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," on 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
2015
Open to Public
Inspection
Name of the organization
MENTAL HEALTH LEADERSHIP INITIATIVE INC
DBA THE KENNEDY FORUM
Employer identification number
46-5714524
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" on 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) IRAQ AND AFGHANISTAN VETERANS OF AMERICA
119 WEST 40TH ST 19TH FLOOR
NEW YORK,NY10018 		20-1664531 501(C)(3) 35,000       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(2) FACING ADDICTION INC
100 MILL PLAIN RD 3RD FLOOR
DANBURY,CT06811 		27-0163591 501(C)(3) 10,000       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(3) NAMI-NYC METRO
505 8TH AVE SUITE 1103
NEW YORK,NY10018 		13-3077692 501(C)(3) 5,000       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(4) HEALTH LAW ADVOCATES INC
1 FEDERAL STREET 5TH FLOOR
BOSTON,MA02110 		04-3298116 501(C)(3) 5,000       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(5) UNIVERSITY OF SOUTHERN CALIFORNIA
837 W DOWNEY WAY ROOM 315
LOS ANGELES,CA90089 		95-1642394 501(C)(3) 12,000       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(6) SAM INC
400 N COLUMBUS ST STE 202
ALEXANDRIA,VA22314 		47-2400657 501(C)(3) 80,000       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(7) THOMAS SCATTERGOOD BEHAVIROAL HEALTH FOUNDATION
4641 ROOSEVELT BOULEVARD
PHILADELPHIA,VA19124 		23-1352178 501(C)(3) 55,500       RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS WITH MENTAL ILLNESS.
(8) ONE MIND INSTITUTE
PO BOX 680
RUTHERFORD,CA94573 		68-0359707 501(C)(3) 200,000       ENABLING RESEARCH AND RAISING AWARENESS TO REMEDY THE SYMPTOMS OF AND RESTORE FUNCTION FOR PERSONS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
8
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) 2015
Page 2

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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)
(2)
(3)
(4)
(5)
(6)
(7)
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 KENNEDY FORUM RECEIVES AND REVIEWS REGULAR REPORTING FROM GRANTEE ORGANIZATIONS REGARDING THE USE OF FUNDS RECEIVED.
Schedule I (Form 990) 2015



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