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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
2023
Open to Public
Inspection
Name of the organization
THEDACARE FAMILY OF FOUNDATIONS INC
 
Employer identification number
46-4112255
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) THEDACARE INC

 
 
39-1509362 501(C)(3) 250,135       ENRICHING PATIENT EXPERIENCES
(2) THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC

 
 
39-0824015 501(C)(3) 555,900       ENRICHING PATIENT EXPERIENCES
(3) THEDACARE MEDICAL CENTER - WAUPACA INC

 
 
39-0871113 501(C)(3) 22,522       ENRICHING PATIENT EXPERIENCES
(4) THEDACARE MEDICAL CENTER - SHAWANO INC

 
 
39-0807068 501(C)(3) 122,671       ENRICHING PATIENT EXPERIENCES
(5) THEDACARE MEDICAL CENTER - NEW LONDON INC

 
 
39-0869788 501(C)(3) 31,504       ENRICHING PATIENT EXPERIENCES
(6) THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC

 
 
39-0830664 501(C)(3) 263,617       ENRICHING PATIENT EXPERIENCES
(7) THEDACARE MEDICAL CENTER - BERLIN INC

 
 
39-0806359 501(C)(3) 96,145       ENRICHING PATIENT EXPERIENCES
(8) THEDACARE MEDICAL CENTER - WILD ROSE INC

 
 
39-6089134 501(C)(3) 6,892       ENRICHING PATIENT EXPERIENCES
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
8
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) 2023
Page 2

Schedule I (Form 990) 2023
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) SCHOLARSHIPS 12 19,500      
(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, Part I, Line 2 Procedures for monitoring use of grant funds. THE ORGANIZATION ONLY WRITES CHECKS OUT FOR THE GRANTS TO ORGANIZATIONS ONCE THE ITEM OR SERVICE HAS ALREADY BEEN RECEIVED BY THE ORGANIZATION. SCHOLARSHIP CHECKS ARE WRITTEN OUT TO THE COLLEGE AND THE RECIPIENT.
Schedule I (Form 990) 2023



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