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
PIEDMONT HEALTHCARE INC
 
Employer identification number
58-1503902
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) AMERICAN CANCER SOCIETY
250 Williams Street NW
Atlanta,GA30303 		58-0566250 501(c)(3) 37,500       Sponsorship
(2) Grady Health Foundation
191 Peachtree Street Ste 820
ATLANTA,GA30303 		58-2130437 501(C)(3) 7,500       event sponsorship
(3) Atlanta Ballet Incorporated
1695 Marietta Blvd NW
ATLANTA,GA30318 		58-1047778 501(c)(3) 10,000       doctors for dance event
(4) MARCH OF DIMES
1652 CHURCH STREET
DECATUR,GA30333 		13-1846366 501(c)(3) 19,000       march for babies sponsor
(5) American Heart Association
7272 Greenville Ave
Dallas,TX75231 		13-5613797 501(c)(3) 175,000       gala Sponsorship
(6) Atlanta Charity Clays Inc
780 Johnson Ferry Rd Ste 325
Atlanta,GA30342 		47-2835630 501(c)(3) 15,000       event Sponsorship
(7) ElevateD Sports Academy
2211 Harbin Terrace Dr
Morrow,GA30260 		61-1781035 501(c)(3) 15,000       tuition sponsorship
(8) It's the Journey
270 Carpenter Dr Ste 515
Atlanta,GA30328 		47-0897591 501(c)(3) 10,000       atlanta 2-day walk
(9) Cathedral of St Philip
2744 Peachtree Rd NW
Atlanta,GA30305 		58-0641230 501(c)(3) 8,050       farmers' market sponsor
(10) Reimagine ATL Inc
910 Bishopswood Pl
Alpharetta,GA30022 		46-5278779 501(c)(3) 8,333       Douglass High School Program
(11) American Lung Association
55 Wacker Dr Ste 1150
Chicago,IL60601 		13-1632524 501(c)(3) 20,000       climb atlanta event
(12) Georgia Ensemble Theatre Co
PO Box 607
Roswell,GA30077 		58-2002934 501(c)(3) 15,000       event sponsorship
(13) Georgia Professional Health PROGRAM
1034 Winding Ridge Court
Atlanta,GA30338 		27-4592137 501(c)(3) 8,000       event sponsorship
(14) Georgia Transplant Foundation
500 Sugar Mill Rd Ste 170A
Atlanta,GA30350 		58-2075193 501(c)(3) 25,000       event sponsorship
(15) Junior League of Atlanta
3154 Northside Pkwy NW
Atlanta,GA30327 		58-0600947 501(c)(3) 15,000       sponsorship
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
15
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: MONITORING THE USE OF GRANT FUNDS MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CARE CAUSES. THE GRANTS ARE ADMINISTERED AND MONITORED THROUGH THE ORGANIZATION'S PUBLIC RELATIONS DEPARTMENT.
Schedule I (Form 990) 2015



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