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 Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
Lions Clubs International Foundation
 
Employer identification number
23-7030455
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) The GAVI Campaign
1776 I Eye Street NW
Washington,DC20006 		91-2004617 501 (C) 3 2,500,000       LCIF- GAVI Partnership to Support Measles Immunization Programs
(2) Special Olympics
1133 19th Street NW
Washington,DC20036 		52-0889518 501 (C) 3 1,689,000       Special Olympics - 2017
(3) LCI Diabetes Pilot Projects Program
300 W 22nd Street
Oak Brook,IL60523 		  750,000       LCI Diabetes Pilot Projects Program is a block grant to fund many smaller pilot activities that support the Lions new global initiative, diabetes.
(4) Remote Area Medical
2200 Stock Creek Blvd
Rockford,TN37853 		58-1647546 501 (C) 3 250,000       Humanitarian Award 2017
(5) KidSight USA Block Grant
300 W 22nd Street
Oak Brook,IL60524 		  200,000       KidSight USA Block Grant II is a block grant to fund many small individual projects that support childhood vision screening.
(6) Lions Quest community Partnership
300 W 22nd Street
Oak Brook,IL60523 		  200,000       Lions Quest Community Partnership Grants. This is a block grant to fund many small individual projects that promote growth of the Lions Quest program. The grantees have not yet been determined.
(7) District 12 O
327 Creekshire Dr
Signal Mountain,TN37377 		51-0170754 501 (C) 4 166,110       Low Vision Rehabilitation Project in Tennessee
(8) Multiple District 22
104 Milford Avenue
Wilmington,DE198091227 		23-7050709 501 (C) 4 130,000       Lions Low Vision Rehabilitation Network
(9) Multiple District 33
43 STEWART TERRACE
BELMONT,MA02478 		83-0504460 501 (C) 4 128,800       Low Vision Rehabilitation Project
(10) District 20 R1
1 Croton Point Avenue
CrotononHudson,NY10520 		13-3876121 501 (C) 4 100,000       Construct Vocational Rehabilitation Center
(11) District 27 B1
205 Fern Ln
Oxford,WI53952 		23-7159372 501 (C) 4 100,000       Equip Handicapped Accessible Playground
(12) District 12 N
220 Portwood Rd
Clinton,TN377164302 		23-7215448 501 (C) 4 100,000       Equip Handicapped Accessible Playground
(13) District 25 B
595 EAST SR 124
MONROE,IN46772 		23-7313213 501 (C) 4 100,000       Facility Expansion for Transport Services
(14) District 5M 6
12117 INDIAN RIVER TRAIL
HASTINAGS,MN550338544 		23-7327790 501 (C) 4 100,000       Equip Handicapped Accessible Playground
(15) District 33 K
228 Rolling Meadow Drive
Holliston,MA01746 		23-7328862 501 (C) 4 100,000       Purchase and Equip Mobile Screening Unit
(16) District 1 A
6628 WOOD RIVER DRIVE
NILES,IL60714 		36-6106638 501 (C) 4 100,000       Construct Center at Chicago Lighthouse for the Blind
(17) District 32 A
503 Verdae Drive
Spartanburg,SC29301 		57-0898989 501 (C) 4 100,000       Equip Handicapped Accessible Playground
(18) District 30 M
349 BROOKS AVE
BOYLE,MS387309629 		64-6027945 501 (C) 4 100,000       Miracle League Field for the Disabled
(19) District 2 S5
PO Box 776
Weimar,TX789621622 		74-2549056 501 (C) 4 100,000       Equip Handicapped Accessible Playground
(20) District 2 S5
335 Club View Drive
La Grange,TX78945 		74-2549056 501 (C) 4 100,000       Equip Recreational Play Area for the Disabled
(21) District 15
P O BOX 368
PINE BLUFFS,WY82082 		83-6009532 501 (C) 4 100,000       Equip Handicapped Accessible Playground
(22) Multiple District 8
4220 Haring Rd
Metairie,LA700062514 		58-1838966 501 (C) 4 100,000       Louisiana Flooding Disaster 2016
(23) District 20 E2
444 RT 245
RUSHVILLE,NY14544 		80-0262267 501 (C) 4 100,000       Construct Corning Hospice Care House
(24) District 49 A
7138 Waterfall Dr
Eagle River,AK99577 		92-0168503 501 (C) 4 100,000       Expand Lions Quest
(25) District 4 A1
3450 Arrowhead Street
Copperopolis,CA95228 		23-7426310 501 (C) 4 97,000       Equip Nature Trail for the Disabled
(26) District 18 L
42 Waterside Court
Ellijay,GA305368354 		58-6043799 501 (C) 4 90,000       Equip Good Samaritan Health and Wellness Center
(27) Multiple District 5M
6770 150TH AVE N W
NEW LONDON,MN56273 		41-1278740 501 (C) 4 86,100       Purchase Vision Screening Equipment
(28) District 36 E
PO Box 495
SUTHERLIN,OR97479 		27-2280716 501 (C) 4 85,000       Dogs for the Deaf Kennel Expansion
(29) Multiple District 3
4833 DELVIEW DR
DEL CITY,OK73115 		23-7050631 501 (C) 4 75,000       Equip Oklahoma Lions Eye Bank
(30) Multiple District 34
1737 East Bank Road
Prattville,AL36067 		23-7050708 501 (C) 4 75,000       Equip Callahan Eye Hospital of Alabama
(31) District 37
703 CONWAY ST
BILLINGS,MT591053301 		38-3951273 501 (C) 4 75,000       Renovate Ennis Seniors Center
(32) Multiple District 33
147 Wilson Avenue
Quincy,MA02170 		83-0504460 501 (C) 4 75,000       Equip Boston Medical Center
(33) District 20 E1
PO Box 118
Hamlin,NY144640118 		16-0743906 501 (C) 4 75,000       Equip Miracle League Field of Rochester
(34) District 14 W
710 MARKET ST
KINGSTON,PA18704 		23-2483171 501 (C) 4 71,400       Equip Geisinger Hospital NICU
(35) Multiple District 12
122 Mt View Avenue
McMinnville,TN371101739 		58-1721334 501 (C) 4 68,588       World Sight Day 2016
(36) District 26 M1
41160 Maries Road 633
Dixon,MO65459 		43-6051716 501 (C) 4 59,375       Renovate Camp Brim Shire
(37) Multiple District 31
207 Archer Ln
Faison,NC28341 		56-0652336 501 (C) 4 54,580       Equip UNC Kittner Eye Center
(38) District 35 I
3614 ASBURY DR
PARRISH,FL342199389 		65-0718435 501 (C) 4 50,000       Equip WPEC School for Special Needs Children
(39) Multiple District 13
13840 Robinson Road
Plain City,OH43064 		31-6064520 501 (C) 4 50,000       Renovate Canine Companions of Ohio
(40) District 20 K2
227 OAK STREET
BELLMORE,NY11710 		11-6032817 501 (C) 4 48,300       Renovate Beacon House for the Blind
(41) Lions KidSight USA Foundation
PO Box 833
Corning,NY14830 		81-3844584 501 (C) 3 40,799       Lions KidSight USA Program
(42) District 2 X3
2517 Crystal Dr
Temple,TX765027382 		23-7291235 501 (C) 4 40,000       Equip Handicapped Accessible Playground
(43) District 24 E
370 Windsor Dr
Christiansburg,VA24073 		54-1113433 501 (C) 4 38,150       Expand Lions Quest
(44) District 5M 2
523 SKYVIEW LANE
CARVER,MN55315 		41-6039926 501 (C) 4 35,000       Renovate Lions Seniors Facility
(45) District 5M 8
39929 Fox Road
Hinckley,MN55037 		41-1390009 501 (C) 4 31,385       Equip Midwest Outdoors Disability Program
(46) District 35 N
5851 SW 11 ST
WEST MIAMI,FL331445163 		27-2753280 501 (C) 4 30,000       Miami Lighthouse for the Blind Expansion Project
(47) District 16 N
15 CREST DR
MIDLAND PARK,NJ074321312 		47-1314821 501 (C) 4 30,000       Purchase Surgical Microscope for Eversight New Jersey
(48) District 24 B
10409 Hyannis Drive
RICHMOND,VA23236 		54-1736852 501 (C) 4 30,000       Purchase and Equip Mobile Health Unit
(49) Multiple District 13
13840 Robinson Road
Plain City,OH43064 		31-6064520 501 (C) 4 25,000       Expand Lions Quest
(50) District 22 C
263 Cove Drive
Lusby,MD20657 		23-7050709 501 (C) 4 23,730       Expand Lions Quest
(51) District 4 L5
11821 Arliss Court
Grand Terrace,CA92313 		95-6133182 501 (C) 4 22,518       Purchase Vision Screening Equipment
(52) District 14 F
510 Vine Street
Tionesta,PA16353 		23-7326285 501 (C) 4 20,546       Meadville Projects for Blind
(53) District 31 N
1107 CHELTON COURT NW
CALABASH,NC28467 		47-4280673 501 (C) 4 20,000       Hurricane Relief
(54) District 20 E2
444 RT 245
RUSHVILLE,NY14544 		80-0262267 501 (C) 4 20,000       Equip Handicapped Accessible Playground
(55) District 36 G
3096 ELIOT DRIVE
HOOD RIVER,OR97031 		23-7309411 501 (C) 4 16,412       Equip CHD Vision Clinic
(56) District 27 B1
205 Fern Ln
Oxford,WI53952 		23-7159372 501 (C) 4 15,000       Equip Wisconsin Lions Camp for Visually Impaired
(57) District 14 J
209 INEZ ST
JOHNSTOWN,PA159041536 		25-1648442 501 (C) 4 14,884       Group Lifestyle Balance Program
(58) District 5M 4
12069 BLUEGILL DR
SAUK CENTRE,MN563789803 		41-1280401 501 (C) 4 14,165       Purchase Vision Screening Equipment
(59) District 13 OH2
1841 COUNTY RD 1095
ASHLAND,OH44805 		34-1196352 501 (C) 4 12,510       Purchase Vision Screening Equipment
(60) District 25 D
108 Canterbury Ct
Anderson,IN460123907 		31-0949232 501 (C) 4 10,995       Purchase Vision Screening Equipment
(61) Americus Lions Club
PO BOX 6254
AMERICUS,GA31709 		58-6038025 501 (C) 4 10,000       Tornado Relief
(62) District 4 A2
38207 SHOREWOOD LANE
SQUAW VALLEY,CA93675 		23-7086254 501 (C) 4 10,000       Wildfire Relief
(63) District 14 M
206 HEINBAUGH ST
CONFLUENCE,PA15424 		23-7179780 501 (C) 4 10,000       Flood Relief
(64) District 14 E
2908 ROUTE 982
MOUNT PLEASANT,PA15666 		23-7295767 501 (C) 4 10,000       Equip Lions Sight and Hearing Program
(65) District 35 L
150 Rivershore Drive
San Mateo,FL32187 		23-7330297 501 (C) 4 10,000       Hurricane Relief
(66) District 26 M5
PO Box 386
Osawatomie,KS66064 		27-1314487 501 (C) 4 10,000       Tornado Relief
(67) District 35 N
16455 SW 236th Street
Homestead,FL33031 		27-2753280 501 (C) 4 10,000       Hurricane Relief
(68) District 32 C
1002 N Park St Ext
MULLINS,SC29574 		30-0327084 501 (C) 4 10,000       Hurricane Relief
(69) District 25 D
108 Canterbury Ct
Anderson,IN460123905 		31-0949232 501 (C) 4 10,000       Tornado Relief
(70) District 2 X2
2001 LAKESIDE
BONHAM,TX75418 		36-3204821 501 (C) 4 10,000       Tornado Relief
(71) District 26 M2
6347 MARDEL AVE
ST LOUIS,MO63109 		43-6036432 501 (C) 4 10,000       Flood Relief
(72) District 25 E
1206 E Main Street
Petersburg,IN47567 		46-1983200 501 (C) 4 10,000       Tornado Relief
(73) District 8 O
502 Cheneau Rd
Kaplan,LA70548 		46-3408569 501 (C) 4 10,000       Flood Relief
(74) District 1 BK
262 BROADWAY
MARSEILLES,IL61341 		47-1879591 501 (C) 4 10,000       Tornado Relief
(75) District 32 B
333 SPRINGHOUSE DRIVE
AIKEN,SC29803 		57-0761379 501 (C) 4 10,000       Hurricane Relief
(76) District 4 C6
Cabrillo Host LC
Aptos,CA950010094 		77-0324761 501 (C) 4 10,000       Wildfire Relief
(77) District 21 B
2871 N Melpomene Dr
TUCSON,AZ85749 		86-0399553 501 (C) 4 10,000       Flood Relief
(78) District 8 N
59526 BADON ST
SLIDELL,LA70460 		90-0620515 501 (C) 4 10,000       Flood Relief
(79) District 30 S
87122 Golf Club Drive
Diamondhead,MS39525 		26-2492853 501 (C) 4 10,000       Tornado Relief
(80) District 31 S
7014 WEXFORD WOODS TRL
RALEIGH,NC276137059 		47-4491571 501 (C) 4 9,964       Hurricane Relief
(81) District 7 O
2811 WOOD ST
JONESBORO,AR724017032 		51-0177276 501 (C) 4 9,757       Flood Relief
(82) District 17 K
903 Delay St
Downs,KS67437 		47-0973669 501 (C) 4 9,692       Wildfire Relief
(83) District 26 M3
937 BROADMOOR LN
SAINT CHARLES,MO633016203 		26-2780017 501 (C) 4 9,471       Disaster Preparedness
(84) District 9 NE
904 8TH AVE
BELLE PLAINE,IA52208 		23-7309647 501 (C) 4 9,240       Tornado Relief
(85) District 12 N
709 Shannondale Way
Maryville,TN37803 		23-7215448 501 (C) 4 9,177       Wildfire Relief
(86) District 12 O
229 County Road 616
Athens,TN37303 		51-0170754 501 (C) 4 8,806       Tornado Relief
(87) District 35 O
2385 Carriage Run Rd
Kissimmee,FL34741 		23-7332945 501 (C) 4 8,375       Flood Relief
(88) District 1 CS
3504 Highland Ave
Cairo,IL62914 		51-0199783 501 (C) 4 7,124       Tornado Relief
(89) District 4 C1
1010 NORTHGATE
WILLOWS,CA95988 		23-7327243 501 (C) 4 7,103       Disaster Preparedness
(90) District 26 M1
41160 Maries Road 633
Dixon,MO65459 		43-6051716 501 (C) 4 6,013       Tornado Relief
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
86
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2016

Schedule I (Form 990) 2016
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)
(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. Grant awards are subject to board approval and recipients must meet requirements necessary to receive said grant. LCIF staff monitors the requirements on a regular basis to ensure all awards are proper. After grants are disbursed in part or in full, the recipient must provide an interim or final report, which includes financial documentation of the use of grant funds and local matching funds and a narrative of the actions taken in developing the project. The interim or final report is initially reviewed and approved by the grant administrator. The report is then reviewed and approved by the district cabinet (or multiple district council) before submission to LCIF.
Schedule I (Form 990) 2016



Additional Data


Software ID: 16000421
Software Version: 2016v3.0