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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
NORTHWEST WISCONSIN COMMUNITY
SERVICES AGENCY INC
Employer identification number
39-1091469
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) NORTHWOODS WOMEN INC
301 ELLIS AVENUE
ASHLAND,WI54806 		39-1364912 3 9,104       HOMELESS PREVENTION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
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) FOOD - COMMODITIES 11187   423,139 GOV'T COST FOOD
(2) FOOD - MEALS 3333   10,983 MEALS/LB FOOD
(3) HOMELESS PREVENTION 222 84,143      
(4) HOTEL VOUCHERS 32 18,477      
(5) TRANSPORTATION 58 1,106      
(6) CLIENT SUPPORT SERVICES 3 2,162      
(7) LIGHT BULBS - ENERGY PROG 200 52,992      
(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 ALL PROGRAMS HAVE ESTABLISHED PROCESSES FOR VERIFYING ELIGIBILITY PRIOR TO RECEIVING ASSISTANCE.
SCHEDULE I, PAGE 4, PART IV FOOD ASSISTANCE - COMMODITIES RECEIPIENTS IS BASED ON THE NUMBER OF MEALS GIVEN OUT TO ELIGIBLE HOUSEHOLDS DURING THE YEAR THROUGH ALL SITES, EXCEPT FOR THE DOUGLAS COUNTY FOOD SHELF AND SOUP KITCHEN WHICH IS DETAILED IN LINE 2. FOOD ASSISTANCE - MEALS RECIPIENTS IS BASED ON THE CUMULATIVE TOTAL OF THE MONTHLY INDIVIDUALS SERVED THROUGH THE DOUGLAS COUNTY FOOD SHELF AND SOUP KITCHEN. ALL OTHER ASSISTANCE RECIPIENTS IS BASED ON NUMBER OF HOUSEHOLDS/INDIVIDUALS SERVED.
Schedule I (Form 990) 2022



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