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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
ADVENTIST DEVELOPMENT & RELIEF AGENCY
INTERNATIONAL
Employer identification number
52-1314847
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) LA SIERRA UNIVERSITY
4500 RIVERWALK PARKWAY
RIVERSIDE,CA92505 		33-0413730 501C(3) 0 139,776 FMV MEDICAL SUPPLIES DISPOSABLE FACEMASKS DONATION FOR DISTRIBUTION IN VACCINE HUBS FOR COVID-19.
(2) LOMA LINDA UNIVERSITY
11145 ANDERSON STREET NO 205
LOMA LINDA,CA92350 		95-1816009 501C(3) 0 416,472 FMV MEDICAL SUPPLIES DISPOSABLE FACEMASKS DONATION FOR DISTRIBUTION IN VACCINE HUBS FOR COVID-19.
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)
(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
PART I, LINE 2: ADRA DOES NOT PROGRAM PUBLICLY FUNDED GRANTS IN THE US. ADRA WORKS WITH LOCAL ORGANIZATIONS AND CHURCHES TO IMPLEMENT PRIVATELY FUNDED PROGRAMS IN THE US. THESE PROGRAMS ADHERE TO STRINGENT EMERGENCY RESPONSE INTERNATIONAL STANDARDS, AND ARE IN COMPLIANCE WITH NATIONAL COORDINATION BODIES, SUCH AS FEMA. ADRA STAFF SUPPORT THE IMPLEMENTATION OF THE PROGRAMS AND PROVIDE TECHNICAL EXPERTISE DURING THE EMERGENCY RESPONSE. THE IDENTIFICATION OF BENEFICIARIES IS DONE THROUGH HOUSEHOLD SURVEYS AND INTERVIEWS. PROGRAMMATIC IMPLEMENTATION AND COMPLIANCE ARE MONITORED THROUGH SITE VISITS, CONFERENCE CALLS AND DOCUMENT VERIFICATION.
Schedule I (Form 990) 2021



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