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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
MATTHEW 25 INC
 
Employer identification number
35-1484951
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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
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) PRESCRIPTION MEDICATION 16405   5,241,759 RETAIL PRESCRIPTIONS
(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, PAGE 1, PART I, LINE 2 ONCE ESTABLISHED AS OUR PATIENT, THEY ARE ELIGIBLE FOR ANY DONATED MEDICATIONS WE RECEIVE. THESE DONATED MEDICATIONS ARE DISPENSED AS PRESCRIBED TO EACH PATIENT. THEY ARE NOT SPECIFIC TO AN INDIVIDUAL. EACH COMPANY REQUIRES DIFFERENT MONITORING AND REPORTING. THEY ARE OUTLINED BELOW. AMERICARES AND DIRECT RELIEF SAFETY NET - THEY REQUIRE NO REPORTING. NO OBLIGATION TO MONITOR WHICH PATIENT RECEIVES WHICH MEDICATION. DIRECT RELIEF REPLENISHMENT PROGRAM - A MONTHLY UTILIZATION REPORT IS PULLED ELECTRONICALLY AT THE BEGINNING OF THE MONTH FOR THE PREVIOUS MONTH'S USAGE. THIS REPORT PULLS THE REPLENISHMENT MEDS DISPENSED TO THE CORRESPONDING PATIENT. THAT REPORT IS SUBMITTED ONLINE THROUGH THEIR REPLENISHMENT PORTAL. DISPENSARY OF HOPE (DOH) - A QUARTERLY UTILIZATION REPORT IS PULLED ELECTRONICALLY. FROM THAT REPORT THE TOTAL 30 DAY COUNTS, NUMBER OF ENCOUNTERS AND NUMBER OF UNIQUE PATIENTS IS GATHERED. THEN THOSE NUMBERS ARE SUBMITTED QUARTERLY VIA DOH'S ONLINE PORTAL. MERCK REPLENISHMENT - A MONTHLY UTILIZATION REPORT IS PULLED ELECTRONICALLY AT THE BEGINNING OF THE MONTH FOR THE PREVIOUS MONTH'S USAGE. THIS REPORT PULLS THE REPLENISHMENT MEDS DISPENSED TO THE CORRESPONDING PATIENT. THAT REPORT IS SUBMITTED VIA EMAIL. PFIZER REPLENISHMENT - A MONTHLY UTILIZATION REPORT IS PULLED ELECTRONICALLY AT THE BEGINNING OF THE MONTH FOR THE PREVIOUS MONTH'S USAGE. THIS REPORT PULLS THE REPLENISHMENT MEDS DISPENSED TO THE CORRESPONDING PATIENT. THAT REPORT IS SUBMITTED ONLINE THROUGH THEIR REPLENISHMENT PORTAL.
Schedule I (Form 990) 2021



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