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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.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
WISCONSIN COMMUNITY ACTION PROGRAM
ASSOCIATION INCORPORATED
Employer identification number
39-1209035
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) ADVOCAP INC
19 W FIRST STREET
FOND DU LAC,WI54936
39-1053365 501(C)(3) 69,700 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(2) CAP SERVICES INC
2900 HOOVER ROAD SUITE A
STEVENS POINT,WI54481
39-1080897 501(C)(3) 63,300 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(3) CENTRAL WISCONSIN COMMUNITY ACTION COUNCIL INC
1000 HWY 13
WISCONSIN DELLS,WI53965
39-1051779 501(C)(3) 37,914 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(4) COULEECAP INC
201 MELBY STREET
WESTBY,WI54667
39-1077614 501(C)(3) 38,600 0     JOBS AND BUSINESS DEVELOPMENT, PROGRAM SUPPORT AND CRISIS COUNSELING PROGRAM
(5) NEWCAP INC
1201 MAIN STREET
OCONTO,WI54153
39-1050492 501(C)(3) 247,536 0     JOBS AND BUSINESS DEVELOPMENT, CRISIS COUNSELING PROGRAM AND PROGRAM SUPPORT
(6) SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM INC
149 NORTH IOWA STREET
DODGEVILLE,WI53533
39-1053511 501(C)(3) 244,753 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(7) WESTERN DAIRYLAND ECONOMIC OPPORTUNITY COUNCIL INC
PO BOX 125
INDEPENDENCE,WI54747
39-1076993 501(C)(3) 63,000 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(8) LAKESHORE CAP INC OF WISCONSIN
PO BOX 2315
MANITOWOC,WI54221
39-1214392 501(C)(3) 6,500 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(9) COMMUNITY RELATIONS - SOCIAL DEVELOPMENT COMMISSION
1730 W NORTH AVENUE
MILWAUKEE,WI53205
39-1033230 501(C)(3) 524,447 0     CRISIS COUNSELING PROGRAM AND PROGRAM SUPPORT
(10) COMMUNITY ACTION INC ROCKWALWORTH
20 ECLIPSE CENTER
BELOIT,WI53511
39-1052077 501(C)(3) 5,500 0     JOBS AND BUSINESS DEVELOPMENT AND PROGRAM SUPPORT
(11) COMMUNITY ACTION COALITION FOR SOUTH CENTRAL WISCONSIN
1717 N STOUGHTON ROAD
MADISON,WI53704
39-1053827 501(C)(3) 706,001 0     CRISIS COUNSELING PROGRAM AND PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
11
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021
Page 2

Schedule I (Form 990) 2021
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 WISCONSIN COMMUNITY ACTION PROGRAM ASSOCIATION, INCORPORATED (WISCAP) WILL CONDUCT MONITORING OF ALL SUB-CONTRACTS (SUB-RECIPIENTS) ON AN ANNUAL BASIS. SUB-RECIPIENTS WILL BE MONITORED ON-SITE ON A THREE-YEAR ROTATING BASIS. IN OTHER YEARS, WISCAP WILL REQUIRE INFORMATION TO BE SUBMITTED TO WISCAP FOR REVIEW. INFORMATION TO BE REVIEWED INCLUDES PARTICIPANT INFORMATION (DOCUMENTATION OF ELIGIBILITY, PROVISION OF SERVICES, ETC.); FINANCIAL AND PAYROLL INFORMATION; AND PERFORMANCE DOCUMENTATION. IF DURING THE MONTHLY OR QUARTERLY OR ANNUAL MONITORING OF FINANCIAL AND PROGRAMMATIC REPORTS AND INVOICES, WISCAP DEEMS THAT ACTIVITIES ARE INCONSISTENT WITH THE GOALS OF THE FUNDED PROGRAM OR TERMS OF THE SUB-CONTRACT, PROGRAM PERFORMANCE STANDARDS HAVE NOT BEEN MET, OR THAT OTHER SUBSTANTIAL MANAGEMENT, FINANCIAL OR SERVICES PROBLEMS EXIST, WISCAP WILL CONTACT THE EXECUTIVE DIRECTOR TO DISCUSS THE ISSUE AND WISCAP MAY ISSUE A REQUIREMENT FOR CORRECTIVE ACTION. IF CORRECTIVE ACTIONS ARE NOT TAKEN BY THE SUB-CONTRACTING AGENCY, THE WISCAP EXECUTIVE DIRECTOR SHALL INFORM THE WISCAP BOARD OR APPROPRIATE BOARD COMMITTEE TOGETHER WITH ANY RECOMMENDATIONS FOR ACTION BY THE BOARD OF DIRECTORS.
Schedule I (Form 990) 2021



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