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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
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) Special Olympics
1133 19th St NW
Washington,DC20036 		52-0889518 501 (C) 3 1,744,200       LCIF Special Olympics Partnership (2021-2022)
(2) Surgical Eye Expeditions International Inc
175 Cremona Drive Suite 100
Goleta,CA93117 		31-1682275 501 (C) 3 250,000       Humanitarian Award 2021-2022
(3) Louisiana Lions Eye Foundation
1104 Lori Drive
Slidell,LA70461 		23-7384897 501 (C) 3 200,000       Baldridge Endowment Special Distribution 2021
(4) LIONS CLUBS INTERNATIONAL
300 W 22nd St
Oak Brook,IL50263 		36-1263962 501 (C) 4 175,000       Afghan Ally Resettlement
(5) Research to Prevent Blindness Inc
150 S Poplar Ave
Elmhurst,IL60126 		13-3471559 501 (C) 3 150,000       Research to Prevent Blindness/LCIF Low Vision Award
(6) Global HOPE
1102 Bates Ave
Houston,TX77023 		74-1100555 501 (C) 3 100,000       Global HOPE Partnership
(7) District 2 X1
408 Greenridge Dr
Coppell,TX750195714 		23-7099350 501 (C) 4 100,000       Mobile Food Pantry
(8) District 26 M6
3633 W Morningside Pl
Springfield,MO65807 		26-3305095 501 (C) 4 100,000       All Inclusive Playground
(9) District 5M 6
12408 SKYLINE DR
BURNSVILLE,MN55337 		23-7327790 501 (C) 4 100,000       Eye Surgery Simulator
(10) Multiple District 33
43 STEWART TERRACE
BELMONT,MA02478 		83-0504460 501 (C) 4 100,000       OCT for Boston Medical Center
(11) District 4 C5
5544 DALHART WAY
SACRAMENTO,CA95835 		94-2525213 501 (C) 4 100,000       Expand UC Davis Tele-ophthalmology Program
(12) District 5M 4
516 N 10th St
Montevideo,MN562651619 		41-1280401 501 (C) 4 100,000       Construct Greenhouse for Food Production and Education
(13) District 12 N
112 Skiatook Way
Loudon,TN377743171 		23-7215448 501 (C) 4 100,000       Construct Adult Day Center
(14) District 1 H
1175 N Broad St
Galesburg,IL614012728 		36-3559600 501 (C) 4 100,000       Construct a Cold Storage Warehouse
(15) Multiple District 7
223 W Third Street
Weiner,AR72479 		23-7052631 501 (C) 4 100,000       Renovate World Services for the Blind Group Home
(16) Panhandle of Texas Lions Foundation
PO Box 489
Wheeler,TX79096 		75-2598929 501 (C) 3 100,000       Kylie Hiner Memorial Playground for Children with Disabilities
(17) District 13 OH1
3003 Freyer Rd
Elida,OH45807 		36-4839441 501 (C) 4 98,427       All Inclusive Playground
(18) District 26 M1
212 Ash St Perryville
Perryville,MO63775 		43-6051716 501 (C) 4 84,000       Equip Missouri Delta Medical Center
(19) District 43-K
203 W White Oak Street
Liectchfield,KY42577 		31-0919835 501 (C) 4 81,270       Midwestern Winter Tornado Outbreak
(20) District 4 L2
11736 Rancho Verde Drive
Whittier,CA906011907 		23-7298664 501 (C) 4 80,270       Expansion of Women's Crisis Center
(21) District 5M 8
320 Augusta Ave
Paynesville,MN56362 		41-1390009 501 (C) 4 75,000       All Inclusive Playground
(22) District 37
PO BOX 357
DENTON,MT59430 		38-3951273 501 (C) 4 75,000       Purchase Ambulance
(23) Special Olympics
1133 19th St NW
Washington,DC20036 		52-0889518 501 (C) 3 66,667       AAOT and Special Olympics Caribbean
(24) District 4 C6
46133 Meadowbrook Dr
King City,CA93930 		77-0324761 501 (C) 4 66,000       Mobile Health Unit
(25) District 14 C
1236 WHITE BIRCH LN
CARLISLE,PA170133580 		23-7333013 501 (C) 4 60,000       Expand Cold Storage Capacity in Food Bank Network
(26) District 1 M
2533 Georgetown Rd
DANVILLE,IL61832 		47-5499262 501 (C) 4 58,446       All Inclusive Playground
(27) Quarry Lions Clubs
P O BOX 561
SANDSTONE,MN550720561 		41-6038030 501 (C) 4 54,761       Panther Park Community Development
(28) District 27 B1
1901 S 8th Street
Sheboygan,WI53081 		23-7159372 501 (C) 4 50,000       All Inclusive Playground (Surfacing)
(29) District 29 I
PO Box 988
FORT ASHBY,WV26719 		31-1077296 501 (C) 4 31,980       Vehicle for Food Pantry
(30) District 20 Y
3 WEST St
Windsor,NY13865 		82-2262906 501 (C) 4 29,625       Upgrade Two Food Pantries with Cold Storage
(31) District 20 Y
3 WEST ST
WINDSOR,NY138654330 		82-2262906 501 (C) 4 26,546       Equip Waiting Room with Child Friendly Playground and Games
(32) District 1 M
621 W Jasper St
Paris,IL61944 		47-5499262 501 (C) 4 25,000       All Inclusive Playground
(33) Multiple District 20
6532 Wills Hollow
Lockport,NY14094 		16-6099328 501 (C) 4 21,030       Expansion of Project IDEAS
(34) District 14 F
13301 N Watson Run Rd
Conneaut Lake,PA163167015 		23-7326285 501 (C) 4 20,244       Meadville Projects for the Blind
(35) District 2 A3
5810 HITCHING POST
BROWNSVILLE,TX785264253 		23-7151923 501 (C) 4 20,000       All Inclusive Playground
(36) Multiple District 25
5100 W Churchhill Ct
Muncie,IN47304 		23-7007876 501 (C) 4 20,000       Equip Lions Speech and Hearing Loaner Libraries
(37) DIstrict 43 K
203 J P CAMPBELL RD
HOPKINSVILLE,KY42240 		31-0919835 501 (C) 4 20,000       Community Recovery
(38) District 11 E2
300 W 22nd St
Oak Brook,IL60523 		38-2117493 501 (C) 4 20,000       Tornado Recovery
(39) CONEJO VALLEY LIONS CLUB
PO Box 1537
Thousand Oaks,CA91358 		82-4479968 501 (C) 4 19,594       Lions-Anthem Volunteer Days (2021)
(40) Louisiana Lions Eye Foundaiton
1104 Lori Drive
Slidell,LA70461 		23-7384897 501 (C) 3 18,960       J & J Sight for Kids - Louisiana
(41) District 14 F
13301 N Watson Run Rd
Conneaut Lake,PA163167015 		23-7326285 501 (C) 4 18,861       Meadville Projects for the Blind
(42) District 5M 8
PO Box 165
Clarissa,MN56440 		41-1390009 501 (C) 4 18,250       Vision Screenings for Kids
(43) VARINA LIONS CLUB FOUNDATION INC
10003 Falconbridge Dr
Henrico,VA23238 		26-1249123 501 (C) 3 18,194       Lions-Anthem Volunteer Days (2021)
(44) Louisiana Lions Eye Foundaiton
1104 Lori Drive
Slidell,LA70461 		23-7384897 501 (C) 3 16,668       Baldridge Endowment Fund for Sight 2021
(45) Multiple District 12
709 Shannondale Way
Maryville,TN37803 		58-1721334 501 (C) 4 16,457       Purchase Vision Screening Equipment
(46) District 11 D1
9417 W PIERSON RD
FLUSHING,MI484339717 		51-0199787 501 (C) 4 16,235       Community Recovery
(47) Louisiana Lions Eye Foundation
1104 Lori Drive
SLIDELL,LA704615379 		23-7384897 501 (C) 3 15,184       Baldridge Endowment Fund for Sight
(48) INTERNATIONAL ASSOCIATION OF LIONS DISTRICT 34A
28164 J Yarbrough Road
Athens,AL35613 		23-7050708 501 (C) 4 15,000       Lions Quest Community Partnership Grant 2021
(49) District 26 M3
709 Route C
LaGrange,MO63448 		26-2780017 501 (C) 4 13,500       Equip Senior Nutrition Center
(50) District 51 O
28 Calle Mercurio Reparto Santa Ana
Sabana Grande,PR00637 		66-0791672 501 (C) 4 13,274       Host a youth softball league
(51) District 32 S
1721 Groce Meadow Rd
Taylors,SC29687 		57-0963906 501 (C) 4 13,000       Youth Vision Screening Cameras
(52) District 5M-8
3160 181st Ave NW
Andover,MN55304 		41-6153383 501 (C) 4 12,893       Peroni Endowment 2021
(53) District 4 C5
21014 CLIVUS DRIVE
GRASS VALLEY,CA95949 		94-2525213 501 (C) 4 12,000       Food for Local Food Bank
(54) Leader Dogs for the Blind
3232 Indian Lake Rd
Oxford,MI48370 		38-1366931 501 (C) 3 11,544       Peroni Endowment - Leader Dogs for the Blind
(55) District 2 S3
P O Box 1091
Taylor,TX76574 		23-7151924 501 (C) 4 11,297       ADA Accessible Park Trail
(56) District 22 D
1400 Forrest Rd
Wilmington,DE19810 		51-0325033 501 (C) 4 10,890       Slit Lamp for Lions Eye Bank of Delaware Valley
(57) District 27 A2
4435 W LAVERNA AVENUE
MEQUON,WI530922113 		23-7301404 501 (C) 4 10,726       Purchase Vision Screening Equipment
(58) District 23 B
PO BOX 380393
EAST HARTFORD,CT061380393 		06-0964500 501 (C) 4 10,000       Food for Local Food Pantries
(59) District 23 B
PO BOX 380393
EAST HARTFORD,CT061380393 		06-0964500 501 (C) 4 10,000       Gaming Carts for Children's Medical Center
(60) District 23 B
PO BOX 380393
EAST HARTFORD,CT061380393 		06-0964500 501 (C) 4 10,000       Matching Funds for Gaming Carts for Children's Medical Center
(61) District 19 H
2908 Montgomery Place
Mount Vernon,WA98274 		23-7330295 501 (C) 4 10,000       Flood Relief (USA)
(62) District 4 C1
14146 Skyway 843
Magalia,CA95954 		23-7327243 501 (C) 4 10,000       Wildfire Relief
(63) District 8 S
1108 Orchid Dr
Harvey,LA70058 		20-5245690 501 (C) 4 10,000       Hurricane Relief
(64) District 4 C5
21014 CLIVUS DRIVE
GRASS VALLEY,CA95949 		94-2525213 501 (C) 4 10,000       Wildfire Relief
(65) District 2 S4
108 Perdido Oaks Dr
Victoria,TX77905 		74-6107079 501 (C) 4 10,000       Hurricane Nicholas Relief
(66) District 2 X1
8705 BALTUSROL DR
FLOWER MOUND,TX75022 		23-7099350 501 (C) 4 10,000       Diabetes Screening and Awareness
(67) District 40 N
107 CR 5018
Bloomfield,NM87413 		23-7357862 501 (C) 4 10,000       Wildfire Relief
(68) District 31 L
200 Dula Springs Rd
Weaverville,NC28787 		47-2946988 501 (C) 4 10,000       Flood Relief
(69) District 24 L
1123 MITCHELL POINT ROAD
MINERAL,VA23117 		83-1219361 501 (C) 4 10,000       Bus for Disadvantaged Children
(70) District 8-N
15239 Salerno Drive
Prairieville,LA70769 		13-4994650 501 (C) 4 10,000       Hurricane Ida 2021
(71) District 22-D
107 W Sheldrake Circle
Dover,DE19904 		51-0325033 501 (C) 4 10,000       Hurricane Ida 2021
(72) District 14-P
402 Megan Court
Kennett Square,PA19348 		90-0421565 501 (C) 4 10,000       Hurricane Ida 2021
(73) District 8-S
1108 Orchid Dr
Harvey,LA70058 		20-5245690 501 (C) 4 10,000       Hurricane Ida 2021
(74) District 12-L
1912 E Main st
Humboldt,TN38343 		23-7240556 501 (C) 4 10,000       Midwestern Winter Tornado Outbreak
(75) District 17 N
4609 E Falcon Court
Wichita,KS67220 		48-1899585 501 (C) 4 10,000       Tornado Relief
(76) District 11 A1
40384 Emerald Lane West
Clinton Township,MI48038 		23-7077189 501 (C) 4 10,000       Flood Relief
(77) District 6 C
4490 Yukon Court 96
Wheat Ridge,CO80033 		23-7313425 501 (C) 4 10,000       Wildfire Relief
(78) District 51 C
Urb Jardines de Bayamonte
Bayamon,PR00956 		66-0359767 501 (C) 4 10,000       Flood Relief
(79) District 9 SW
1119 N Division St
Audubon,IA500251441 		33-1205931 501 (C) 4 10,000       Tornado Relief
(80) District 16 J
12 Sagmore Ave
Edison,NJ08820 		47-1326015 501 (C) 4 10,000       Hurricane Relief
(81) District 35 O
935 Highgate BLVD
Winter Garden,FL34787 		46-0684975 501 (C) 4 9,135       Disaster Preparedness
(82) District 20 N
56 VIA DONATO E
DEPEW,NY140434550 		23-7248810 501 (C) 4 8,000       Western NY Lions Vision Program
(83) District 12 I
1012 Claremont Drive
Columbia,TN38401 		58-1452525 501 (C) 4 7,447       Flood Relief
(84) District 10
W4472 OLD 352 RD
STEPHENSON,MI498879108 		38-3614110 501 (C) 4 6,935       Food and Education Materials to Address Food Insecurity
(85) District 24 L
1123 MITCHELL POINT ROAD
MINERAL,VA23117 		83-1219361 501 (C) 4 6,500       Renovate Northern Virginia Lions Eyeglass Recycling Center
(86) District 35 O
935 Highgate BLVD
Winter Garden,FL34787 		46-0684975 501 (C) 4 6,040       Equipping Satellite Beach KidSight Program with Vision Screener
(87) District 18 L
4458 Parkhurst St SW
Powder Springs,GA30127 		20-8734734 501 (C) 4 6,000       Carroll County Soup Kitchen (Anthem)
(88) District 21 S
P O BOX 233
BUCKEYE,AZ85326 		86-6053121 501 (C) 4 5,844       Flood Relief
(89) District 35 O
935 Highgate BLVD
Winter Garden,FL34787 		46-0684975 501 (C) 4 5,657       Equipping Project Right To Sight with Lens Analyzers
(90) ZIONSVILLE LIONS CLUB
750 Pineview Drive
Zionsville,IN46077 		35-6063916 501 (C) 4 5,600       KidSight Screening Program
(91) DALLASTOWN LIONS CLUB
2864 S QUEEN STREET
DALLASTOWN,PA17313 		23-6296413 501 (C) 4 5,500       Tree Planting (Enel Energy)
(92) District 12 N
709 Shannondale Way
Maryville,TN37803 		23-7215448 501 (C) 4 5,423       Wildfire Relief
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
12
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
80
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, 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) 2021



Additional Data


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