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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
OREGON IMPACT
 
Employer identification number
93-1258474
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) AUMSVILLE POLICE DEPARTMENT
597 MAIN ST
AUMSVILLE,OR97325 		  7,240 0 FMV   DUII EDUCATION PROGRAMS
(2) BEAVERTON POLICE DEPARTMENT
4755 SW GRIFFIN DR
BEAVERTON,OR97005 		  78,563 0 FMV   DUII EDUCATION PROGRAMS
(3) CANBY POLICE DEPARTMENT
1175 NW 3RD AVE
CANBY,OR97013 		  14,011 0 FMV   DUII EDUCATION PROGRAMS
(4) COOS BAY POLICE DEPARTMENT
500 CENTRAL AVE
COOS BAY,OR97420 		  7,464 0 FMV   DUII EDUCATION PROGRAMS
(5) EUGENE POLICE DEPARTMENT
300 COUNTRY CLUB RD
EUGENE,OR97401 		  41,438 0 FMV   DUII EDUCATION PROGRAMS
(6) GLADSTONE POLICE DEPARTMENT
535 PORTLAND AVE
GLADSTONE,OR97027 		  7,268 0 FMV   DUII EDUCATION PROGRAMS
(7) GRANTS PASS POLICE DEPARTMENT
101 NW A STREET
GRANTS PASS,OR97526 		  37,078 0 FMV   DUII EDUCATION PROGRAMS
(8) INDEPENDENCE POLICE DEPARTMEN
555 S MAIN ST
INDEPENDENCE,OR97351 		  7,451 0 FMV   DUII EDUCATION PROGRAMS
(9) KEIZER POLICE DEPARTMENT
930 CHEMAWA RD NE
KEIZER,OR97303 		  5,068 0 FMV   DUII EDUCATION PROGRAMS
(10) LAKE OSWEGO POLICE DEPARTMENT
380 A AVE
LAKE OSWEGO,OR97034 		  5,139 0 FMV   DUII EDUCATION PROGRAMS
(11) LINCOLN CITY POLICE DEPARTMEN
1503 SE EAST DEVILS LAKE ROAD
LINCOLN CITY,OR97367 		  5,288 0 FMV   DUII EDUCATION PROGRAMS
(12) MCMINNVILLE POLICE DEPARTMENT
121 SE ADAMS ST
MCMINNVILLE,OR97128 		  38,275 0 FMV   DUII EDUCATION PROGRAMS
(13) MYRTLE CREEK POLICED DEPARTME
215 NW PLEASANT ST
MYRTLE CREEK,OR97457 		  5,257 0 FMV   DUII EDUCATION PROGRAMS
(14) PORTLAND POLICE DEPARTMENT
1111 SW 2ND AVE
PORTLAND,OR97204 		  73,636 0 FMV   DUII EDUCATION PROGRAMS
(15) PRINEVILLE POLICE DEPARTMENT
400 NE 3RD ST
PRINEVILLE,OR97754 		  5,080 0 FMV   DUII EDUCATION PROGRAMS
(16) REDMOND POLICE DEPARTMENT
777 SW DESCHUTES AVE
REDMOND,OR97756 		  5,223 0 FMV   DUII EDUCATION PROGRAMS
(17) ROCKAWAY POLICE DEPARTMENT
220 N HWY 101
ROCKAWAY,OR97136 		  5,856 0 FMV   DUII EDUCATION PROGRAMS
(18) SALEM POLICE DEPARTMENT
555 LIBERTY ST NE
SALEM,OR97301 		  20,646 0 FMV   DUII EDUCATION PROGRAMS
(19) SILVERTON POLICE DEPARTMENT
306 S WATER AVE
SILVERTON,OR97381 		  7,072 0 FMV   DUII EDUCATION PROGRAMS
(20) SPRINGFIELD POLICE DEPARTMENT
230 4TH ST
SPRINGFIELD,OR97477 		  9,191 0 FMV   DUII EDUCATION PROGRAMS
(21) THE DALLES POLICE DEPARTMENT
401 COURT ST
THE DALLES,OR97058 		  11,451 0 FMV   DUII EDUCATION PROGRAMS
(22) UNIVERSITY OF OREGON POLICE D
2141 E 15TH AVE
EUGENE,OR97403 		  6,392 0 FMV   DUII EDUCATION PROGRAMS
(23) WEST LINN POLICE DEPARTMENT
1800 8TH AVE
WEST LINN,OR97068 		  7,344 0 FMV   DUII EDUCATION PROGRAMS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
23
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
Schedule I (Form 990) 2017



Additional Data


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