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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.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
JB'S KEYS TO DMD INC
 
Employer identification number
27-1060320
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) CHARLEY'S FUND INC
635 MAIN STREET STE 3
GREAT BARRINGTON,MA01230
20-2014968 501c3 100,000       DMD CLINIC
(2) TEAM JOSEPH INC
5745 W MAPLE ROAD 204
WEST BLOOMFIELD,MI48322
80-0613664 501c3 60,000       OUTREACH
(3) HOPE FOR GUS FOUNDATION
583 GREENFIELD ROAD
PETERBOROUGH,NH03458
27-2224833 501c3 5,750       RESEARCH
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
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) 2022
Page 2

Schedule I (Form 990) 2022
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) COLLEGE SCHOLARSHIPS 7 17,500 0 0 N/A
(2) FAMILY SUPPORT/HOLIDAY GIFT 85 64,139 0 0 N/A
(3) SPORTING EVENT TICKETS 9 0 3,725 FMV BRUINS HOCKEY TICKETS
(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
Pt I Line 2 GRANT ALLOCATIONS FOR RESEARCH, EDUCATION, AWARENESS AND CLINICAL SUPPORT ARE MONITORED THROUGH PERIODIC FINANCIAL REPORTS, RESEARCH PROGRESS STUDIES, PARTNERING AND SITE VISITS.
Schedule I (Form 990) 2022



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