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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
WAKE FOREST UNIVERSITY HEALTH SCIENCES
 
Employer identification number
22-3849199
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) WAKE FOREST UNIVERSITY
1834 WAKE FOREST RD BOX 7201
WINSTONSALEM,NC27109 		56-0532138 501(C)(3) 2,000,000 0     ACADEMIC ENRICHMENT FUND
(2) LEXINGTON MEDICAL CENTER FOUNDATION INC
PO BOX 1817 250 HOSPITAL DRIVE
LEXINGTON,NC27293 		58-1876553 501(C)(3) 10,000 0     SUPPORTING THE OPERATIONS OF THE FOUNDATION'S MISSION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

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) SCHOLARSHIPS AND FELLOWSHIPS 1392 12,797,240      
(2) ASSISTANCE TO PATIENTS - FINANCIAL ASSISTANCE 61 4,351      
(3) ASSISTANCE TO PATIENTS - TRANSPORTATION 158 1,605      
(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
PART I, LINE 2: THE ORGANIZATION FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED.
SCHEDULE I, PART III, GRANTS & OTHER ASSISTANCE TO DOMESTIC INDIVIDUALS THE ORGANIZATION MONITORS THE ACADEMIC PROGRESS AND OTHER ACHIEVEMENTS OF STUDENTS RECEIVING SCHOLARSHIPS AND FELLOWSHIPS.
Schedule I (Form 990) 2021



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