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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
WICKENBURG COMMUNITY SERVICES
CORPORATION
Employer identification number
86-0310614
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) FOUNDATION FOR SENIOR LIVING
460 S WEST ROAD
WICKENBURG,AZ85390 		86-0298945 501(C)(3) 71,624 0 N/A N/A FINANCIAL ASSISTANCE
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
0
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) CAP INDIVIDUAL ASSISTANCE 8   5,109 COST GAS VOUCHERS, PRESCRIPTIONS, XEROX
(2) HOLIDAY FOOD BASKET 285   32,912 COST FOOD VOUCHERS, HYGIENE ITEMS
(3) BACK TO SCHOOL 280   35,047 COST SCHOOL SUPPLIES AND CLOTHES
(4) WELLIK FDN GIFTCARDS 388   50,000 COST GIFTCARDS
(5) THANKSGIVING MEAL 128   1,586 COST THANKSGIVING MEALS
(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: FINANCIAL ASSISTANCE IS PROVIDED TO OTHER PUBLIC CHARITIES WITH 501(C)(3) EXEMPT STATUS. THE ORGANIZATION DOES NOT FEEL FURTHER MONITORING IS NECESSARY. CAP ASSISTANCE IS TO PROVIDE CRISIS HELP TO CITIZENS IN NEED WHO PROVE THEY CANNOT AFFORD TO PURCHASE GAS FOR THEIR VEHICLES OR PAY FOR THEIR PRESCRIPTIONS. FSL ISSUES NUMBERED AND SIGNED VOUCHERS AS PART OF THEIR WORK IN THE WELLIK SENIOR CENTER AND WCSC PAYS THE APPROVED INVOICES. CHRISTMAS HOLIDAY FOOD & HYGIENE RECIPIENTS PROVING NEED RECEIVE A FOOD VOUCHER FROM BASHAS THE BACK TO SCHOOL PROGRAM CHILDREN RECEIVE A BACK PACK WITH SCHOOL SUPPLIES, NEW PAIR OF SHOES AND TWO FULL OUTFITS. $100 GIFT CARDS ARE HANDED OUT TO SENIORS/FAMILIES IN NEED THROUGHOUT WICKENBURG AND SURROUNDING COMMUNITIES AS PART OF A PROGRAM SPONSORED BY THE WELLIK FOUNDATION.
Schedule I (Form 990) 2022



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