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
2016
Open to Public
Inspection
Name of the organization
Heart to Heart International
 
Employer identification number
48-1108359
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
noncash assistance		 (h) Purpose of grant
or assistance
(1) WOMEN OF WORTH INC
1513 DEAN STREET
ROME,GA30161 		80-0306378 501(C)(3)   91,418 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(2) CONVOY OF HOPE
330 SOUTH PATTERSON
SPRINGFIELD,MO65802 		68-0051386 501(C)(3)   88,769 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(3) AMERICARES
88 HAMILTON AVENUE
STAMFORD,CT06902 		06-1008595 501(C)(3)   73,311 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(4) EUNICE COMMUNITY HEALTH CENTER
450 MOOSA BLVD SUITE E
EUNICE,LA70535 		27-0213992 501(C)(3)   69,594 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(5) PENOBSCOT COMMUNITY HEALTH CENTER
103 MAINE AVE
BANGOR,ME04401 		01-0514750 501(C)(3)   60,239 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(6) SAVE THE CHILDREN FEDERATION
501 KINGS HIGHWAY EAST SUITE 400
FAIRFIELD,CT06825 		06-0726487 501(C)(3)   57,222 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(7) CATHOLIC CHARITIES OF THE DIOCESE OF BATON ROUGE
1900 South Acadian Thruway
BATON ROUGE,LA70821 		72-0590685 501(C)(3)   49,123 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(8) DIRECT RELIEF
27 S LA PATERA LANE
SANTA BARBARA,CA93117 		95-1831116 501(C)(3)   46,056 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(9) SERVE THE PEOPLE
1206 EAST 17TH STREET SUITE 101
SANTA ANA,CA92701 		27-0421556 501(C)(3)   35,760 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(10) OUR LADY OF HOPE
4232 MERCIER
KANSAS CITY,MO64111 		44-0546494 501(C)(3)   33,478 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(11) MILES AGAINST MELANOMA
PO BOX 190
GRAIN VALLEY,MO64029 		35-2391462 501(C)(3)   32,862 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(12) OUT PACING MELANOMA
11939 NOLAND STREET
OVERLAND PARK,KS66213 		45-3704195 501(C)(3)   26,222 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(13) INLAND BEHAVIORAL AND HEALTH SERVICES INC
1963 NORTH E STREET
SAN BERNARDINO,CA92405 		95-3246624 501(C)(3)   22,324 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(14) CITY UNION MISSION
1100 EAST 11TH STREET
KANSAS CITY,MO641063095 		44-6005481 501(C)(3)   18,466 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(15) GOOD HEALTH CLINIC
91555 OVERSEAS HIGHWAY SUITE 2
TAVERNIER,FL33070 		04-3745805 501(C)(3)   18,420 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(16) WYANDOTTE COUNTY JUVENILE DETENTION
710 NORTH 7TH STREET SUITE 20
KANSAS CITY,KS66101 		48-1194075 501(C)(3)   16,411 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(17) OKLAHOMA LIONS SERVICE FOUNDATION
4123 NW 10TH
OKLAHOMA CITY,OK73107 		23-7396135 501(C)(3)   16,161 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(18) KANSAS CITY CARE CLINIC
3515 BROADWAY
KANSAS CITY,MO64111 		43-0967292 501(C)(3)   13,907 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(19) SALVATION ARMY - TEXAS DIVISION
6500 HARRY HINES BLVD
DALLAS,TX75235 		22-2406433 501(C)(3)   13,354 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(20) REMOTE AREA MEDICAL
2200 Stock Creek Blvd
ROCKFORD,TN37853 		62-1650446 501(C)(3)   12,323 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(21) NATIONAL OSTEOPATHIC MEDICAL ASSOCIATION
PO BOX 5651
PHILADELPHIA,PA19129 		36-2170786 501(C)(3)   12,215 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(22) MAUI MEMORIAL MEDICAL CENTER
221 MAHALANI STREET
WAILUKU,HI96793 		99-0330698 501(C)(3)   10,762 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(23) TRI-CITY HEALTH CENTER
39465 PASEO PADRE PARKWAY
FREMONT,CA94538 		23-7255435 501(C)(3)   10,379 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(24) HELPCARE CLINIC
PO BOX 3227
KEARNEY,NE68848 		46-5551263 501(C)(3)   10,011 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(25) RIVERVIEW HEALTH SERVICES INC
722 REYNOLDS AVENUE
KANSAS CITY,KS66101 		48-1072716 501(C)(3)   8,096 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(26) KIDS LIVING BRAVE
8421 UNIVERSITY BLV STE G
CLIVE,IA50325 		45-3565845 501(C)(3)   8,035 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(27) BATON ROUGE FIRST CHURCH OF THE NAZARENE
9955 OLD HAMMOND HWY
BATON ROUGE,LA70816 		72-0788735 501(C)(3)   7,770 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(28) PALMER COLLEGE FOUNDATION
1000 BRADY STREET
DAVENPORT,IA52803 		42-6081293 501(C)(3)   6,896 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(29) MISSION OF HOPE CLINIC
10500 E 350 HWY
RAYTOWN,MO64138 		26-0240331 501(C)(3)   6,371 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(30) TURNER HOUSE CLINIC
21 NORTH 12TH STREET SUITE 300
KANSAS CITY,KS66102 		48-1151382 501(C)(3)   6,024 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(31) OCHSNER MEDICAL CENTER BATON ROUGE
1700 Medical Center Drive
BATON ROUGE,LA70816 		20-5296918 501(C)(3)   5,654 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(32) KC PET PROJECT
4400 RAYTOWN RD
KANSAS CITY,MO64129 		45-3067615 501(C)(3)   5,284 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(33) HEALTHFINDERS COLLABORATIVE
710 DIVISION STREET
NORTHFIELD,MN55057 		20-1805262 501(C)(3)   5,259 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
(34) SAVED BY GRACE MINISTRY INC
226 Center Road
EAST AURORA,NY14052 		16-1560404 501(C)(3)   5,181 FMV PHARMACEUTICALS, MEDICAL SUPPLIES AND HYGIENE ITEMS MEDICAL ASSISTANCE
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
34
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) 2016
Page 2

Schedule I (Form 990) 2016
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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash 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: RECIPIENT ORGANIZATIONS ARE REQUIRED TO PROVIDE HEART TO HEART WITH DISTRIBUTION REPORTS AND OTHER DOCUMENTATION SUCH AS PHOTOGRAPHS DETAILING THE HUMANITARIAN IMPACT OF THE DONATION. HEART TO HEART AND/OR DISTRIBUTION PARTNER ORGANIZATION STAFF PERSONALLY CONDUCT SITE VISITS AND FIELD INVESTIGATIONS FOR SPECIFIED RECIPIENTS EACH YEAR.
Schedule I (Form 990) 2016



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