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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
COVANTAGE CARES FOUNDATION INC
 
Employer identification number
81-1056981
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) FRIENDS OF CAMP BATAWAGAMA
PO BOX 482
IRON RIVER,MI49935 		34-1832902 501(C)(3) 54,166       GENERAL SUPPORT
(2) BIG BROTHERS BIG SISTERS OF NORTHCENTRAL WISCONSIN INC
2600 STEWART AVV RM/STE 262
WAUSAU,WI54401 		39-1258616 501(C)(3) 52,739       WEEKEND BACKPACK PROGRAM & GENERAL SUPPORT
(3) SHAWANO AREA MATTHEW 25 INC
213 EAST GREEN BAY ST
SHAWANO,WI54166 		46-5493989 501(C)(3) 52,620       GENERAL SUPPORT
(4) UNITED WAY OF LANGLADE COUNTY INC
PO BOX 594
ANTIGO,WI54409 		39-1374401 501(C)(3) 51,463       GENERAL SUPPORT
(5) ELCHO FOOD PANTRY
PO BOX 404
ELCHO,WI54428 		47-4882455 501(C)(3) 19,181       GENERAL SUPPORT
(6) ASPIRUS IRON AREA HEALTH FOUNDATION
PO BOX 468
IRON RIVER,MI49935 		38-3762132 501(C)(3) 10,000       GENERAL SUPPORT
(7) NORTHWOODS UNITED WAY INC
PO BOX 177
RHINELANDER,WI54501 		39-1247457 501(C)(3) 6,053       GENERAL SUPPORT
(8) IRON COUNTY CANCER UNIT
1020 N 7TH AVE
IRON RIVER,MI49935 		38-3361072 501(C)(3) 5,836       GENERAL SUPPORT
(9) ANTIGO AREA COMMUNITY FOOD PANTRY
2120 PROGRESS BLVD
ANTIGO,WI54409 		45-4834406 501(C)(3) 5,000       GENERAL SUPPORT
(10) BOYS AND GIRLS CLUB OF THE WAUSAU AREA
PO BOX 2386
WAUSAU,WI54402 		39-1850386 501(C)(3) 5,000       GENERAL SUPPORT
(11) CATHOLIC CHARITIES OF THE DIOCESE OF LA CROSSE INC
PO BOX 266
LA CROSSE,WI54602 		39-1896823 501(C)(3) 5,000       GENERAL SUPPORT
(12) LANGLADE AREA MOUNTAIN BIKING
PO BOX 344
ELCHO,WI54428 		26-3026111 501(C)(3) 5,000       GENERAL SUPPORT
(13) NORTHWOODS ALLIANCE FOR TEMPORARY HOUSING INC
PO BOX 913
RHINELANDER,WI54501 		27-0991363 501(C)(3) 5,000       GENERAL SUPPORT
(14) SS MARY AND HYANCINTH FUND
819 3RD AVE
ANTIGO,WI54409 		39-0806874 501(C)(3) 5,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
14
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)
(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 ORGANIZATION SELECTS ORGANIZATIONS TO GRANT TO BASED ON THEIR MISSION ALIGNING WITH THE MISSION OF COVANTAGE CARES.
Schedule I (Form 990) 2017



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