. lf the organization fails io <br />Calendar year (or liscal year beginning in) > <br />1 Gifts, grants, contributions, and <br />membership fees received. (Do not <br />include any "unusual grants.") ...... <br />2 Gross receipts from admissions, <br />merchandise sold or services per. <br />formed, or facilities furnished in <br />any activity that is related to the <br />organization's tax-exempt purpose <br />3 Gross receipts from activities thai <br />are not an unrelated trade or bus- <br />iness under section 513 <br />4 Tax revenues levied for the organ- <br />ization's benefjt and either paid to <br />or expended on its behalf <br />5 The value of services or facilities <br />furnished by a governmental unit to <br />the organization without charge ... <br />6 Total. Add lines 1 through 5 ... .. <br />7a Amounts included on lines 1,2, and <br />3 received from disqualified persons <br />b Amounts included on lines 2 ancl 3 received <br />lrom other than disqualified persons that <br />exceed the greater of $5,000 or i% of the <br />amount on line 13 for the year <br />c Add lines 7a and 7b <br />Calendar year (or liscal year beginning in) ) <br />I Amounts from line 6 . . <br />10a Gross income from interest, <br />dividends, payments received on <br />securities loans, rents, royalties, <br />and income from simiiar sources ... <br />b Unrelated business laxable income <br />(less section 51 1 taxes) from businesses <br />acquired after June 30, l975 <br />c Add lines 10a and 10b ,.. . . ..11 Net income from unrelated business <br />activities not included on line iOb, <br />whether or not the business is <br />regularly carried on <br />12 Other income. Do not include gain <br />or loss from the sale of capital <br />assets (Explain in Part Vl.) <br />13 <br />14 <br />TOtal SUppoft. (Add tines s. 1oc, 1.1, and i2.) <br />First 5 years. lf the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 50i (cX3) organization, <br />'15 Public suppod percentage for 2021 (line B, column (f), divided by line 13, column (f)) <br />f <br />lnvestment income percentage for 2021 (line 1oc, column (f), divided by line 13, column (f)) <br />lnvestment income percentage from 202O Schedule A, part lll, line 17 <br />3g 1tg% support tests - 2021. lf the organization did not check the box on line ra ,rJ "" rs i" ,"r" ,n, J;;;d [,* 1, b ,o. <br />more than 33 1/3%' check this box and stop here. The organization qualifies as a publicly supported organization >Eb33 1/3%supporttests-2o2o. lf theorganizationdidnotcheckaboxonlinel4orlinelga,andlinei6ismorethan 33 1/3%o,and <br />17 <br />18 <br />19a <br />line 18 is not more than 33 1/3%o, check this box and stop here. The organization qualifies as a publicly supported organization E <br />132023 01 04-22 Schedule A (Form 990) 2021 <br />DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12