﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" returnVersion="2020v4.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2021-11-15T15:24:05-05:00</ReturnTs>
    <TaxPeriodEndDt>2020-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>800324537</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Smith &amp; Barnes CPA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>41 Johnson Rd</AddressLine1Txt>
        <CityNm>The Plains</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>45780</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990PF</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>061731994</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>SCHECK CHARITABLE FOUNDATION</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>SCHE</BusinessNameControlTxt>
      <USAddress>
        <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
        <CityNm>The Plains</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>45780</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MARLENE SCHECK</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>7405938987</PhoneNum>
      <SignatureDt>2021-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>MARLENE</PersonFirstNm>
        <PersonLastNm>SCHECK</PersonLastNm>
      </PersonFullName>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Jay Barnes CPA</PreparerPersonNm>
      <PTIN>P00045571</PTIN>
      <PhoneNum>7407974542</PhoneNum>
      <PreparationDt>2021-11-15</PreparationDt>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>0</TrustedCustomerCd>
        <OOBSecurityVerificationCd>00</OOBSecurityVerificationCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990PF documentId="IRS990PF">
      <AmendedReturnInd>X</AmendedReturnInd>
      <Organization501c3ExemptPFInd>X</Organization501c3ExemptPFInd>
      <FMVAssetsEOYAmt>23318</FMVAssetsEOYAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AnalysisOfRevenueAndExpenses>
        <ContriRcvdRevAndExpnssAmt>28000</ContriRcvdRevAndExpnssAmt>
        <DividendsRevAndExpnssAmt>1</DividendsRevAndExpnssAmt>
        <DividendsNetInvstIncmAmt>1</DividendsNetInvstIncmAmt>
        <TotalRevAndExpnssAmt>28001</TotalRevAndExpnssAmt>
        <TotalNetInvstIncmAmt>1</TotalNetInvstIncmAmt>
        <AccountingFeesRevAndExpnssAmt referenceDocumentId="STM108">450</AccountingFeesRevAndExpnssAmt>
        <AccountingFeesChrtblPrpsAmt>450</AccountingFeesChrtblPrpsAmt>
        <TaxesRevAndExpnssAmt referenceDocumentId="STM110">300</TaxesRevAndExpnssAmt>
        <TaxesDsbrsChrtblAmt>300</TaxesDsbrsChrtblAmt>
        <TotOprExpensesRevAndExpnssAmt>750</TotOprExpensesRevAndExpnssAmt>
        <TotOprExpensesNetInvstIncmAmt>0</TotOprExpensesNetInvstIncmAmt>
        <TotOprExpensesDsbrsChrtblAmt>750</TotOprExpensesDsbrsChrtblAmt>
        <ContriPaidRevAndExpnssAmt>7000</ContriPaidRevAndExpnssAmt>
        <ContriPaidDsbrsChrtblAmt>7000</ContriPaidDsbrsChrtblAmt>
        <TotalExpensesRevAndExpnssAmt>7750</TotalExpensesRevAndExpnssAmt>
        <TotalExpensesNetInvstIncmAmt>0</TotalExpensesNetInvstIncmAmt>
        <TotalExpensesDsbrsChrtblAmt>7750</TotalExpensesDsbrsChrtblAmt>
        <ExcessRevenueOverExpensesAmt>20251</ExcessRevenueOverExpensesAmt>
        <NetInvestmentIncomeAmt>1</NetInvestmentIncomeAmt>
        <AdjustedNetIncomeAmt>0</AdjustedNetIncomeAmt>
      </AnalysisOfRevenueAndExpenses>
      <Form990PFBalanceSheetsGrp>
        <CashBOYAmt>4903</CashBOYAmt>
        <CashEOYAmt>6333</CashEOYAmt>
        <CashEOYFMVAmt>6333</CashEOYFMVAmt>
        <SavAndTempCashInvstEOYAmt>15311</SavAndTempCashInvstEOYAmt>
        <SavAndTempCashInvstEOYFMVAmt>15311</SavAndTempCashInvstEOYFMVAmt>
        <OtherAssetsBOYAmt>66846</OtherAssetsBOYAmt>
        <OtherAssetsEOYAmt>1674</OtherAssetsEOYAmt>
        <OtherAssetsEOYFMVAmt referenceDocumentId="STM120">1674</OtherAssetsEOYFMVAmt>
        <TotalAssetsBOYAmt>71749</TotalAssetsBOYAmt>
        <TotalAssetsEOYAmt>23318</TotalAssetsEOYAmt>
        <TotalAssetsEOYFMVAmt>23318</TotalAssetsEOYFMVAmt>
        <TotalLiabilitiesBOYAmt>0</TotalLiabilitiesBOYAmt>
        <TotalLiabilitiesEOYAmt>0</TotalLiabilitiesEOYAmt>
        <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
        <NoDonorRstrNetAssestsBOYAmt>71749</NoDonorRstrNetAssestsBOYAmt>
        <NoDonorRstrNetAssestsEOYAmt>23318</NoDonorRstrNetAssestsEOYAmt>
        <TotNetAstOrFundBalancesBOYAmt>71749</TotNetAstOrFundBalancesBOYAmt>
        <TotNetAstOrFundBalancesEOYAmt>23318</TotNetAstOrFundBalancesEOYAmt>
        <TotalLiabilitiesNetAstBOYAmt>71749</TotalLiabilitiesNetAstBOYAmt>
        <TotalLiabilitiesNetAstEOYAmt>23318</TotalLiabilitiesNetAstEOYAmt>
      </Form990PFBalanceSheetsGrp>
      <ChgInNetAssetsFundBalancesGrp>
        <TotNetAstOrFundBalancesBOYAmt>71749</TotNetAstOrFundBalancesBOYAmt>
        <ExcessRevenueOverExpensesAmt>20251</ExcessRevenueOverExpensesAmt>
        <OtherIncreasesAmt referenceDocumentId="STM115">2180</OtherIncreasesAmt>
        <SubtotalAmt>94180</SubtotalAmt>
        <OtherDecreasesAmt referenceDocumentId="STM116">70862</OtherDecreasesAmt>
        <TotNetAstOrFundBalancesEOYAmt>23318</TotNetAstOrFundBalancesEOYAmt>
      </ChgInNetAssetsFundBalancesGrp>
      <ExciseTaxBasedOnInvstIncmGrp>
        <InvestmentIncomeExciseTaxAmt>0</InvestmentIncomeExciseTaxAmt>
        <TaxUnderSection511Amt>0</TaxUnderSection511Amt>
        <SubtitleATaxAmt>0</SubtitleATaxAmt>
        <TaxBasedOnInvestmentIncomeAmt>0</TaxBasedOnInvestmentIncomeAmt>
      </ExciseTaxBasedOnInvstIncmGrp>
      <StatementsRegardingActyGrp>
        <LegislativePoliticalActyInd>false</LegislativePoliticalActyInd>
        <MoreThan100SpentInd>false</MoreThan100SpentInd>
        <Form1120POLFiledInd>false</Form1120POLFiledInd>
        <ActivitiesNotPreviouslyRptInd>false</ActivitiesNotPreviouslyRptInd>
        <ChangesToArticlesOrBylawsInd>false</ChangesToArticlesOrBylawsInd>
        <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
        <OrganizationDissolvedEtcInd>false</OrganizationDissolvedEtcInd>
        <Section508eRqrSatisfiedInd>true</Section508eRqrSatisfiedInd>
        <AtLeast5000InAssetsInd>true</AtLeast5000InAssetsInd>
        <OrgReportOrRegisterStateCd>OH</OrgReportOrRegisterStateCd>
        <Form990PFFiledWithAttyGenInd>true</Form990PFFiledWithAttyGenInd>
        <PrivateOperatingFoundationInd>false</PrivateOperatingFoundationInd>
        <NewSubstantialContributorsInd>false</NewSubstantialContributorsInd>
        <OwnControlledEntityInd>false</OwnControlledEntityInd>
        <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
        <ComplyWithPublicInspRqrInd>true</ComplyWithPublicInspRqrInd>
        <IndividualWithBooksNm>NICOLE WILLIAMSON</IndividualWithBooksNm>
        <PhoneNum>7405938987</PhoneNum>
        <LocationOfBooksUSAddress>
          <AddressLine1Txt>80 NURAD RD</AddressLine1Txt>
          <CityNm>Athens</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45701</ZIPCd>
        </LocationOfBooksUSAddress>
        <ForeignAccountsQuestionInd>false</ForeignAccountsQuestionInd>
      </StatementsRegardingActyGrp>
      <StatementsRegardingActy4720Grp>
        <SaleOrExchDisqualifiedPrsnInd>false</SaleOrExchDisqualifiedPrsnInd>
        <BrrwOrLendDisqualifiedPrsnInd>false</BrrwOrLendDisqualifiedPrsnInd>
        <FurnGoodsDisqualifiedPrsnInd>false</FurnGoodsDisqualifiedPrsnInd>
        <PayCompDisqualifiedPrsnInd>false</PayCompDisqualifiedPrsnInd>
        <TransferAstDisqualifiedPrsnInd>false</TransferAstDisqualifiedPrsnInd>
        <PaymentToGovernmentOfficialInd>false</PaymentToGovernmentOfficialInd>
        <UndistributedIncomePYInd>false</UndistributedIncomePYInd>
        <BusinessHoldingsInd>false</BusinessHoldingsInd>
        <JeopardyInvestmentsInd>false</JeopardyInvestmentsInd>
        <UncorrectedPYJeopardyInvstInd>false</UncorrectedPYJeopardyInvstInd>
        <InfluenceLegislationInd>false</InfluenceLegislationInd>
        <InfluenceElectionInd>false</InfluenceElectionInd>
        <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
        <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
        <NoncharitablePurposeInd>false</NoncharitablePurposeInd>
        <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
        <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
        <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
        <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      </StatementsRegardingActy4720Grp>
      <OfficerDirTrstKeyEmplInfoGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>MARLENE SCHECK</PersonNm>
          <USAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </USAddress>
          <TitleTxt>PRESIDENT</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>ROXANE SCHECK</PersonNm>
          <USAddress>
            <AddressLine1Txt>2422 ENTERPRISE DR</AddressLine1Txt>
            <CityNm>Westchester</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60154</ZIPCd>
          </USAddress>
          <TitleTxt>SECRETARY</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>NICOLE WILLIAMSON</PersonNm>
          <USAddress>
            <AddressLine1Txt>80 NURAD RD</AddressLine1Txt>
            <CityNm>Athens</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45701</ZIPCd>
          </USAddress>
          <TitleTxt>TREASURER</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>PAT DAVIDSON</PersonNm>
          <USAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </USAddress>
          <TitleTxt>BOARD MEMBER</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>GEORGE MAUZY</PersonNm>
          <USAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </USAddress>
          <TitleTxt>BOARD MEMBER</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>CONNIE WOODRUFF</PersonNm>
          <USAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </USAddress>
          <TitleTxt>BOARD MEMBER</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>PAUL RICHARD</PersonNm>
          <USAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </USAddress>
          <TitleTxt>BOARD MEMBER</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>BOB MAHER</PersonNm>
          <USAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </USAddress>
          <TitleTxt>BOARD MEMBER</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <CompOfHghstPdEmplOrNONETxt>NONE</CompOfHghstPdEmplOrNONETxt>
        <OtherEmployeePaidOver50kCnt>0</OtherEmployeePaidOver50kCnt>
        <CompOfHghstPdCntrctOrNONETxt>NONE</CompOfHghstPdCntrctOrNONETxt>
      </OfficerDirTrstKeyEmplInfoGrp>
      <SummaryOfDirectChrtblActyGrp>
        <Description1Txt>DONATIONS TO OTHER 501C3 ORGANIZATIONS</Description1Txt>
        <Expenses1Amt>7000</Expenses1Amt>
      </SummaryOfDirectChrtblActyGrp>
      <MinimumInvestmentReturnGrp>
        <AverageMonthlyFMVOfSecAmt>0</AverageMonthlyFMVOfSecAmt>
        <AverageMonthlyCashBalancesAmt>16168</AverageMonthlyCashBalancesAmt>
        <FMVAllOtherNoncharitableAstAmt>1674</FMVAllOtherNoncharitableAstAmt>
        <TotalFMVOfUnusedAssetsAmt>17842</TotalFMVOfUnusedAssetsAmt>
        <AcquisitionIndebtednessAmt>0</AcquisitionIndebtednessAmt>
        <AdjustedTotalFMVOfUnusedAstAmt>17842</AdjustedTotalFMVOfUnusedAstAmt>
        <CashDeemedCharitableAmt>268</CashDeemedCharitableAmt>
        <NetVlNoncharitableAssetsAmt>17574</NetVlNoncharitableAssetsAmt>
        <MinimumInvestmentReturnAmt>879</MinimumInvestmentReturnAmt>
      </MinimumInvestmentReturnGrp>
      <DistributableAmountGrp>
        <MinimumInvestmentReturnAmt>879</MinimumInvestmentReturnAmt>
        <DistributableBeforeAdjAmt>879</DistributableBeforeAdjAmt>
        <DistributableBeforeDedAmt>879</DistributableBeforeDedAmt>
        <DistributableAsAdjustedAmt>879</DistributableAsAdjustedAmt>
      </DistributableAmountGrp>
      <QualifyingDistriPartXIIGrp>
        <ExpensesAndContributionsAmt>7750</ExpensesAndContributionsAmt>
        <QualifyingDistributionsAmt>7750</QualifyingDistributionsAmt>
        <AdjustedQualifyingDistriAmt>7750</AdjustedQualifyingDistriAmt>
      </QualifyingDistriPartXIIGrp>
      <UndistributedIncomeGrp>
        <DistributableAsAdjustedAmt>879</DistributableAsAdjustedAmt>
        <ExcessDistributionCyovYr5Amt>10213</ExcessDistributionCyovYr5Amt>
        <ExcessDistributionCyovYr4Amt>14826</ExcessDistributionCyovYr4Amt>
        <ExcessDistributionCyovYr3Amt>15000</ExcessDistributionCyovYr3Amt>
        <ExcessDistributionCyovYr2Amt>15769</ExcessDistributionCyovYr2Amt>
        <ExcessDistributionCyovYr1Amt>10003</ExcessDistributionCyovYr1Amt>
        <TotalExcessDistributionCyovAmt>65811</TotalExcessDistributionCyovAmt>
        <QualifyingDistributionsAmt>7750</QualifyingDistributionsAmt>
        <AppliedToCurrentYearAmt>879</AppliedToCurrentYearAmt>
        <RemainingDistriFromCorpusAmt>6871</RemainingDistriFromCorpusAmt>
        <TotalCorpusAmt>72682</TotalCorpusAmt>
        <UndistributedIncomeCYAmt>0</UndistributedIncomeCYAmt>
        <ExcessDistriCyovFromYr5Amt>10213</ExcessDistriCyovFromYr5Amt>
        <ExcessDistriCyovToNextYrAmt>62469</ExcessDistriCyovToNextYrAmt>
        <ExcessFromYear4Amt>14826</ExcessFromYear4Amt>
        <ExcessFromYear3Amt>15000</ExcessFromYear3Amt>
        <ExcessFromYear2Amt>15769</ExcessFromYear2Amt>
        <ExcessFromYear1Amt>10003</ExcessFromYear1Amt>
        <ExcessFromCurrentYearAmt>6871</ExcessFromCurrentYearAmt>
      </UndistributedIncomeGrp>
      <SupplementaryInformationGrp>
        <ApplicationSubmissionInfoGrp>
          <RecipientPersonNm>SCHECK CHARITABLE FOUNDATION</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>8800 JOHNSON ROAD</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </RecipientUSAddress>
          <RecipientPhoneNum>7405938987</RecipientPhoneNum>
          <FormAndInfoAndMaterialsTxt>IN WRITING</FormAndInfoAndMaterialsTxt>
          <SubmissionDeadlinesTxt>NONE</SubmissionDeadlinesTxt>
          <RestrictionsOnAwardsTxt>NONE</RestrictionsOnAwardsTxt>
        </ApplicationSubmissionInfoGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>HOCKING ATHENS PERRY COMMUNITY ACTI</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>3 CARDARAS DR</AddressLine1Txt>
            <CityNm>Glouster</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45732</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>UNRELATED</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PC</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CHARITABLE PURPOSES</GrantOrContributionPurposeTxt>
          <Amt>2000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>HABITAT FOR HUMANITY</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>14440 OH 13</AddressLine1Txt>
            <CityNm>Millfield</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45761</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>UNRELATED</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PC</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CHARITABLE PURPOSES</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>GOOD WORKS INC</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>PO BOX 4</AddressLine1Txt>
            <CityNm>Athens</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45701</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>UNRELATED</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PC</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CHARITABLE PURPOSES</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>AMERICAN RED CROSS</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>100 S MAY AVE</AddressLine1Txt>
            <CityNm>Athens</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45701</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>UNRELATED</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PC</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CHARITABLE PURPOSES</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>DOCTORS WITHOUT BORDERS</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>PO BOX 5030</AddressLine1Txt>
            <CityNm>Hagerstown</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21741</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>UNRELATED</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PC</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CHARITABLE PURPOSES</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientPersonNm>SALVATION ARMY</RecipientPersonNm>
          <RecipientUSAddress>
            <AddressLine1Txt>70 SR 682 UNIT 122</AddressLine1Txt>
            <CityNm>The Plains</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45780</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>UNRELATED</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PC</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CHARITABLE PURPOSES</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <TotalGrantOrContriPdDurYrAmt>7000</TotalGrantOrContriPdDurYrAmt>
        <TotalGrantOrContriApprvFutAmt>0</TotalGrantOrContriApprvFutAmt>
      </SupplementaryInformationGrp>
      <AnalysisIncomeProducingActyGrp>
        <DivAndIntFromSecPartVIIGrp>
          <ExclusionCd>14</ExclusionCd>
          <ExclusionAmt>1</ExclusionAmt>
        </DivAndIntFromSecPartVIIGrp>
        <SubtotalsIncmProducingActyGrp>
          <ExclusionAmt>1</ExclusionAmt>
        </SubtotalsIncmProducingActyGrp>
        <TotalIncomeProducingActyAmt>1</TotalIncomeProducingActyAmt>
      </AnalysisIncomeProducingActyGrp>
      <RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>01a</LineNumberTxt>
          <RelationshipStatementTxt>TO PROVIDE FUNDING FOR OTHER 501C3 ORGANIZATIONS</RelationshipStatementTxt>
        </RlnOfActyToAccomOfExmptPrpsGrp>
      </RlnOfActyToAccomOfExmptPrpsGrp>
      <TrnsfrTransRlnNonchrtblEOGrp>
        <TrnsfrOfCashToNonchrtblEOInd>false</TrnsfrOfCashToNonchrtblEOInd>
        <TrnsfrOtherAssetNonchrtblEOInd>false</TrnsfrOtherAssetNonchrtblEOInd>
        <SalesOrExchangesOfAssetsInd>false</SalesOrExchangesOfAssetsInd>
        <PurchaseOfAssetsNonchrtblEOInd>false</PurchaseOfAssetsNonchrtblEOInd>
        <RentalOfFacilitiesOthAssetsInd>false</RentalOfFacilitiesOthAssetsInd>
        <ReimbursementArrangementsInd>false</ReimbursementArrangementsInd>
        <LoansOrLoanGuaranteesInd>false</LoansOrLoanGuaranteesInd>
        <PerformanceOfServicesEtcInd>false</PerformanceOfServicesEtcInd>
        <SharingOfFacilitiesEtcInd>false</SharingOfFacilitiesEtcInd>
        <RelationshipsNonchrtblEOInd>false</RelationshipsNonchrtblEOInd>
      </TrnsfrTransRlnNonchrtblEOGrp>
    </IRS990PF>
    <IRS990ScheduleB documentId="990B">
      <Organization501c3ExemptPFInd>X</Organization501c3ExemptPFInd>
      <GeneralRuleInd>X</GeneralRuleInd>
      <ContributorInformationGrp>
        <ContributorNum>1</ContributorNum>
        <ContributorPersonNm>MARLENE SCHECK</ContributorPersonNm>
        <ContributorUSAddress>
          <AddressLine1Txt>8800 JOHNSON ROAD UNIT 103</AddressLine1Txt>
          <CityNm>Athens</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45701</ZIPCd>
        </ContributorUSAddress>
        <TotalContributionsAmt>28000</TotalContributionsAmt>
        <PersonContributionInd>X</PersonContributionInd>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <AccountingFeesSchedule documentId="STM108">
      <AccountingFeesDetail>
        <CategoryTxt>Accounting Fees</CategoryTxt>
        <Amt>450</Amt>
        <NetInvestmentIncomeAmt>0</NetInvestmentIncomeAmt>
        <AdjustedNetIncomeAmt>0</AdjustedNetIncomeAmt>
        <DisbursementsCharitablePrpsAmt>450</DisbursementsCharitablePrpsAmt>
      </AccountingFeesDetail>
    </AccountingFeesSchedule>
    <OtherAssetsSchedule documentId="STM120">
      <OtherAssetsScheduleGrp>
        <Desc>INVESTMENT IN LIFE INSURANCE CONTRA</Desc>
        <BOYBookValueAmt>66846</BOYBookValueAmt>
        <EOYBookValueAmt>1674</EOYBookValueAmt>
        <EOYFMVAmt>1674</EOYFMVAmt>
      </OtherAssetsScheduleGrp>
    </OtherAssetsSchedule>
    <OtherDecreasesSchedule documentId="STM116">
      <OtherDecreasesDetail>
        <Desc>NON-DEDUCTIBLE LIFE INS PREMIUMS</Desc>
        <Amt>5690</Amt>
      </OtherDecreasesDetail>
      <OtherDecreasesDetail>
        <Desc>DECREASE IN LIFE INS CSV</Desc>
        <Amt>65172</Amt>
      </OtherDecreasesDetail>
    </OtherDecreasesSchedule>
    <OtherIncreasesSchedule documentId="STM115">
      <OtherIncreasesDetail>
        <Desc>PRIOR PERIOD ADJUSTMENT</Desc>
        <Amt>2180</Amt>
      </OtherIncreasesDetail>
    </OtherIncreasesSchedule>
    <TaxesSchedule documentId="STM110">
      <TaxesDetail>
        <CategoryTxt>Ohio Attorney General</CategoryTxt>
        <Amt>300</Amt>
        <NetInvestmentIncomeAmt>0</NetInvestmentIncomeAmt>
        <AdjustedNetIncomeAmt>0</AdjustedNetIncomeAmt>
        <DisbursementsCharitablePrpsAmt>300</DisbursementsCharitablePrpsAmt>
      </TaxesDetail>
    </TaxesSchedule>
  </ReturnData>
</Return>