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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
KAUAI UNITED WAY
 
Employer identification number
99-0146288
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) BOY SCOUTS OF AMERICA
3088-C AUKELE STREET
LIHUE,HI96766 		99-0073482 501C3 11,270       GENERAL SUPPORT
(2) CHILD AND FAMILY SERVICES
2970 KELE STREET 2ND FLOOR
LIHUE,HI96766 		99-0073483 501C3 12,670       GENERAL SUPPORT
(3) FRIENDS OF THE KAUAI DRUG COURT
C/O 4393 KUKUI GROVE ST STE 102
LIHUE,HI96766 		46-0520304 501C3 7,000       GENERAL SUPPORT
(4) FRIENDSHIP CLUB
4-1751 KUHIO HIGHWAY
KAPAA,HI96746 		99-0325672 501C3 6,449       GENERAL SUPPORT
(5) GIRL SCOUT COUNCIL OF HAWAII
4268-I RICE STREET
LIHUE,HI96766 		99-0034788 501C3 10,350       GENERAL SUPPORT
(6) KAUAI ECONOMIC OPPORTUNITY
PO BOX 1027
LIHUE,HI96766 		99-0112851 501C3 13,000       GENERAL SUPPORT
(7) KAUAI ECONOMIC OPPORTUNITY-HOMELESS
PO BOX 1027
LIHUE,HI96766 		99-0112851 501C3 12,887       GENERAL SUPPORT
(8) SALVATION ARMY LIHUE
PO BOX 1431
LIHUE,HI96766 		99-0073540 501C3 8,744       GENERAL SUPPORT
(9) YMCA
PO BOX 1786
LIHUE,HI96766 		99-0074494 501C3 14,000       GENERAL SUPPORT
(10) CATHOLIC CHARITIES
3343 KANAKOLU STREET
LIHUE,HI96766 		99-0073547 501C3 16,357       GENERAL SUPPORT
(11) LEGAL AID SOCIETY OF HI - KAUAI
4334 RICE STREET 204A
LIHUE,HI96766 		99-0076020 501C3 10,113       GENERAL SUPPORT
(12) MENTAL HEALTH KOKUA
1221 KAPIOLANI BLVD 345
HONOLULU,HI96814 		99-0154505 501C3 14,210       GENERAL SUPPORT
(13) BIG BROTHERS BIG SISTERS
3-2600 KAUMUALII HWY
LIHUE,HI96766 		99-0109970 501C3 10,261       GENERAL SUPPORT
(14) PARENTS AND CHILDREN TOGETHER
4-1579 KUHIO HIGHWAY STE 201A
KAPAA,HI96746 		99-0119678 501C3 5,858       GENERAL SUPPORT
(15) LIFE BRIDGES HAWAII
PO BOX 1965
LIHUE,HI96766 		99-0146288 501C3 7,761       GENERAL SUPPORT
(16) HAWAII FOODBANK-KAUAI
3285 WAAPA ROAD
LIHUE,HI96766 		99-0317431 501C3 14,827       COVID EMERGENCY GRAN
(17) PATCH
3016 UMI STREET 203
LIHUE,HI96766 		99-0167464 501C3 8,140       COVID EMERGENCY GRAN
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
 
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
SCHEDULE I, PAGE 1, PART I, LINE 2 AGENCIES SUPPORTED BY THE ORGANIZATION ARE VISITED BY THE BOARD AND EXECUTIVE DIRECTOR DURING THE YEAR. SUPPORTED AGENCIES ARE REQUIRED TO ATTEND A HEARING TO GO OVER USE OF GRANTS AND SUBMIT FINANCIAL STATEMENTS.
Schedule I (Form 990) 2021



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