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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
2020
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) ACS ALLEGHENY EAST CONFERENCE OF SEVENTH-DAY ADVENTIST
767 DOUGLASS DR
DOUGLASSVILLE,PA19518 		23-6000040 501C(3)   6,970 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES (NITRILE GLOVES) DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES DURING THEIR FOOD PANTRY OPERATIONS.
(2) TEXAS CONFERENCE OF SEVENTH-DAY ADVENTIST
1211 US-67
ALVARADO,TX76009 		75-0939961 501C(3)   519,119 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES DONATION IN RESPONSE TO THE COVID-19 PANDEMIC. THIS INCLUDE, GOWNS, FACEMASKS, EXAM GLOVES, SPECULUMS, BLOOD PRESSURE CUFFS, BANDAGES AND MANY OTHER MEDICAL ITEMS.
(3) ADRA - PUERTO RICO
PO BOX 3269
MAYAGUEZ,PR006813269 		66-0558432 501C(3) 3,933 20,789 FMV BLANKETS AND TENT STORAGE FOR TARPS FOR DISASTER PREPAREDNESS. BLANKETS AND TENT DONATIONS FOR THE PURPOSE OF DISTRIBUTING TO THE VICTIMS OF THE EARTHQUAKE IN PUERTO RICO.
(4) ADVENTIST COMMUNITY SERVICES NORTH AMERICA INC
9705 PATUXENT WOODS DRIVE
COLUMBIA,MD21046 		20-3519054 501C(3) 150,000       TO IMPLEMENT FOOD PANTRIES IN THE UNITED STATES, AND TO SUPPORT ADVENTIST MEDICAL FACILITIES, NURSING HOMES,AND OTHER HEALTH CARE INSTITUTIONS AS THEY RESPOND TO COVID-19
(5) ST HELENA HOSPITAL FOUNDATION
10 WOODLAND ROAD ST
HELENA,CA94574 		20-1384250 501C(3) 50,000       EMERGENCY ASSISTANCE TO APPROXIMATE 20,000 NAPA COUNTY RESIDENTS DISPOLACED BY THE GLASS FIRE INCIDENT.
(6) NEW JERSEY CONFERENCE OF SDA
233 BRUNSWICK AVE
LAWRENCE TOWNSHIP,NJ08648 		21-0672757 501C(3)   17,478 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES (EXAM AND SURGICAL GLOVES) DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES DURING THEIR FOOD PANTRY OPERATIONS.
(7) SOUTH CENTRAL CONFERENCE OF SDA
715 YOUNGS LN
NASHVILLE,TN37207 		62-6001383 501C(3)   16,978 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES (EXAM AND SURGICAL GLOVES) DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES DURING THEIR FOOD PANTRY OPERATIONS.
(8) IOWA-MISSOURI CONFERENCE OF SDA
1005 GRAND AVE
WEST DES MOINES,IA50265 		42-0801837 501C(3)   6,316 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES (EXAM GLOVES) DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES.
(9) MICHIGAN CONFERENCE
5801 W MICHIGAN AVE
LANSING,MI48917 		38-1467642 501C(3)   6,316 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES (EXAM AND SURGICAL GLOVES) DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES DURING THEIR FOOD PANTRY OPERATIONS.
(10) CHESAPEAKE CONFERENCE OF SDA
6600 MARTIN RD
COLUMBIA,MD21044 		52-0685419 501C(3)   442,982 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES. THIS INCLUDE, GOWNS, FACEMASKS, EXAM GLOVES, SPECULUMS, BLOOD PRESSURE CUFFS, BANDAGES AND MANY OTHER MEDICAL ITEMS.
(11) SOUTHERN CALIFORNIA CONFERENCE OF SDA
1535 E CHEVY CHASE DR
GLENDALE,CA91206 		36-4651793 501C(3)   435,213 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES. THIS INCLUDE, GOWNS, FACEMASKS, EXAM GLOVES, SPECULUMS, BLOOD PRESSURE CUFFS, BANDAGES AND MANY OTHER MEDICAL ITEMS.
(12) ALASKA CONFERENCE OF SDA
6100 OMALLEY RD
ANCHORAGE,AK99507 		92-0020506 501C(3)   401,076 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES. THIS INCLUDE, GOWNS, FACEMASKS, EXAM GLOVES, SPECULUMS, BLOOD PRESSURE CUFFS, BANDAGES AND MANY OTHER MEDICAL ITEMS.
(13) GREATER NEW YORK CONFERENCE OF SDA
7 SHELTER ROCK RD
MANHASSET,NY11030 		13-3558616 501C(3)   475,849 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES. THIS INCLUDE, GOWNS, FACEMASKS, EXAM GLOVES, SPECULUMS, BLOOD PRESSURE CUFFS, BANDAGES AND MANY OTHER MEDICAL ITEMS.
(14) LOMA LINDA UNIVERSITY HOSPITAL
125 E CLUB CENTER DRIVE
SAN BERNARDINO,CA92408 		95-3522679 501C(3)   45,470 FMV MEDICAL SUPPLIES MEDICAL SUPPLIES DONATION IN RESPONSE TO THE COVID-19 PANDEMIC DURING THE PEAK OF COVID-19 SEVERE PPE SHORTAGES. THIS INCLUDE, GOWNS, FACEMASKS, EXAM GLOVES, SPECULUMS, BLOOD PRESSURE CUFFS, BANDAGES AND MANY OTHER MEDICAL ITEMS.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
14
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) 2020

Schedule I (Form 990) 2020
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) 2020



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