Form Schedule I (Form 9 Schedule I (Form 9 Grants and Other Assistance to Organizations, Government

SCHEDULE I
(Form 990)

Name of the organization

1
2

2
3

Open to Public
Inspection
Employer identification number

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees’ eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance?
Describe in Part IV the organization’s procedures for monitoring the use of grant funds in the United States.

Part II

1

2009

Complete if the organization answered “Yes” to Form 990, Part IV, line 21 or 22.
© Attach to Form 990.

Department of the Treasury
Internal Revenue Service

Part I

OMB No. 1545-0047

Grants and Other Assistance to Organizations,
Governments, and Individuals in the United States

Yes

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered “Yes” to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed

(a) Name and address of organization
or government

(b) EIN

(c) IRC section
if applicable

(d) Amount of cash grant

(e) Amount of non-cash
assistance

(f) Method of valuation
(book, FMV, appraisal,
other)

©

(h) Purpose of grant
or assistance

©

Enter total number of section 501(c)(3) and government organizations
Enter total number of other organizations

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

(g) Description of
non-cash assistance

No

©

Cat. No. 50055P

Schedule I (Form 990) 2009

Schedule I (Form 990) 2009

Part III

(a) Type of grant or assistance

Part IV

Page

2

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 22.
Use Part IV and Schedule I-1 (Form 990) if additional space is needed.
(b) Number of
recipients

(c) Amount of
cash grant

(d) Amount of
non-cash assistance

(e) Method of valuation (book,
FMV, appraisal, other)

(f) Description of non-cash assistance

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Schedule I (Form 990) 2009

Schedule I (Form 990) 2009

Section references are to the Internal Revenue
Code unless otherwise noted.

General Instructions
Note. Terms in bold are defined in the
Glossary of the Instructions for Form
990.

Purpose of Schedule
Schedule I (Form 990) is used by an
organization that files Form 990 to provide
information on grants and other assistance
made by the filing organization during the tax
year to organizations, governments, and
individuals in the United States. Report
activities conducted by the organization
directly. Also, report activities conducted by
the organization indirectly through a
disregarded entity or a joint venture treated
as a partnership.
Grants and other assistance include awards,
prizes, allocations, stipends, scholarships,
fellowships, research grants, and similar
payments and distributions. Grants and other
assistance do not include salaries or other
compensation to employees. Grants and
other assistance also do not include grants to
affiliates that are not organized as legal entities
separate from the filing organization or grants
made to branch offices, accounts, or
employees located in the United States.
Organizations in the United States include
nonprofits or other exempt organizations,
partnerships, corporations, or other business
entities that are created or organized in the
United States or under the laws of the United
States or any state, the District of Columbia,
the Commonwealth of Puerto Rico, the
Commonwealth of the Northern Mariana
Islands, Guam, American Samoa, the United
States Virgin Islands, and an estate or trust
other than a foreign estate or trust.
Governments in the United States include
the U.S. government and the government of
any state, the District of Columbia, or any
possession of the United States, or political
subdivision thereof. A grant to a U.S.
government agency must be included on this
schedule regardless of where the agency is
located or operated.
Individuals in the United States include
persons who are U.S. citizens or residents of
the United States but do not include U.S.
citizens or residents of the United States living
or residing outside the United States at the
time the grant is paid or distributed.
Use Schedule I-1 (Form 990) as a
continuation sheet to list additional entries for
Schedule I (Form 990), Parts II or III. Use as
many Schedules I-1 (Form 990) as needed.
Except as noted regarding grants to
individuals, do not report foreign grants and
assistance on this schedule. Instead, report
them on Schedule F (Form 990), Statement of
Activities Outside the United States.

Who Must File
An organization that answered “Yes” to Form
990, Part IV, Checklist of Required Schedules,
line 21 or 22, must complete Part I and either
Part II or Part III of this schedule and attach it
to Form 990.

Page

If an organization is not required to file Form
990 but chooses to do so, it must file a
complete return and provide all of the
information requested, including the required
schedules.

Specific Instructions
Part I. General Information on
Grants and Assistance
Complete this part if the organization
answered “Yes” on Form 990, Part IV, line 21
or 22.
Lines 1 and 2. On line 1, indicate “Yes” or
“No” regarding whether the organization
maintains records to substantiate amounts,
eligibility, and selection criteria used for
grants. In general terms, describe how the
organization monitors its grants to ensure that
such grants are used for proper purposes and
are not otherwise diverted from the intended
use. For example, the organization can
describe the periodic reports required or field
investigations conducted. Use Part IV for the
organization’s narrative response to line 2.

Part II. Grants and Other
Assistance to Governments
and Organizations in the
United States
Line 1. Complete line 1 if the organization
answered “Yes” on Form 990, Part IV, line 21.
A “Yes” response means that the organization
reported more than $5,000 on Form 990, Part
IX, Statement of Functional Expenses, line 1,
column (A). Enter information only for each
recipient U.S. organization or government
entity that received more than $5,000
aggregate of grants or assistance from the
organization during the tax year.
Do not complete line 1 if the
organization checked the box in
Part II that no one recipient
received more than $5,000 from
the organization.

TIP

Enter the details of each organization or
entity on a separate line of Part II. If there are
more organizations or entities to report in Part
II than space available, report the additional
organizations or entities on Schedule I-1, Part
I. Use as many Schedules I-1 as needed. Use
Part IV if additional space is needed for
descriptions of particular column entries.
Column (a). Enter the full legal name and
mailing address of each recipient organization
or government entity.
Column (b). Enter the employer
identification number (EIN) of the grant
recipient.
Column (c). Enter the section of the
Internal Revenue Code under which the
organization receiving the assistance is
tax-exempt, if applicable (for example, a
school described in section 501(c)(3) or a
social club described in section 501(c)(7)). If a
recipient is a government entity, enter the
name of the government entity. If a recipient
is neither a tax-exempt nor a government
entity, leave column (c) blank.

3

Column (d). Enter the total dollar amount of
cash grants to each recipient organization or
entity for the tax year. Cash grants include
grants and allocations paid by cash, check,
money order, electronic fund or wire transfer,
and other charges against funds on deposit at
a financial institution.
Columns (e) and (f). Enter the fair market
value of noncash property. Describe the
method of valuation. Report property with a
readily determinable market value (for
example, market quotations for securities) at
its fair market value. For marketable securities
registered and listed on a recognized
securities exchange, measure market value on
the date the property is distributed to the
grantee by the average of the highest and
lowest quoted selling prices or the average
between the bona fide bid and asked prices.
When fair market value cannot be readily
determined, use an appraised or estimated
value.
Column (g). For noncash property or
assistance, enter a description of the property
or assistance. List all that apply. Examples of
noncash assistance include medical supplies
or equipment, pharmaceuticals, blankets, and
books or other educational supplies.
Column (h). Describe the purpose or
ultimate use of the grant funds. Do not use
general terms such as charitable, educational,
religious, or scientific. Use more specific
descriptions such as general support,
payments for nursing services, or laboratory
construction. Enter the type of assistance,
such as medical, dental, or free care for
indigent hospital patients. In the case of
disaster assistance, include a description of
the disaster and the assistance provided (for
example, “Food, shelter, and clothing for
Organization A’s assistance to Hurricane
Katrina disaster victims”). Use Part IV if
additional space is needed for descriptions.
Line 2. Add the number of recipient
organizations listed on line 1 of Schedule I
(Form 990), Part II, and Schedule I-1 (Form
990), Part I, that (a) have been recognized by
the Internal Revenue Service as exempt from
federal income tax as described in section
501(c)(3), (b) are churches, including
synagogues, temples, and mosques, (c) are
integrated auxiliaries of churches and
coventions or association of churches, or
(d) are governmental units or entities in the
United States. Enter the total.
Line 3. Add the number of recipient
organizations listed on line 1 of Schedule I
(Form 990), Part II, and Schedule I-1 (Form
990), Part I, that are not described on line 2.
This number should include organizations that
are exempt under section 501(c) other than
section 501(c)(3). Enter the total.

Part III. Grants and Other
Assistance to Individuals in the
United States
Complete Part III if the organization answered
“Yes” on Form 990, Part IV, line 22. A “Yes”
response means that the organization reported
more than $5,000 on Form 990, Part IX, line 2,
column (A).

Schedule I (Form 990) 2009

Page

Enter information for grants and other
assistance directly made to or for the benefit
of individual recipients. Do not complete Part
III for grants or assistance provided to
individuals through another organization or
entity. Instead, complete Part II, earlier. For
example, report a payment to a hospital
designated to cover the medical expenses of a
particular individual in Part III and report a
contribution to a hospital designated to
provide some service to the general public or
to unspecified charity patients in Part II.

Use more specific descriptions, such as
scholarships for students attending school in a
particular county or attending a particular
school; provision of books or other
educational supplies; food, clothing, and
shelter for indigents, or direct cash assistance
to indigents; etc. In the case of specific
disaster assistance, include a description of
the type of assistance provided and identify
the disaster (for example, “Food, shelter, and
clothing for immediate relief for Hurricane
Katrina disaster victims”).

Enter the details of each type of assistance
to individuals on a separate line of Part III. If
there are more types of assistance than space
available, report the additional assistance
transactions on Schedule I-1 (Form 990), Part
II. Use as many Schedules I-1 (Form 990) as
needed. Use Part IV if additional space is
needed for descriptions of particular column
entries.

Column (b). Enter the number of recipients for
each type of assistance. If the organization is
unable to determine the actual number,
provide an estimate of the number. Explain in
Part IV how the organization arrived at the
estimate.

Column (a). Specify type(s) of assistance
provided, or describe the purpose or use of
grant funds. Do not use general terms such as
charitable, educational, religious, or scientific.

Column (c). Enter the aggregate dollar amount
of cash grants for each type of grant or
assistance. Cash grants include grants and
allocations paid by cash, check, money order,
electronic fund or wire transfer, and other
charges against funds on deposit at a financial
institution.
Columns (d) and (e). Enter the fair market
value of noncash property. Describe the
method of valuation. Report property with a
readily determinable market value (for

4

example, market quotations for securities) at
its fair market value. For marketable securities
registered and listed on a recognized securities
exchange, measure market value by the
average of the highest and lowest quoted
selling prices or the average between the bona
fide bid and asked prices, on the date the
property is distributed to the grantee. When fair
market value cannot be readily determined, use
an appraised or estimated value.
Column (f). For noncash grants or assistance,
enter descriptions of property. List all that
apply. Examples of noncash assistance
include medical supplies or equipment,
pharmaceuticals, blankets, and books or other
educational supplies.

Part IV. Supplemental
Information
Use Part IV to provide narrative information
required in Part I, line 2, regarding monitoring
of funds. Also use Part IV to provide other
narrative explanations and descriptions, as
needed. Identify the specific part and line(s)
that the response supports. Part IV can be
duplicated if more space is needed.