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        <StateAbbreviationCd>NC</StateAbbreviationCd>
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        <BusinessNameLine1Txt>THE JONATHAN &amp; ANNE SMITH FAMILY</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>FOUNDATION INC</BusinessNameLine2Txt>
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      <PhoneNum>3362729844</PhoneNum>
      <USAddress>
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      <PersonNm>ANNE SMITH</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>3362729488</PhoneNum>
      <SignatureDt>2017-05-09</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
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      <PreparerPersonNm>LESLIE L ANDERSON</PreparerPersonNm>
      <PTIN>P00021396</PTIN>
      <PhoneNum>3364822444</PhoneNum>
      <PreparationDt>2017-05-08</PreparationDt>
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      <IPAddress>
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      <IPDt>2017-05-09</IPDt>
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    <TaxYr>2016</TaxYr>
    <BuildTS>2021-01-29 14:40:06Z</BuildTS>
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      <FMVAssetsEOYAmt>27017</FMVAssetsEOYAmt>
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      <AnalysisOfRevenueAndExpenses>
        <ScheduleBNotRequiredInd>X</ScheduleBNotRequiredInd>
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        <InterestOnSavNetInvstIncmAmt>3</InterestOnSavNetInvstIncmAmt>
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        <TotalRevAndExpnssAmt>3</TotalRevAndExpnssAmt>
        <TotalNetInvstIncmAmt>3</TotalNetInvstIncmAmt>
        <CompOfcrDirTrstRevAndExpnssAmt>0</CompOfcrDirTrstRevAndExpnssAmt>
        <CompOfcrDirTrstNetInvstIncmAmt>0</CompOfcrDirTrstNetInvstIncmAmt>
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        <TaxesRevAndExpnssAmt referenceDocumentId="RetDoc2002500001">1000</TaxesRevAndExpnssAmt>
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        <ContriPaidRevAndExpnssAmt>9845</ContriPaidRevAndExpnssAmt>
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        <TotalExpensesDsbrsChrtblAmt>10699</TotalExpensesDsbrsChrtblAmt>
        <ExcessRevenueOverExpensesAmt>-11696</ExcessRevenueOverExpensesAmt>
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      <QlfyUndSect4940eReducedTaxGrp>
        <LiableSection4942TaxInd>0</LiableSection4942TaxInd>
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        <SubtitleATaxAmt>0</SubtitleATaxAmt>
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        <AppliedToESTaxAmt>203</AppliedToESTaxAmt>
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        <MoreThan100SpentInd>0</MoreThan100SpentInd>
        <Form1120POLFiledInd>0</Form1120POLFiledInd>
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        <ActivitiesNotPreviouslyRptInd>0</ActivitiesNotPreviouslyRptInd>
        <ChangesToArticlesOrBylawsInd>0</ChangesToArticlesOrBylawsInd>
        <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
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        <Section508eRqrSatisfiedInd>1</Section508eRqrSatisfiedInd>
        <AtLeast5000InAssetsInd>1</AtLeast5000InAssetsInd>
        <OrgReportOrRegisterStateCd>NC</OrgReportOrRegisterStateCd>
        <Form990PFFiledWithAttyGenInd>1</Form990PFFiledWithAttyGenInd>
        <PrivateOperatingFoundationInd>0</PrivateOperatingFoundationInd>
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        <DonorAdvisedFundInd>0</DonorAdvisedFundInd>
        <ComplyWithPublicInspRqrInd>1</ComplyWithPublicInspRqrInd>
        <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
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        <LocationOfBooksUSAddress>
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          <CityNm>GREENSBORO</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27401</ZIPCd>
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        <ForeignAccountsQuestionInd>0</ForeignAccountsQuestionInd>
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        <SaleOrExchDisqualifiedPrsnInd>0</SaleOrExchDisqualifiedPrsnInd>
        <BrrwOrLendDisqualifiedPrsnInd>0</BrrwOrLendDisqualifiedPrsnInd>
        <FurnGoodsDisqualifiedPrsnInd>0</FurnGoodsDisqualifiedPrsnInd>
        <PayCompDisqualifiedPrsnInd>0</PayCompDisqualifiedPrsnInd>
        <TransferAstDisqualifiedPrsnInd>0</TransferAstDisqualifiedPrsnInd>
        <PaymentToGovernmentOfficialInd>0</PaymentToGovernmentOfficialInd>
        <UncorrectedPriorActsInd>0</UncorrectedPriorActsInd>
        <UndistributedIncomePYInd>0</UndistributedIncomePYInd>
        <BusinessHoldingsInd>0</BusinessHoldingsInd>
        <JeopardyInvestmentsInd>0</JeopardyInvestmentsInd>
        <UncorrectedPYJeopardyInvstInd>0</UncorrectedPYJeopardyInvstInd>
        <InfluenceLegislationInd>0</InfluenceLegislationInd>
        <InfluenceElectionInd>0</InfluenceElectionInd>
        <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
        <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
        <NoncharitablePurposeInd>0</NoncharitablePurposeInd>
        <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
        <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
        <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
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      <OfficerDirTrstKeyEmplInfoGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>JONATHAN W SMITH</PersonNm>
          <USAddress>
            <AddressLine1Txt>2205 MADISON AVENUE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27403</ZIPCd>
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          <TitleTxt>PRESIDENT, DIRECTOR</TitleTxt>
          <AverageHrsPerWkDevotedToPosRt>1.00</AverageHrsPerWkDevotedToPosRt>
          <CompensationAmt>0</CompensationAmt>
          <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>ANNE F SMITH</PersonNm>
          <USAddress>
            <AddressLine1Txt>2205 MADISON AVENUE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27403</ZIPCd>
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          <TitleTxt>SECRETARY-TREASURER, DIREC</TitleTxt>
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          <CompensationAmt>0</CompensationAmt>
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          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
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        <OfficerDirTrstKeyEmplGrp>
          <PersonNm>JUSTIN W SMITH</PersonNm>
          <USAddress>
            <AddressLine1Txt>128 EAST FISHER AVENUE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
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          <TitleTxt>DIRECTOR</TitleTxt>
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          <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
        </OfficerDirTrstKeyEmplGrp>
        <CompOfHghstPdEmplOrNONETxt>NONE</CompOfHghstPdEmplOrNONETxt>
        <OtherEmployeePaidOver50kCnt>0</OtherEmployeePaidOver50kCnt>
        <CompOfHghstPdCntrctOrNONETxt>NONE</CompOfHghstPdCntrctOrNONETxt>
        <ContractorPaidOver50kCnt>0</ContractorPaidOver50kCnt>
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      <SummaryOfDirectChrtblActyGrp>
        <Description1Txt>N/A</Description1Txt>
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        <ExcessDistriCyovAppCYCorpusAmt>0</ExcessDistriCyovAppCYCorpusAmt>
        <ExcessDistributionCyovAppCYAmt>0</ExcessDistributionCyovAppCYAmt>
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        <PriorYearDeficiencyOrTaxAmt>0</PriorYearDeficiencyOrTaxAmt>
        <Taxable1Amt>0</Taxable1Amt>
        <Taxable2Amt>0</Taxable2Amt>
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      </UndistributedIncomeGrp>
      <SupplementaryInformationGrp>
        <ContributingManagerNm>JONATHAN W SMITH</ContributingManagerNm>
        <ApplicationSubmissionInfoGrp>
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          <RecipientUSAddress>
            <AddressLine1Txt>128 EAST FISHER AVENUE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
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          <RecipientPhoneNum>3362729488</RecipientPhoneNum>
          <FormAndInfoAndMaterialsTxt>TYPED</FormAndInfoAndMaterialsTxt>
          <SubmissionDeadlinesTxt>NONE</SubmissionDeadlinesTxt>
          <RestrictionsOnAwardsTxt>NONE</RestrictionsOnAwardsTxt>
        </ApplicationSubmissionInfoGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>ALS ASSOCIATION</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>4 N BLOUNT ST SUITE 200</AddressLine1Txt>
            <CityNm>RALIEGH</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27601</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THE ALS ASSOCIATION IS THE ONLY NATIONAL NON-PROFIT ORGANIZATION FIGHTING LOU GEHRIG'S DISEASE ON EVERY FRONT. BY LEADING THE WAY IN GLOBAL RESEARCH, PROVIDING ASSISTANCE FOR PEOPLE WITH ALS THROUGH A NATIONWIDE NETWORK OF CHAPTERS, COORDINATING MULTIDISCIPLINARY CARE THROUGH CERTIFIED CLINICAL CARE CENTERS, AND FOSTERING GOVERNMENT PARTNERSHIPS, THE ASSOCIATION BUILDS HOPE AND ENHANCES QUALITY OF LIFE WHILE AGGRESSIVELY SEARCHING FOR NEW TREATMENTS AND A CURE.</GrantOrContributionPurposeTxt>
          <Amt>150</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>ANGELMAN SYNDROME FOUNDATION</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>76 EXECUTIVE DRIVE SUITE 327</AddressLine1Txt>
            <CityNm>AURORA</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60504</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>ASF FUNDED RESEARCH HAS BROUGHT FORTH NEW DISCOVERIES THAT BRING HOPE FOR THERAPIESAND ULTIMATELY A CURE FOR ANGELMAN SYNDROME.</GrantOrContributionPurposeTxt>
          <Amt>250</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>ARTS GREENSBORO</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>200 N DAVIE ST 201</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THROUGH ITS ARTSFUND-SUPPORTED GRANT PROGRAMS, THE 17DAYS ARTS &amp; CULTURE FESTIVAL, AND OTHER OPPORTUNITIES INCLUDING THE NATIONAL FOLK FESTIVAL, THE NEW VAN DYKE PERFORMANCE SPACE, AND THE LEVITT AMP GREENSBORO MUSIC SERIES, ARTSGREENSBORO IS DRIVING THE HEALTH AND VITALITY OF OUR COMMUNITY BY SUPPORTING ARTS EDUCATION, CELEBRATING THE DIVERSITY OF GREENSBORO, AND DRIVING ECONOMIC IMPACT THROUGH EXCELLENCE IN ARTS PROGRAMMING.</GrantOrContributionPurposeTxt>
          <Amt>100</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>AVON WALK TO END BREAST CANCER</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>PO BOX 3535</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10163</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THE AVON BREAST CANCER CRUSADE SEEKS TO IMPROVE BREAST CANCER OUTCOMES AND REDUCE DISPARITIES IN SURVIVAL RATES AT THE COMMUNITY AND NATIONAL LEVELS.</GrantOrContributionPurposeTxt>
          <Amt>200</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>ENDURING GRATITUDE</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>2276 W GREENSBORO CHAPEL HILL ROAD</AddressLine1Txt>
            <CityNm>SNOW CAMP</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27349</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>MISSION IS TO DEMONSTRATE GRATITUDE TO SERVICE MEN AND WOMEN BY OFFERING MEANINGFUL OUTDOOR EXPERIENCES, FREE TO THE PARTICIPANTS.</GrantOrContributionPurposeTxt>
          <Amt>250</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>BOYKIN SPANIEL RESCUE</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>1624 YORKTOWN DR</AddressLine1Txt>
            <CityNm>CHARLOTTESVILLE</CityNm>
            <StateAbbreviationCd>VA</StateAbbreviationCd>
            <ZIPCd>22901</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TO SUPPORT BOYKIN SPANIEL RESCUE, INC. IN ITS OPERATIONS DEDICATED TO THE RESCUE, REHABILITATION AND REHOMING OF UNWANTED OR NEGLECTED PUREBRED BOYKIN SPANIELS.</GrantOrContributionPurposeTxt>
          <Amt>100</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>CALDWELL ACADEMY</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>2900 HORSE PEN CREEK RD</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27410</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>CALDWELL COMPASSION FUNDRAISER AND SCHOOLWIDE DAY OF SERVICE IN THE LOCAL COMMUNITY.</GrantOrContributionPurposeTxt>
          <Amt>100</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>GATE CITY ROTARY FOUNDATION</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>4565 SPRINGMOOR CT</AddressLine1Txt>
            <CityNm>RALEIGH</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27615</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>AFTER MORE THAN A DECADE OF SERVICE, GATE CITY ROTARY REMAINS AN ACTIVE MEMBERSHIP SUPPORTING COMMUNITY CHARITIES IN THE TRIAD.</GrantOrContributionPurposeTxt>
          <Amt>500</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>GRACE COMMUNITY CHURCH</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>643 W GATE CITY BLVD</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27403</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TO SUPPORT GRACE COMMUNITY CHURCH IN STRIVING TO BRING TOGETHER GOD'S PEOPLE FROM ALL WALKS OF LIFE THAT EACH MIGHT MINISTER TO THE OTHER ACCORDING TO THEIR GIFTS AND ABILITIES.</GrantOrContributionPurposeTxt>
          <Amt>500</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>GREENSBORO CHILDRENS MUSEUM</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>220 NORTH CHURCH STREET</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THE GREENSBORO CHILDREN'S MUSEUM ENGAGES ALL CHILDREN AND FAMILIES IN HANDS-ON, FUN, LEARNING EXPERIENCES WHICH CONTRIBUTE TO THEIR GROWTH AND DEVELOPMENT THROUGH PLAY, CREATION AND OUTDOOR EXPLORATION.</GrantOrContributionPurposeTxt>
          <Amt>1350</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>GREENSBORO AIRPORT ROTARY FOUNDATION</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>4565 SPRINGMOOR CT</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THE ROTARY CLUB OF GREENSBORO IS INVOLVED IN SERVICE PROJECTS IN GREENSBORO AND THROUGHOUT THE WORLD.</GrantOrContributionPurposeTxt>
          <Amt>250</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>GREENSBORO SYMPHONY</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>200 N DAVIE ST 301</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THE GREENSBORO SYMPHONY SOCIETY WAS CREATED WITH THE GOALS OF PROMOTING AND FOSTERING MUSICAL CULTURE AND EDUCATION IN THE COMMUNITY.</GrantOrContributionPurposeTxt>
          <Amt>1000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>GUILFORD COLLEGE</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>5800 W FRIENDLY AVE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27410</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>HOWARD COBLE FORUM CONTRIBUTION TO SUPPORT PROGRAMS FEATURING EXPERTS ON IMPORTANT ISSUES INCLUDING ENVIRONMENTAL SUSTAINABILITY, HIGHER EDUCATION AND INNOVATION.</GrantOrContributionPurposeTxt>
          <Amt>145</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>HUMANE SOCIETY OF DAVIE COUNTY</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>291 EATON RD</AddressLine1Txt>
            <CityNm>MOCKSVILLE</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27028</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>THE HUMANE SOCIETY'S MISSION IS TO PREVENT CRUELTY AND SUFFERING AMONG DOGS AND CATS THROUGH RESCUE, ADOPTION, AND EDUCATION.</GrantOrContributionPurposeTxt>
          <Amt>350</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>OAKRIDGE UNITED METHODIST CHURCH</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>2424 OAK RIDGE RD</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27310</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>OAK RIDGE UNITED METHODIST CHURCH EXISTS TO MAKE FOLLOWERS OF JESUS CHRIST THROUGH INSPIRING WORSHIP; CHRIST-LIKE HOSPITALITY; VIBRANT CHILDREN, YOUTH AND ADULT MINISTRIES; NURTURING CHRISTIAN EDUCATION; AND SERVANT OUTREACH IN LOCAL, NATIONAL AND GLOBAL COMMUNITIES.</GrantOrContributionPurposeTxt>
          <Amt>300</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>OPERATION LBD</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>729 QUEENS WAY</AddressLine1Txt>
            <CityNm>AUBURN</CityNm>
            <StateAbbreviationCd>AL</StateAbbreviationCd>
            <ZIPCd>36830</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TO ASSIST BOYKIN SPANIELS IN NEED THAT ARE NOT BEING SERVED BY OTHER ORGANIZATIONS AND ULTIMATELY PLACE THESE DOGS WITH THOSE WHO WILL LOVE, NURTURE AND RESPECT THIS WONDERFUL AND HISTORIC BREED.</GrantOrContributionPurposeTxt>
          <Amt>400</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>READING CONNECTIONS</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>122 N ELM ST 920</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>ADULT LITERACY PROGRAMS FOR GUILFORD COUNTY</GrantOrContributionPurposeTxt>
          <Amt>250</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>TRIAD HEALTH PROJECT</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>801 SUMMIT AVE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27405</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TO SUPPORT THE TRIAD HEALTH PROJECT IN PROVIDING EMOTIONAL AND PRACTICAL SUPPORT TO INDIVIDUALS LIVING WITH HIV/AIDS, TO THEIR LOVED ONES, AND TO THOSE AT RISK FOR HIV/AIDS.</GrantOrContributionPurposeTxt>
          <Amt>500</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>TRIAD STAGE</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>232 S ELM ST</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27401</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TRIAD STAGE IS A PROFESSIONAL NOT-FOR-PROFIT REGIONAL THEATRE TO SERVE THE COMMUNITIES OF THE TRIAD.</GrantOrContributionPurposeTxt>
          <Amt>250</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>WOMEN'S PROFESSIONAL FORUM FOUNDATION</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>PO BOX 38594</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27438</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TO SUPPORT THE WPF FOUNDATION IN ITS MISSION OF CREATING OPPORTUNITIES FOR WOMEN AND GIRLS TO ACHIEVE THEIR LEADERSHIP AND PROFESSIONAL DREAMS.</GrantOrContributionPurposeTxt>
          <Amt>250</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>WOMEN'S RESOURCE CENTER OF GREENSBORO</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>628 SUMMIT AVE</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27405</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>WOMEN'S RESOURCE CENTER IS WOMEN HELPING WOMEN TO NAVIGATE LIFE'S HURDLES, TO ACCESS COMMUNITY SERVICES, TO DEVELOP NEW SKILL SETS, TO MOVE LIVES FORWARD.</GrantOrContributionPurposeTxt>
          <Amt>500</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1Txt>YOUNG LIFE</BusinessNameLine1Txt>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1Txt>4713 KINGSWOOD DR</AddressLine1Txt>
            <CityNm>GREENSBORO</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27408</ZIPCd>
          </RecipientUSAddress>
          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>OTHER PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>TO SUPPORT YOUNG LIFE WHICH INTRODUCES ADOLESCENTS TO JESUS CHRIST AND HELPS THEM GROW IN THEIR FAITH.</GrantOrContributionPurposeTxt>
          <Amt>2150</Amt>
        </GrantOrContributionPdDurYrGrp>
        <TotalGrantOrContriPdDurYrAmt>9845</TotalGrantOrContriPdDurYrAmt>
        <TotalGrantOrContriApprvFutAmt>0</TotalGrantOrContriApprvFutAmt>
      </SupplementaryInformationGrp>
      <AnalysisIncomeProducingActyGrp>
        <IntOnSavAndTempCashInvstGrp>
          <ExclusionCd>14</ExclusionCd>
          <ExclusionAmt>3</ExclusionAmt>
        </IntOnSavAndTempCashInvstGrp>
        <SubtotalsIncmProducingActyGrp>
          <UnrelatedBusinessTaxblIncmAmt>0</UnrelatedBusinessTaxblIncmAmt>
          <ExclusionAmt>3</ExclusionAmt>
          <RelatedOrExemptFunctionIncmAmt>0</RelatedOrExemptFunctionIncmAmt>
        </SubtotalsIncmProducingActyGrp>
        <TotalIncomeProducingActyAmt>3</TotalIncomeProducingActyAmt>
      </AnalysisIncomeProducingActyGrp>
      <TrnsfrTransRlnNonchrtblEOGrp>
        <TrnsfrOfCashToNonchrtblEOInd>0</TrnsfrOfCashToNonchrtblEOInd>
        <TrnsfrOtherAssetNonchrtblEOInd>0</TrnsfrOtherAssetNonchrtblEOInd>
        <SalesOrExchangesOfAssetsInd>0</SalesOrExchangesOfAssetsInd>
        <PurchaseOfAssetsNonchrtblEOInd>0</PurchaseOfAssetsNonchrtblEOInd>
        <RentalOfFacilitiesOthAssetsInd>0</RentalOfFacilitiesOthAssetsInd>
        <ReimbursementArrangementsInd>0</ReimbursementArrangementsInd>
        <LoansOrLoanGuaranteesInd>0</LoansOrLoanGuaranteesInd>
        <PerformanceOfServicesEtcInd>0</PerformanceOfServicesEtcInd>
        <SharingOfFacilitiesEtcInd>0</SharingOfFacilitiesEtcInd>
        <RelationshipsNonchrtblEOInd>0</RelationshipsNonchrtblEOInd>
      </TrnsfrTransRlnNonchrtblEOGrp>
    </IRS990PF>
    <AccountingFeesSchedule documentId="RetDoc2002200001">
      <AccountingFeesDetail>
        <CategoryTxt>PROFESSIONAL FEES</CategoryTxt>
        <Amt>310</Amt>
        <NetInvestmentIncomeAmt>0</NetInvestmentIncomeAmt>
        <DisbursementsCharitablePrpsAmt>310</DisbursementsCharitablePrpsAmt>
      </AccountingFeesDetail>
    </AccountingFeesSchedule>
    <OtherExpensesSchedule documentId="RetDoc2003200001">
      <OtherExpensesScheduleGrp>
        <Desc>REGISTRATION FEES</Desc>
        <RevenueAndExpensesPerBooksAmt>90</RevenueAndExpensesPerBooksAmt>
        <NetInvestmentIncomeAmt>0</NetInvestmentIncomeAmt>
        <DisbursementsCharitablePrpsAmt>90</DisbursementsCharitablePrpsAmt>
      </OtherExpensesScheduleGrp>
      <OtherExpensesScheduleGrp>
        <Desc>REPAIRS &amp; MAINTENCE</Desc>
        <RevenueAndExpensesPerBooksAmt>454</RevenueAndExpensesPerBooksAmt>
        <NetInvestmentIncomeAmt>0</NetInvestmentIncomeAmt>
        <DisbursementsCharitablePrpsAmt>454</DisbursementsCharitablePrpsAmt>
      </OtherExpensesScheduleGrp>
    </OtherExpensesSchedule>
    <TaxesSchedule documentId="RetDoc2002500001">
      <TaxesDetail>
        <CategoryTxt>EXCISE TAX</CategoryTxt>
        <Amt>1000</Amt>
        <NetInvestmentIncomeAmt>0</NetInvestmentIncomeAmt>
        <DisbursementsCharitablePrpsAmt>0</DisbursementsCharitablePrpsAmt>
      </TaxesDetail>
    </TaxesSchedule>
  </ReturnData>
</Return>