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
MIDWEST TRANSPLANT NETWORK INC
 
Employer identification number
43-1016328
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) GIFT OF LIFE INC
6405 METCALF STE 109
OVERLAND PARK,KS66202 		48-1198979 501(C)(3) 12,000       GENERAL SUPPORT
(2) TRANSPLANT GAMES OF AMERICA
217 GRANDVILLE AVE SW STE 301
GRAND RAPIDS,MI49503 		46-1252372 501(C)(3) 12,000       GENERAL SUPPORT
(3) ONELEGACY FOUNDATION
221 SOUTH FIGUEROA ST STE 500
LOS ANGELES,CA90012 		45-2936915 501(C)(3) 19,855       GENERAL SUPPORT
(4) THE UNIVERSITY OF KANSAS HOSPITAL
2330 SHAWNEE MISSION PKWY STE 302
WESTWOOD,KS66205 		48-1202402 GOVT 20,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
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) 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
SCHEDULE I, PART I, LINE 2 MIDWEST TRANSPLANT NETWORK, INC. (MTN) MONITORS THE USE OF GRANT FUNDS BY ONLY ISSUING GRANTS TO ORGANIZATIONS OR ACTIVITIES WITH WHICH IT IS VERY KNOWLEDGEABLE. BASED ON MTN'S KNOWLEDGE OF THE GRANT ACTIVITY OR PARTICIPATION IN THE EVENT FOR WHICH THE GRANT IS USED, MTN IS ABLE TO ENSURE THAT ALL GRANT FUNDS EXPENDED ARE USED IN ACCORDANCE WITH THE STATED PURPOSE.
Schedule I (Form 990) 2015



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