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
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
CATHOLIC CHARITIES COMMUNITY SERVICES
ARCHDIOCESE OF NEW YORK
Employer identification number
13-5562185
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 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. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code 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) GOOD SHEPHERD SERVICES
12 WEST 12TH STREET
NEW YORK,NY10011 		13-5598710 501(C)(3) 29,025   N/A N/A FUND PARTIAL SCHOLARSHIPS FOR STUDENTS
(2) CARDINAL MCCLOSKEY SERVICES
115 STEVENS AVENUE
VALHALLA,NY10595 		13-1740443 501(C)(3) 10,163   N/A N/A SUMMER YOUTH PROGRAM GRANT
(3) CSWA CHINESE WORKERS & STAFF
PO BOX 130401
NEW YORK,NY10013 		12-3456789 501(C)(3) 7,500   N/A N/A SANDY RELIEF EFFORT SUPPORT
(4) NMASS NATIONAL
PO BOX 130293
NEW YORK,NY10013 		98-7654321 501(C)(3) 7,500   N/A N/A SANDY RELIEF EFFORT SUPPORT
(5) EL CENTRO DEL IMMIGRANTE
1546 CASTLETON AVE
STATEN ISLAND,NY10302 		13-2456789 501(C)(3) 15,000   N/A N/A SANDY RELIEF EFFORT 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
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012
Page 2

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. 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
(1) FOOD AND SHELTER SERVICES FOR INDIGENTS, ETC. 58902 1,511,431   N/A N/A
(2) DIRECT CASH ASSISTANCE/CLIENT MONEY MANAGEMENT 627 203,788   N/A N/A
(3) OTHER RELIEF EXPENSES/CASE MANAGEMENT 4225 871,537   N/A N/A








Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS AND OTHER ASSISTANCE TO GOVERNMENTS AND ORGANIZATIONS - OPERATING GRANTS WERE MADE FOR SPECIFIC USES TO NOT-FOR-PROFIT RECIPIENTS WELL KNOWN TO THE ORGANIZATION AND WERE APPROVED BY THE EXECUTIVE DIRECTOR BASED ON STAFF RECOMMENDATIONS. GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS - THE MAJOR TYPES OF ASSISTANCE TO THOUSANDS OF INDIVIDUALS INCLUDES EMERGENCY FOOD SUPPORT, HOUSING/EVICTION PREVENTION ASSISTANCE, UTILITIES CUTOFF ASSISTANCE AND ASSISTANCE FOR OTHER DAILY LIVING REQUIREMENTS. PARTICIPANTS ARE REQUIRED TO MEET PROGRAM ELIGIBILITY REQUIREMENTS DETERMINED BASED ON INITIAL SCREENING AND SUPERVISORY APPROVALS.
Schedule I (Form 990) 2012


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