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
59-1844633
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)  
1116 FRANKFORD AVE
PANAMA CITY,FL32401 		59-1352672 501(C)(3) 863,117       ELDER SERVICES
(2)  
16859 N EAST CAYSON ST
BLOUNSTOWN,FL32424 		59-1945679 501(C)(3) 180,121       ELDER SERVICES
(3)  
79 LASALLE LEFFALL DRIVE
QUINCY,FL32351 		20-2779901 501(C)(3) 362,854       ELDER SERVICES
(4)  
120 LIBRARY DRIVE
PORT ST JOE,FL32456 		59-1777183 501(C)(3) 162,115       ELDER SERVICES
(5)  
210 WEST KANSAS AVE
BONIFAY,FL32425 		59-1311210 501(C)(3) 178,327       ELDER SERVICES
(6)  
5400 CLIFF ST
GRACEVILLE,FL32440 		59-1613298 501(C)(3) 349,140       ELDER SERVICES
(7)  
1155 N JEFFERSON ST
MONTICELLO,FL32344 		59-2015689 501(C)(3) 219,074       ELDER SERVICES
(8)  
2518 WEST TENNESSEE ST
TALLAHASSEE,FL32304 		59-1426079 501(C)(3) 957,370       ELDER SERVICES
(9)  
PO BOX 730
BRISTOL,FL32321 		59-1769552 501(C)(3) 194,258       ELDER SERVICES
(10)  
PO BOX 204
MADISON,FL32341 		23-7097794 501(C)(3) 311,006       ELDER SERVICES
(11)  
800 W ASH ST
PERRY,FL32347 		20-3093915 501(C)(3) 200,287       ELDER SERVICES
(12)  
33 MICHAEL DRIVE
CRAWFORDVILLE,FL32327 		59-1316667 501(C)(3) 254,554       ELDER SERVICES
(13)  
1348 SOUTH BOULEVARD
CHIPLEY,FL32428 		59-1485912 501(C)(3) 300,384       ELDER SERVICES
(14)  
2119 DELTA BOULEVARD
TALLAHASSEE,FL32303 		51-0197090 501(C)(3) 30,246       ELDER SERVICES
(15)  
192 14TH STREET
APALACHICOLA,FL32320 		59-1777183 501(C)(3) 85,672       ELDER SERVICES
(16)  
33 MICHAEL DRIVE
CRAWFORDVILLE,FL32327 		59-1316667 501(C)(3) 109,648       ELDER SERVICES
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
16
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
PART I, LINE 2: THE SUB-RECIPIENTS ARE BEING INFORMED OF THE CFDA/CSFA TITLE AND NUMBER AND THE AWARD'S NAME AND NUMBER THROUGH THE CONTRACT AGREEMENTS AND ARE BEING ADVISED OF THE REQUIREMENTS IMPOSED ON THEM BY FEDERAL LAWS, REGULATIONS, AND THE PROVISIONS OF CONTRACT/GRANT AGREEMENTS. MONITORING OF SUB-RECIPIENTS IS BEING DONE AT LEAST ONE TIME PER YEAR. IF A PROVIDER HAS SIGNIFICANT FINDINGS, THEN A CORRECTIVE ACTION PLAN IS REQUIRED AND THE PROVIDER WILL BE MONITORED AGAIN TO ENSURE THAT PROCEDURES HAVE BEEN ESTABLISHED TO CORRECT THE DEFICIENCIES. 4. ALL AUDIT REPORTS ARE REVIEWED TO ENSURE THERE ARE NO PROBLEMS. A DOEA CHECKLIST IS COMPLETED TO ENSURE THAT THE SUB RECIPIENT AUDIT IS IN COMPLIANCE. IF PROBLEMS ARE IDENTIFIED WITHIN THE AUDIT REPORT, THEN A CORRECTIVE ACTION PLAN IS SUBMITTED TO THE ORGANIZATION, WHO WILL SUBSEQUENTLY MONITOR THE PROBLEMS THAT WERE FOUND TO ENSURE THAT THE DEFICIENCIES HAVE BEEN CORRECTED.
Schedule I (Form 990) 2014



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