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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
SPECIAL OLYMPICS ARIZONA INC
 
Employer identification number
86-0307564
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) ARIZONA TRANSPORTATION EDUCATION FOUNDATION
7500 W MADISON ST
TOLLESON,AZ85353
27-0284164 501(C)(3) 15,000       PROGRAM SERVICE
(2) ST MARY'S FOOD BANK
2831 N 31ST AVE
PHOENIX,AZ85009
23-7353532 501(C)(3) 10,000       PROGRAM SERVICE
(3) JEWISH FAMILY & CHILDREN'S SERVICES
4747 N 7TH STREET STE 100
PHOENIX,AZ85014
86-0096781 501(C)(3) 20,000       PROGRAM SERVICE
(4) JUNIOR GOLF ASSOCIATION OF ARIZONA
10888 N 19TH AVE
PHOENIX,AZ85029
86-0464216 501(C)(3) 10,000       PROGRAM SERVICE
(5) HACIENDA HEALTHCARE
1402 E SOUTH MOUNTAIN AVE
PHOENIX,AZ85042
86-0253158 501(C)(3) 12,782       PROGRAM SERVICE
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
5
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) 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: IN COORDINATION WITH SPECIAL EVENTS HELD, SPONSORS DESIGNATE AN AMOUNT OF THEIR GRANT TO BE ALLOCATED TO A SPECIFIC CHARITY ORGANIZATION. THE SPONSOR CHOOSES A CHARITY OF THEIR CHOICE AND THE AMOUNT OF THEIR GRANT ALLOCATED TO THAT CHOSEN CHARITY. THERE IS NO REPORTING OR SPECIFIC USE TO THE FUNDS.
Schedule I (Form 990) 2017



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