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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
MERCER COUNTY CIVIC FOUNDATION
 
Employer identification number
34-6539139
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) AMERICAN RED CROSS - WEST CENTRAL
227 E MAIN ST SUITE 102
OTTAWA,OH45875
  9,000        
(2) CITY OF CELINA
225 N MAIN ST
CELINA,OH45822
  30,000        
(3) CELINA CITY SCHOOLS
585 E LIVINGSTON ST
CELINA,OH45822
  30,000        
(4) CHOOSING LIFE PREGNANCY CTR
560 TOUVELLE ST
CELINA,OH45822
  9,500        
(5) COUNCIL ON AGING
217 RILEY ST
CELINA,OH45822
  23,000        
(6) FAMILY CARE OPTIONS
5327 STATE ROUTE 29
CELINA,OH45822
  7,500        
(7) JTD HOSPITAL FOUNDATION
200 ST CLAIR AVE
ST MARYS,OH45885
  10,000        
(8) MARIA STEIN SHRINE OF HOLY RELICS
2291 ST JOHNS ROAD
MARIA STEIN,OH45860
  8,000        
(9) MERCER CO EMERGENCY RESPONSE VOLUNT
PO BOX 35
COLDWATER,OH45848
  5,700        
(10) MEDICAL EDUCATION & DEVELOP FOUNDAT
800 W MAIN ST
COLDWATER,OH45828
  15,000        
(11) MERCER RESIDENTIAL SERVICES
420 S SUGAR ST PO BOX 603
CELINA,OH45822
  15,000        
(12) OUR HOME FAMILY RES
PO BOX 439
CELINA,OH45822
  11,500        
(13) RONALD MCDONALD HOUSE
555 VALLEY ST
DAYTON,OH45404
  10,000        
(14) MISC SCHOLARSHIPS
ALL LESS THAN 5000
PO BOX 439
CELINA,OH45822
  241,509        
(15) C-PAY GRANTS
ALL LESS THAN 5000
PO BOX 439
CELINA,OH45822
  1,583,093        
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
 
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
Schedule I (Form 990) 2021



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