Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
 
 
Employer identification number
03-0272383
Part I
General Information on Grants and Assistance
1
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? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated 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)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1)  
PO BOX 493
MIDDLEBURY,VT05753
23-7302549 3 9,415       REDUCE OPERATG COSTS
(2)  
CHARLES AVE
MIDDLEBURY,VT05753
03-6003514 GOV 11,042       PROGRAM SUPPORT
(3)  
CHARLES AVE
MIDDLEBURY,VT05753
03-6003514 GOV 12,112       PROGRAM SUPPORT


















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
5
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014
Page 2

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (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












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
SCHEDULE I, PAGE 1, PART I, LINE 2 MAHA (MIDDLEBURY AMATEUR HOCKEY ASSOCIATION) AND MUHS VARSITY TEAMS RECEIVE ASSISTANCE THROUGH THE FUNDRAISING THAT OCCURS BY FRIENDS OF MIDDLEBURY HOCKEY, INC. IN ORDER TO RECEIVE SUCH ASSISTANCE THE REQUESTING ORGANIZATIONS MUST PROVIDE WRITTEN DOCUMENTATION AS TO HOW THE FUNDS WILL BE USED. IN ADDITION, BOTH MAHA & MUHS VARSITY TEAMS HAVE A REPRESENTATIVE ON THE FOMH, INC. BOARD THAT EACH ACT AS A LIASON BETWEEN THE ORGANIZATIONS TO REPORT ON ACTIVITIES OF THE RECIPIENT ORGANIZATIONS AND TO HELP CARRY OUT THE DIRECTIVES ESTABLISHED TO FURTHER THE MISSION OF FOMH, INC. THE GRANTS MADE TO FAIR HAVEN UNION HIGH SCHOOL, MT ABE UNION HIGH SCHOOL, AND VERGENNES UNION HIGH SCHOOL ARE FOR A MEMBER TO MEMBER PROGRAM ALLOWING STUDENTS TO PLAY ON THE MUHS VARSITY HOCKEY TEAMS.
Schedule I (Form 990) 2014



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