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
53-0159200
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)  
1701 K STREET NW
WASHINGTON,DC20006 		53-0242038   12,500       DINNER SPONSOR
(2)  
802 KENT AVENUE
BROOKLYN,NY11205 		45-3813436   7,500       DONATION
(3)  
36-12 34TH AVE 4TH FL
ASTORIA,NY11106 		13-3962392   7,500       DINNER SPONSOR
(4)  
ROUTE 79 - 5722 CABIN CREEK
DAWES,WV25054 		55-0709223   10,000       PULMONARY REHABILITATION PROJECT
(5)  
815 16TH STREET NW
WASHINGTON,DC20006 		52-2277805   6,000       DONATION
(6)  
16619 NORTH HAGLER ROAD
NORTHPORT,AL35475 		45-5210764   6,500       DONATION
(7)  
PO BOX 66268
WASHINGTON,DC20036 		52-1128179   8,000       DONATION
(8)  
PO BOX 8200
MORGANTOWN,WV26506 		55-0643304   25,000       DONATION
(9)  
1444 I STREET NW STE 910
WASHINGTON,DC20005 		52-1746328   7,500       DINNER SPONSOR
(10)  
1020 W BRYN MAWR 4TH FL
CHICAGO,IL60660 		36-4063982   11,500       DONATION
(11)  
1616 P STREET NW STE 150
WASHINGTON,DC20036 		22-2604923   10,000       DINNER SPONSOR


2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
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 (Form 990) 2014



Additional Data


Software ID:  
Software Version: