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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.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
SCHOLARSHIP AMERICA INC
 
Employer identification number
23-7039405
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) PUTNAM COUNTY COMMUNITY FOUNDATION
2 S JACKSON STREET
GREENCASTLE,IN46135 		31-1159916 501(C)(3) 13,525   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(2) COMMUNITY FOUNDATION OF ELKHART COUNTY
300 NIBCO PARKWAY STE 301
ELKHART,IN46516 		31-1255886 501(C)(3) 12,570   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(3) DEARBORN COMMUNITY FOUNDATION
322 WALNUT STREET
LAWRENCEBURG,IN47025 		35-2036110 501(C)(3) 10,000   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(4) SOUTH CENTRAL IOWA COMMUNITY FOUNDATION
108 N GRAND
CHARITON,IA50049 		42-1411234 501(C)(3) 9,631   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(5) OMAHA COMMUNITY FOUNDATION
302 SOUTH 36TH ST STE 100
OMAHA,NE68131 		47-0645958 501(C)(3) 7,500   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(6) COMMUNITY FOUNDATION OF JOHNSON COUNTY
325 E WASHINGTON STREET
IOWA CITY,IA52240 		42-1508117 501(C)(3) 9,275   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(7) COMMUNITY FOUNDATION OF NORTHEAST IOWA
3117 GREENHILL CIR
CEDAR FALLS,IA50613 		42-6060414 501(C)(3) 25,000   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(8) INDEPENDENT SCHOOL DISTRICT # 786
310 CENTRAL AVE S
BERTHA,MN56437 		41-6008395 GOVT 10,003   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(9) COMMUNITY GIVING
101 7TH AVE S STE 100
ST CLOUD,MN56301 		36-3412544 501(C)(3) 50,000   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(10) NEW HAMPSHIRE CHARITABLE FOUNDATION
39 PLEASANT STREET
CONCORD,NH03301 		02-6005625 501(C)(3) 102,784   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(11) ROCHESTER AREA COMMUNITY FOUNDATION
500 EAST AVE
ROCHESTER,NY14607 		23-7250641 501(C)(3) 90,000   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(12) GREATER TACOMA COMMUNITY FOUNDATION
950 PACIFIC AVE STE 1220
TACOMA,WA98402 		91-1007459 501(C)(3) 8,500   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
(13) INLAND NORTHWEST COMMUNITY FOUNDATION
421 W RIVERSIDE AVE STE 606
SPOKANE,WA992010405 		91-0941053 501(C)(3) 15,794   FMV N/A INVESTMENT TO FUND FUTURE SCHOLARSHIPS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
13
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) 2017
Page 2

Schedule I (Form 990) 2017
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) SCHOLARSHIPS 16732 17,855,142      
(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: THESE FUNDS WERE DONATED TO THE COMMUNITY FOUNDATIONS LISTED AND ARE NO LONGER THE PROPERTY OF THE SUBORDINATE GROUPS. INVESTMENT EARNINGS ARE DONATED BY THE COMMUNITY FOUNDATIONS TO THE RESPECTIVE SUBORDINATE GROUPS EACH YEAR TO FUND SCHOLARSHIPS. AFFILIATES SUBMIT SCHOLARSHIPS AWARDED TO THE COLLEGES AND UNIVERSITIES THAT THE RECIPIENTS ARE ATTENDING TO BE APPLIED TO STUDENT ACCOUNTS.
Schedule I (Form 990) 2017



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