Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
James Whitcomb Riley Memorial Association
 
Employer identification number
35-0868147
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) INDIANA UNIVERSITY
PO BOX 66057
INDIANAPOLIS,IN46266 		35-6001673 501(c)(3) 18,213,599       HOSPITAL & RESEARCH
(2) INDIANA UNIVERSITY FOUNDATION
950 N MERIDIAN ST
INDIANAPOLIS,IN46204 		35-6018940 501(c)(3) 123,117       PROFESSORSHIP
(3) INDIANA UNIVERSITY HEALTH
340 WEST 10TH STREET
INDIANAPOLIS,IN46206 		35-1955872 501(c)(3) 8,377,668       HOSPITAL PROJECTS
(4) INDIANA UNIVERSITY HEALTH PHYSICIANS
705 RILEY HSPTL DR
INDIANAPOLIS,IN46202 		35-1747218 501(C)(3) 1,788,888       HOSPITAL PROJECTS
(5) DEACONESS HOSPITAL
600 MARY STREET
EVANSVILLE,IN47747 		35-0593390 501(C)(3) 25,730       HOSPITAL PROJECTS
(6) CHRISTAMORE HOUSE
502 N TREMONT STREET
INDIANAPOLIS,IN46222 		35-0885588 501(C)(3) 20,000       COMMUNITY GRANT
(7) BIG BROTHERS BIG SISTERS OF S CENTRAL IN
807 N COLLEGE AVE STE A
BLOOMINGTON,IN47404 		35-1330448 501(C)(3) 10,000       COMMUNITY GRANT
(8) EVANSVILLE BALLET THEATRE
PO BOX 3906
EVANSVILLE,IN47737 		45-3597924 501(C)(3) 10,000       COMMUNITY GRANT
(9) FAMILY SERVICE INC
1531 13TH STREET
COLUMBUS,IN47201 		35-1148259 501(C)(3) 10,000       COMMUNITY GRANT
(10) HEALTHIER MOMS AND BABIES
750 BROADWAY STE 250
FORT WAYNE,IN46802 		35-6049685 501(C)(3) 10,000       COMMUNITY GRANT
(11) JOE'S KIDS INC
3540 COMMERCE DRIVE
WARSAW,IN46580 		46-4095781 501(C)(3) 10,000       COMMUNITY GRANT
(12) YWCA NORTH CENTRAL INDIANA
1102 FELLOWS STREET
SOUTH BEND,IN46601 		35-0868226 501(C)(3) 10,000       COMMUNITY GRANT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
12
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) 2019
Page 2

Schedule I (Form 990) 2019
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, PART I, LINE 2 EXPENDITURES FOR GRANT FUNDS ARE MONITORED QUARTERLY AND COMPARED WITH THE GRANT AWARD CUMULATIVE AMOUNT BEFORE DISBURSEMENT OF FUNDS OCCURS. ACCOUNTABILITY REPORTS ARE SOLICITED FROM GRANTEES AND REVIEWED ON AN ANNUAL BASIS.
Schedule I (Form 990) 2019



Additional Data


Software ID:  
Software Version: