TY 2018 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
OCTAGON INC, PO BOX 74008253 CHICAGO,IL60674	MANAGEMENT	962,006
RHODE ISLAND COUNTRY CLUB, 150 NAYATT ROAD PO BOX 74 BARRINGTON,RI02806	RENTAL SERVICES	353,629
DUNKIN' DONUTS CENTER, LA SALLE SQUARE PROVIDENCE,RI02903	RENTAL SERVICES	299,883
EXQUISITE EVENTS, 22 SEXTANT LANE SUITE B NARRAGANSETT,RI02882	ENTERTAINMENT	238,441
PRANZI CATERING, 10 ROSARIO DRIVE PROVIDENCE,RI02909	CATERING	171,024
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 11

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	2,419,220	4,212,533	4,157,037	4,048,803	3,787,181	18,624,774
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	2,419,220	4,212,533	4,157,037	4,048,803	3,787,181	18,624,774
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..						3,667,692
6	Public support. Subtract line 5 from line 4.						14,957,082

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	2,419,220	4,212,533	4,157,037	4,048,803	3,787,181	18,624,774
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	228	191	208	195	0	822
9	Net income from unrelated business activities, whether or not the business is regularly carried on..						0
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..						0
11	Total support. Add lines 7 through 10						18,625,596

Gross receipts from related activities, etc. (see instructions) ..................

23,815,212

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

80.304 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

79.514 %

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization CVS HEALTH CHARITY CLASSIC INC

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization CVS HEALTH CHARITY CLASSIC INC		Employer identification number 05-0508742

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization CVS HEALTH CHARITY CLASSIC INC			Employer identification number 05-0508742
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO AFFILIATES	68
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	68
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	7,791,078
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b	102,670
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	6,983,067
e	Add lines 2a through 2d .....................			2e	7,085,737
3	Subtract line 2e from line 1..................			3	705,341
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	705,341

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	7,971,337
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	102,670
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	6,983,067
e	Add lines 2a through 2d....................			2e	7,085,737
3	Subtract line 2e from line 1...................			3	885,600
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	885,600

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART XI, LINE 2D	$6,983,067 RECLASSIFY FUNDRAISING EXPENSES.
SCHEDULE D, PART XII, LINE 2D	$6,983,067 RECLASSIFY FUNDRAISING EXPENSES.
SCHEDULE D, PART X, LINE 2D	FIN 48 FOOTNOTE THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE ORGANIZATION HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GOLF/AUCTION (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	6,872,051	6,872,051
2	Less: Contributions . . . .	2,970,824	2,970,824
3	Gross income (line 1 minus line 2) . . . . . .	3,901,227	3,901,227

4	Cash prizes . . . . .	1,698,500	1,698,500
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	900,998	900,998
7	Food and beverages . . .	690,840	690,840
8	Entertainment . . . .	597,348	597,348
9	Other direct expenses . . .	3,095,381	3,095,381
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		6,983,067
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-3,081,840

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

2018

Open to Public
Inspection

Name of the organization
CVS HEALTH CHARITY CLASSIC INC

Employer identification number
05-0508742

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Alzheimer's Foundation of America 322 Eighth Ave New York,NY10001	91-1792864	501(c)(3)	10,000	FMV	N/A	Health Care
(2) American Heart Association One State St Providence,RI02908	13-5613797	501(c)(3)	30,000	FMV	N/A	Health & Human Services
(3) American Red Cross 209 Farmington Ave Farmington,CT06032	53-0196605	501(c)(3)	25,000	FMV	N/A	Health & Human Services
(4) Arthritis Foundation New England Region Inc 2348 Post Rd Warwick,RI02886	58-1341679	501(c)(3)	30,000	FMV	N/A	Health Care
(5) Autism Project 1516 Atwood Ave Johnston,RI02919	05-0512037	501(c)(3)	25,000	FMV	N/A	Health and Advocacy
(6) Bayside YMCA 70 West St Barrington,RI02806	05-0258878	501(c)(3)	10,000	FMV	N/A	Health and Human Services
(7) BOKS BUILD OUR KIDS SUCCESS 25 Drydock Ave Boston,MA02210	04-3073548	501(c)(3)	10,000	FMV	N/A	Youth Development
(8) Boston Red Sox Foundation 4 Jersey Way Boston,MA02215	33-1007984	501(c)(3)	15,000	FMV	N/A	Youth Development
(9) Boys & Girls Clubs of Providence 550 Wickenden St Providence,RI02903	05-0258929	501(c)(3)	30,000	FMV	N/A	Youth Development
(10) Brain Injury Association of RI 1017 Waterman Ave East Providence,RI02914	22-2528586	501(c)(3)	35,000	FMV	N/A	Health & Human Services
(11) Children's Friend & Service 153 Summer St Providence,RI02903	05-0258819	501(c)(3)	15,000	FMV	N/A	Health and Human Services
(12) Children's Wish Group of RI Inc 2346 Post Road Warwick,RI02886	26-4662878	501(c)(3)	30,000	FMV	N/A	Youth Development
(13) City Year Providence 275 Westminster St Providence,RI02903	22-2882549	501(c)(3)	25,000	FMV	N/A	Youth Development
(14) College Visions 131 Washington St Providence,RI02903	27-2344723	501(c)(3)	7,500	FMV	N/A	Education
(15) Community Scholarship Fund of Barrington 144 Westminster St Providence,RI02903	30-0798085	501(c)(3)	10,000	FMV	N/A	Education
(16) Crossroads Rhode Island 160 Broad St Providence,RI02903	05-0259094	501(c)(3)	25,000	FMV	N/A	Adult Services Program
(17) Economic Progress Institute 600 Mount Pleasant Ave Providence,RI02908	32-0295517	501(c)(3)	10,000	FMV	N/A	Health and Social Services
(18) Emma Pendleton Bradley Hospital 1011 Vet Mem Pkwy East Providence,RI02915	05-0258806	501(c)(3)	20,000	FMV	N/A	Health and Youth Education
(19) Golf Foundation of RI Button Hole One Button Hole Dr Providence,RI02909	05-0497481	501(c)(3)	20,000	FMV	N/A	Recreation and Education
(20) Hockomock Area YMCA 300 Elmwood St North Attleboro,MA02760	04-2131749	501(c)(3)	20,000	FMV	N/A	Youth Development
(21) Hole in the Wall Gang Camp 555 Long Wharf Dr New Haven,CT06511	06-1157655	501(c)(3)	17,500	FMV	N/A	Youth Development
(22) Joe Andruzzi Foundation 49 Plain St North Attleboro,MA02760	26-2017043	501(c)(3)	15,000	FMV	N/A	Health & Human Services
(23) Learning Center for the Deaf Inc 848 Central St Framingham,MA01701	23-7064431	501(c)(3)	25,000	FMV	N/A	Community Services
(24) March of Dimes 260 West Exchange St Providence,RI02903	13-1846366	501(c)(3)	35,000	FMV	N/A	Health and Human Services
(25) Meeting Street 1000 Eddy St Providence,RI02905	05-0269232	501(c)(3)	25,000	FMV	N/A	Education
(26) Old Colony Habitat for Humanity PO Box 100 Attleboro,MA02703	04-3014778	501(c)(3)	125,000	FMV	N/A	Community Services
(27) Our Sister's School Inc 145 Brownell Ave New Bedford,MA02740	26-0367118	501(c)(3)	26,000	FMV	N/A	Education
(28) PeaceLove Foundation 999 Main Street 708 Pawtucket,RI02860	27-2224246	501(c)(3)	15,000	FMV	N/A	Arts & Culture
(29) Rhode Island Community Food Bank 200 Niantic Ave Providence,RI02907	05-0395601	501(c)(3)	10,000	FMV	N/A	Community Services
(30) San Miguel Education Center 525 Branch Ave Providence,RI02904	22-3232973	501(c)(3)	21,000	FMV	N/A	Education
(31) Save the Bay 100 Save The Bay Dr Providence,RI02905	05-0343046	501(c)(3)	25,000	FMV	N/A	Environment
(32) Sojourner House 386 Smith St Providence,RI02907	05-0370419	501(c)(3)	25,000	FMV	N/A	Community Services
(33) Special Olympics Rhode Island 370 GW Hwy Smithfield,RI02917	05-0377867	501(c)(3)	30,000	FMV	N/A	Youth Development
(34) Spurwink RI One Spurwink Place Cranston,RI02910	01-0370716	501(c)(3)	15,000	FMV	N/A	Health and Human Services
(35) Stadium Theatre Foundation 28 Monument Sq Woonsocket,RI02895	05-0486986	501(c)(3)	7,500	FMV	N/A	Arts & Culture
(36) Tides Family Services 215 Washington St West Warwick,RI02893	22-2478229	501(c)(3)	25,000	FMV	N/A	Health and Human Services
(37) Woonsocket Education Department 108 High St Woonsocket,RI02895	05-0494840	501(c)(3)	10,000	FMV	N/A	Education

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

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

DESCRIPTION OF ORGANIZATIONAL PROCEDURES

FORM 990, SCHEDULE I DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS PARTICIPATING ORGANIZATIONS ARE ASKED TO COMPLETE A GRANT APPLICANT QUESTIONNAIRE IN WHICH THEY ARE REQUIRED TO PROVIDE INFORMATION REGARDING PROGRAMS, FINANCES, TAX STATUS INFORMATION & COPIES OF TAX RETURNS. THE CVS HEALTH CHARITY CLASSIC REVIEWS ALL DOCUMENTS SUBMITTED BY GRANT APPLICANTS AND INDEPENDENTLY VERIFIES TAX-EXEMPT STATUS. IN ADDITION, THE CVS HEALTH CHARITY CLASSIC REVIEWS THE IMPACT OF THE PROPOSED GRANT ON THE RESIDENTS OF RHODE ISLAND.

Schedule I (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( BOSTON RED SOX PACKAGE )	X	23	12,709	FAIR MARKET VALUE
26 Other ( LEXUS CHAMPIONS FOR CHARITY )	X	3	6,500	FAIR MARKET VALUE
27 Other ( GOODY BAGS/GIFTS )	X	1,136	473,356	FAIR MARKET VALUE
28 Other ( GOODY BAGS/GIFTS )	X	35	4,547	RETAIL VALUE
Other ( SODA & WATER )	X	1,750	1,593	RETAIL VALUE

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Return Reference	Explanation
ORGANIZATION'S MISSION STATEMENT	FORM 990, PART I, LINE 1 AND PART III, LINE 1 THE PURPOSE OF THE ORGANIZATION IS TO ORGANIZE AND CONDUCT FUNDRAISING EVENTS IN ORDER TO RAISE MONEY TO MAKE CHARITABLE CONTRIBUTIONS TO ORGANIZATIONS THAT ARE EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WHOSE TAX EXEMPT PURPOSES RELATES DIRECTLY OR INDIRECTLY TO THE HEALTH EDUCATION AND/OR GENERAL WELFARE OF THE GENERAL PUBLIC.
DESCRIPTION OF RELATIONSHIPS	FORM 990, PART VI, SECTION A, LINE 2 EILEEN HOWARD BOONE, A DIRECTOR ON THE CVS HEALTH CHARITY CLASSIC'S BOARD, IS ALSO AN OFFICER OF CVS PHARMACY, INC. JEFFERY E. CLARK, FAITH WEINER AND MELANIE K. LUKER ARE EMPLOYEES OF CVS PHARMACY, INC. CAROL A. DENALE AND THOMAS S. MOFFATT ARE OFFICERS OF CVS HEALTH CORPORATION.
COMMITTEE AUTHORITY	FORM 990, PART VI, SECTION A, LINE 8 THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD.
PROCESS FOR REVIEW OF FORM 990	FORM 990, PART VI, SECTION B, LINE 11B CVS HEALTH EMPLOYEES GATHER ALL DATA FOR THE RETURN AND PROVIDE THE INFORMATION TO AN OUTSIDE ACCOUNTING FIRM FOR PREPARATION. THE RETURN IS REVIEWED BY CVS HEALTH MANAGEMENT AND THE OUTSIDE ACCOUNTING FIRM THAT SIGNS AS PREPARER. THE MANAGEMENT OF THE CHARITY CLASSIC REVIEWS THE RETURN AND MAKES ANY ADJUSTMENTS DEEMED NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN. BEFORE FILING WITH THE IRS, THE COMPLETE FORM 990 AND SUPPORTING SCHEDULES ARE REVIEWED BY THE BOARD OF DIRECTORS.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTEREST	FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS IS AN INTERESTED PERSON AND MUST ANNUALLY AFFIRM THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY OF CVS HEALTH CORPORATION, AND HAVE AGREED TO COMPLY WITH THE POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON HAS AN ONGOING DUTY TO DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND SHALL BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONCERNING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSIONS WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING DURING THE DISCUSSION OF THE POTENTIAL CONFLICT OF INTEREST AND THE VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE CHAIRMAN OF THE BOARD OR THE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST.
PUBLIC ACCESS TO ORGANIZATION'S DOCUMENTS	FORM 990, PART VI, SECTION C, LINE 10 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

CVS HEALTH CHARITY CLASSIC INC

Employer identification number

05-0508742

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CVS FOUNDATION ONE CVS DRIVE WOONSOCKET,RI02895 22-3206973	GRANTMAKING	RI	501(c)(3)	PF	CVS PHARMACY	Yes
(2)CVS HEALTH EMPLOYEE RELIEF FUND ONE CVS DRIVE WOONSOCKET,RI02895 27-4380115	GRANTMAKING	RI	501(c)(3)	7	CVS PHARMACY	Yes
(3)AETNA FOUNDATION INC 151 FARMINGTON AVENUE HARTFORD,CT06156 23-7241940	GRANTMAKING	CT	501(C)(3)	PF	CVS PHARMACY	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) Accendo Insurance Company One CVS Drive Woonsocket,RI02895 06-1566092	Medicare Part D	UT	CVS Pharmacy	CORP			Yes
(2) ACS ACQCO CORP One CVS Drive Woonsocket,RI02895 26-2775482	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(3) Advanced Care Scripts Inc One CVS Drive Woonsocket,RI02895 43-2080503	Long-Term Care Ph	FL	CVS Pharmacy	CORP			Yes
(4) Alabama CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-3648395	CVS Pharmacy Reta	AL	CVS Pharmacy	LLC Corp			Yes
(5) AMC - Tennessee Inc One CVS Drive Woonsocket,RI02895 62-1696813	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(6) BPNY Acquisition Corp One CVS Drive Woonsocket,RI02895 31-1563804	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(7) CHP Acquisition Corp One CVS Drive Woonsocket,RI02895 31-1483612	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(8) Connecticut CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-3648725	CVS Pharmacy Reta	CT	CVS Pharmacy	LLC Corp			Yes
(9) Coram Alternate Site Services Inc One CVS Drive Woonsocket,RI02895 76-0215922	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(10) Coram Clinical Trials Inc One CVS Drive Woonsocket,RI02895 58-2160656	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(11) Coram Healthcare Corporation of Alabama One CVS Drive Woonsocket,RI02895 58-1813484	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(12) Coram Healthcare Corporation of Florida One CVS Drive Woonsocket,RI02895 58-1949695	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(13) Coram Healthcare Corporation of Greater One CVS Drive Woonsocket,RI02895 58-2035129	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(14) Coram Healthcare Corporation of Greater One CVS Drive Woonsocket,RI02895 58-1844719	Specialty Infusio	NY	CVS Pharmacy	CORP			Yes
(15) Coram Healthcare Corporation of Indiana One CVS Drive Woonsocket,RI02895 58-1813491	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(16) Coram Healthcare Corporation of Massachu One CVS Drive Woonsocket,RI02895 33-0532814	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(17) Coram Healthcare Corporation of Mississi One CVS Drive Woonsocket,RI02895 58-1813479	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(18) Coram Healthcare Corporation of Nevada One CVS Drive Woonsocket,RI02895 58-1972771	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(19) Coram Healthcare Corporation of North Te One CVS Drive Woonsocket,RI02895 33-0556959	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(20) Coram Healthcare Corporation of Northern One CVS Drive Woonsocket,RI02895 58-1972773	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(21) Coram Healthcare Corporation of Southern One CVS Drive Woonsocket,RI02895 58-2006708	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(22) Coram Healthcare Corporation of Southern One CVS Drive Woonsocket,RI02895 58-1949686	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(23) Coram Healthcare Corporation of Utah One CVS Drive Woonsocket,RI02895 95-4446209	Specialty Infusio	DE	CVS Pharmacy	CORP			Yes
(24) CP Acquisition Corp One CVS Drive Woonsocket,RI02895 61-1317566	Long-Term Care Ph	OK	CVS Pharmacy	CORP			Yes
(25) CVS Caremark Indemnity Ltd One CVS Drive Woonsocket,RI02895 05-0500188	Insurance	DE	CVS Pharmacy	CORP			Yes
(26) CVS Health Corporation One CVS Drive Woonsocket,RI02895 05-0494040	Holding Company	RI	CVS Pharmacy	CORP				No
(27) CVS Pharmacy Inc One CVS Drive Woonsocket,RI02895 05-0340626	Retail Pharmacy C	RI	CVS Health Corp	CORP				No
(28) CVS Rx Services Inc One CVS Drive Woonsocket,RI02895 05-0501917	Pharmacist Employ	NY	CVS Pharmacy	CORP			Yes
(29) Delaware CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 26-0223262	CVS Pharmacy Reta	DE	CVS Pharmacy	LLC Corp			Yes
(30) Drogaria Onofre Ltda ONE CVS DRIVE WOONSOCKET,RI02895 98-1131843	Retail Pharmacy	BR	CVS Pharmacy	CORP			Yes
(31) ETB INC One CVS Drive Woonsocket,RI02895 74-2118879	License Holder (T	TX	CVS Pharmacy	CORP			Yes
(32) Eric C Marshall MD PC One CVS Drive Woonsocket,RI02895 20-8550517	Ambulatory Health	DC	CVS Pharmacy	PC			Yes
(33) Evergreen Pharmaceutical of California One CVS Drive Woonsocket,RI02895 61-1321151	Long-Term Care Ph	CA	CVS Pharmacy	CORP			Yes
(34) Geneva Woods Pharmacy Inc One CVS Drive Woonsocket,RI02895 92-0074555	Long-Term Care Ph	AK	CVS Pharmacy	CORP			Yes
(35) George Safran MD PC One CVS Drive Woonsocket,RI02895 27-1511452	Ambulatory Health	NY	CVS Pharmacy	PC			Yes
(36) Holiday CVS LLC One CVS Drive Woonsocket,RI02895 03-0394176	CVS Pharmacy Reta	FL	CVS Pharmacy	LLC Corp			Yes
(37) Innovative Worldwide Distributors (HK) L One CVS Drive Woonsocket,RI02895 35-2486385	International Dis	DE	CVS Pharmacy	CORP			Yes
(38) Iowa CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-4281257	CVS Pharmacy Reta	IA	CVS Pharmacy	LLC Corp			Yes
(39) JEC Funding Inc One CVS Drive Woonsocket,RI02895 13-3388181	Real Estate	DE	CVS Pharmacy	CORP			Yes
(40) Kentucky CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-4452072	CVS Pharmacy Reta	KY	CVS Pharmacy	LLC Corp			Yes
(41) Managed HealthCare Inc One CVS Drive Woonsocket,RI02895 31-1450845	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(42) Martin Health Services Inc One CVS Drive Woonsocket,RI02895 20-3100455	Long-Term Care Ph	IA	CVS Pharmacy	CORP			Yes
(43) Maryland CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 65-1262539	CVS Pharmacy Reta	MD	CVS Pharmacy	LLC Corp			Yes
(44) MC Diagnostic of Connecticut PC One CVS Drive Woonsocket,RI02895 20-5414393	Ambulatory Health	CT	CVS Pharmacy	PC			Yes
(45) Med World Acquisition Corp One CVS Drive Woonsocket,RI02895 61-1322120	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(46) Medical Arts Health Care Inc One CVS Drive Woonsocket,RI02895 58-1640672	Long-Term Care Ph	GA	CVS Pharmacy	CORP			Yes
(47) Melville Realty Company Inc One CVS Drive Woonsocket,RI02895 04-6050302	Real Estate	NY	CVS Pharmacy	CORP			Yes
(48) Minute Clinic Diagnostic of North Caroli One CVS Drive Woonsocket,RI02895 20-3555819	Ambulatory Health	NC	CVS Pharmacy	PC			Yes
(49) MinuteClinic Diagnostic Medical Group of One CVS Drive Woonsocket,RI02895 42-1731802	Ambulatory Health	CA	CVS Pharmacy	CORP			Yes
(50) MinuteClinic Diagnostic Medical Group of One CVS Drive Woonsocket,RI02895 26-0844287	Ambulatory Health	CA	CVS Pharmacy	CORP			Yes
(51) MinuteClinic Diagnostic Medical Group of One CVS Drive Woonsocket,RI02895 26-0844323	Ambulatory Health	CA	CVS Pharmacy	CORP			Yes
(52) MinuteClinic Diagnostic of Illinois LLC One CVS Drive Woonsocket,RI02895 20-5818281	Ambulatory Health	DE	CVS Pharmacy	LLC Corp			Yes
(53) MinuteClinic Diagnostic of Kansas PA One CVS Drive Woonsocket,RI02895 20-5096637	Ambulatory Health	KS	CVS Pharmacy	PA			Yes
(54) MinuteClinic Diagnostic of Michigan PC One CVS Drive Woonsocket,RI02895 20-4269269	Ambulatory Health	MI	CVS Pharmacy	PC			Yes
(55) MinuteClinic Diagnostic of Minnesota P One CVS Drive Woonsocket,RI02895 47-5140770	Ambulatory Health	MN	CVS Pharmacy	PA			Yes
(56) MinuteClinic Diagnostic of New Jersey L One CVS Drive Woonsocket,RI02895 20-4868967	Ambulatory Health	NJ	CVS Pharmacy	LLC Corp			Yes
(57) MinuteClinic Diagnostic of Tennessee P One CVS Drive Woonsocket,RI02895 20-3348922	Ambulatory Health	TN	CVS Pharmacy	PC			Yes
(58) MinuteClinic Diagnostic PA One CVS Drive Woonsocket,RI02895 41-1952112	Ambulatory Health	MN	CVS Pharmacy	PA			Yes
(59) MinuteClinic Diagnostics of Indiana LLC One CVS Drive Woonsocket,RI02895 20-3207688	Ambulatory Health	IN	CVS Pharmacy	LLC Corp			Yes
(60) NCS Healthcare of Kentucky Inc One CVS Drive Woonsocket,RI02895 31-1521217	Long-Term Care Ph	OH	CVS Pharmacy	CORP			Yes
(61) NCS Healthcare of Montana Inc One CVS Drive Woonsocket,RI02895 34-1851710	Long-Term Care Ph	OH	CVS Pharmacy	CORP			Yes
(62) NCS Healthcare of New Mexico Inc One CVS Drive Woonsocket,RI02895 34-1866493	Long-Term Care Ph	OH	CVS Pharmacy	CORP			Yes
(63) NCS Healthcare of South Carolina Inc One CVS Drive Woonsocket,RI02895 31-1508225	Long-Term Care Ph	OH	CVS Pharmacy	CORP			Yes
(64) NCS Healthcare of Tennessee Inc One CVS Drive Woonsocket,RI02895 34-1866494	Long-Term Care Ph	OH	CVS Pharmacy	CORP			Yes
(65) NeighborCare Pharmacy Services Inc One CVS Drive Woonsocket,RI02895 23-2963282	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(66) NeighborCare Services Corporation One CVS Drive Woonsocket,RI02895 23-2585556	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(67) NeighborCare Inc One CVS Drive Woonsocket,RI02895 06-1132947	Long-Term Care Ph	PA	CVS Pharmacy	CORP			Yes
(68) New Jersey CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-3618568	CVS Pharmacy Reta	NJ	CVS Pharmacy	LLC Corp			Yes
(69) North Carolina CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-3649570	CVS Pharmacy Reta	NC	CVS Pharmacy	LLC Corp			Yes
(70) OCR Services Corporation One CVS Drive Woonsocket,RI02895 31-1402845	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(71) Oklahoma CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-4837341	CVS Pharmacy Reta	OK	CVS Pharmacy	LLC Corp			Yes
(72) Omnicare Pharmacies of The Great Plains One CVS Drive Woonsocket,RI02895 61-1386242	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(73) Parekh MinuteClinic of Nevada PC One CVS Drive Woonsocket,RI02895 20-5793559	Ambulatory Health	NV	CVS Pharmacy	PC			Yes
(74) Pennsylvania Life Insurance Company One CVS Drive Woonsocket,RI02895 23-1305366	Medicare Part D	PA	CVS Pharmacy	CORP			Yes
(75) Pharmacy Associates of Glens Falls Inc One CVS Drive Woonsocket,RI02895 14-1554120	Long-Term Care Ph	NY	CVS Pharmacy	CORP			Yes
(76) Professional Pharmacy Services Inc One CVS Drive Woonsocket,RI02895 23-2847488	Long-Term Care Ph	MD	CVS Pharmacy	CORP			Yes
(77) Rhode Island CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-4451847	CVS Pharmacy Reta	RI	CVS Pharmacy	LLC Corp			Yes
(78) Richmond Heights Acquisition Corp One CVS Drive Woonsocket,RI02895 61-1428940	Real Estate	OH	CVS Pharmacy	CORP			Yes
(79) SilverScript Insurance Company One CVS Drive Woonsocket,RI02895 20-2833904	Medicare Part D	TN	CVS Pharmacy	CORP			Yes
(80) Sterling Healthcare Services Inc One CVS Drive Woonsocket,RI02895 36-4031863	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(81) Superior Care Pharmacy Inc One CVS Drive Woonsocket,RI02895 31-1543728	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(82) TCPI Acquisition Corp One CVS Drive Woonsocket,RI02895 31-1508476	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(83) Tennessee CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-3738440	CVS Pharmacy Reta	TN	CVS Pharmacy	LLC Corp			Yes
(84) UC Acquisition Corp One CVS Drive Woonsocket,RI02895 31-1414594	Long-Term Care Ph	DE	CVS Pharmacy	CORP			Yes
(85) Uni-Care Health Services of Maine Inc One CVS Drive Woonsocket,RI02895 02-0468192	Long-Term Care Ph	NH	CVS Pharmacy	CORP			Yes
(86) Virginia CVS Pharmacy LLC One CVS Drive Woonsocket,RI02895 20-3649917	CVS Pharmacy Reta	VA	CVS Pharmacy	LLC Corp			Yes
(87) Williamson Drug Company Incorporated One CVS Drive Woonsocket,RI02895 54-0590067	Long-Term Care Ph	VA	CVS Pharmacy	CORP			Yes
(88) Credentials Inc 151 Farmington Avenue Hartford,CT06156 23-2671370	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(89) Accendo Insurance Company 151 Farmington Avenue Hartford,CT06156 06-1566092	Healthcare/Insura	UT	CVS Pharmacy	CORP			Yes
(90) Active Health Management Inc 151 Farmington Avenue Hartford,CT06156 52-2182411	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(91) Adminco Inc 151 Farmington Avenue Hartford,CT06156 86-0537707	Healthcare/Insura	AZ	CVS Pharmacy	CORP			Yes
(92) Administrative Enterprises Inc 151 Farmington Avenue Hartford,CT06156 86-0527428	Healthcare/Insura	AZ	CVS Pharmacy	CORP			Yes
(93) AE Fourteen Incorporated 151 Farmington Avenue Hartford,CT06156 06-1028469	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(94) Aetna ACO Holdings Inc 151 Farmington Avenue Hartford,CT06156 45-4901541	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(95) Aetna Better Health Inc (CT) 151 Farmington Avenue Hartford,CT06156 26-2867560	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(96) Aetna Better Health Inc (GA) 151 Farmington Avenue Hartford,CT06156 20-2207534	Healthcare/Insura	GA	CVS Pharmacy	CORP			Yes
(97) Aetna Better Health Inc (IL) 151 Farmington Avenue Hartford,CT06156 27-2512072	Healthcare/Insura	IL	CVS Pharmacy	CORP			Yes
(98) Aetna Better Health Inc (NJ) 151 Farmington Avenue Hartford,CT06156 46-3203088	Healthcare/Insura	NJ	CVS Pharmacy	CORP			Yes
(99) Aetna Better Health Inc (NY) 151 Farmington Avenue Hartford,CT06156 45-2634734	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(100) Aetna Better Health Inc (OH) 151 Farmington Avenue Hartford,CT06156 45-2764938	Healthcare/Insura	OH	CVS Pharmacy	CORP			Yes
(101) Aetna Better Health Inc (PA) 151 Farmington Avenue Hartford,CT06156 27-0563973	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(102) Aetna Better Health Inc (TN) 151 Farmington Avenue Hartford,CT06156 20-4416606	Healthcare/Insura	TN	CVS Pharmacy	CORP			Yes
(103) Aetna Better Health of California Inc 151 Farmington Avenue Hartford,CT06156 47-5178095	Healthcare/Insura	CA	CVS Pharmacy	CORP			Yes
(104) Aetna Better Health of Iowa Inc 151 Farmington Avenue Hartford,CT06156 47-3850677	Healthcare/Insura	OH	CVS Pharmacy	CORP			Yes
(105) Aetna Better Health of Kansas Inc 151 Farmington Avenue Hartford,CT06156 81-3370401	Healthcare/Insura	KS	CVS Pharmacy	CORP			Yes
(106) Aetna Better Health of Kentucky Insuranc 151 Farmington Avenue Hartford,CT06156 47-3279217	Healthcare/Insura	KY	CVS Pharmacy	CORP			Yes
(107) Aetna Better Health of Michigan Inc 151 Farmington Avenue Hartford,CT06156 20-1052897	Healthcare/Insura	MI	CVS Pharmacy	CORP			Yes
(108) Aetna Better Health of Nevada Inc 151 Farmington Avenue Hartford,CT06156 81-3564875	Healthcare/Insura	NV	CVS Pharmacy	CORP			Yes
(109) Aetna Better Health of North Carolina In 151 Farmington Avenue Hartford,CT06156 82-3333789	Healthcare/Insura	NC	CVS Pharmacy	CORP			Yes
(110) Aetna Better Health of Oklahoma Inc 151 Farmington Avenue Hartford,CT06156 81-1143850	Healthcare/Insura	OK	CVS Pharmacy	CORP			Yes
(111) Aetna Better Health of Texas Inc 151 Farmington Avenue Hartford,CT06156 74-1844335	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(112) Aetna Better Health of Washington Inc 151 Farmington Avenue Hartford,CT06156 81-5030233	Healthcare/Insura	WA	CVS Pharmacy	CORP			Yes
(113) Aetna Better Health Inc (LA) 151 Farmington Avenue Hartford,CT06156 80-0629718	Healthcare/Insura	LA	CVS Pharmacy	CORP			Yes
(114) Aetna Dental Inc (NJ) 151 Farmington Avenue Hartford,CT06156 22-2990909	Healthcare/Insura	NJ	CVS Pharmacy	CORP			Yes
(115) Aetna Dental Inc (TX) 151 Farmington Avenue Hartford,CT06156 06-1177531	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(116) Aetna Dental of California Inc 151 Farmington Avenue Hartford,CT06156 06-1160812	Healthcare/Insura	CA	CVS Pharmacy	CORP			Yes
(117) Aetna Florida Inc 151 Farmington Avenue Hartford,CT06156 80-0671703	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(118) Aetna Global Benefits (Asia Pacific) Lim 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	HK	CVS Pharmacy	CORP			Yes
(119) Aetna Global Benefits (UK) Limited 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	UK	CVS Pharmacy	CORP			Yes
(120) Aetna Health and Life Insurance Company 151 Farmington Avenue Hartford,CT06156 06-0876836	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(121) Aetna Health Inc (CT) 151 Farmington Avenue Hartford,CT06156 23-2442048	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(122) Aetna Health Inc (FL) 151 Farmington Avenue Hartford,CT06156 59-2411584	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(123) Aetna Health Inc (GA) 151 Farmington Avenue Hartford,CT06156 58-1649568	Healthcare/Insura	GA	CVS Pharmacy	CORP			Yes
(124) Aetna Health Inc (LA) 151 Farmington Avenue Hartford,CT06156 74-2381406	Healthcare/Insura	LA	CVS Pharmacy	CORP			Yes
(125) Aetna Health Inc (ME) 151 Farmington Avenue Hartford,CT06156 01-0504252	Healthcare/Insura	ME	CVS Pharmacy	CORP			Yes
(126) Aetna Health Inc (NJ) 151 Farmington Avenue Hartford,CT06156 52-1270921	Healthcare/Insura	NJ	CVS Pharmacy	CORP			Yes
(127) Aetna Health Inc (NY) 151 Farmington Avenue Hartford,CT06156 22-2663623	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(128) Aetna Health Inc (PA) 151 Farmington Avenue Hartford,CT06156 23-2169745	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(129) Aetna Health Inc (TX) 151 Farmington Avenue Hartford,CT06156 76-0189680	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(130) Aetna Health Insurance (Thailand) Public 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	TH	CVS Pharmacy	CORP			Yes
(131) Aetna Health Insurance Company 151 Farmington Avenue Hartford,CT06156 23-2710210	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(132) Aetna Health Insurance Company of New Yo 151 Farmington Avenue Hartford,CT06156 57-0805126	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(133) Aetna Health of California Inc 151 Farmington Avenue Hartford,CT06156 95-3402799	Healthcare/Insura	CA	CVS Pharmacy	CORP			Yes
(134) Aetna Health of Iowa Inc 151 Farmington Avenue Hartford,CT06156 42-1244752	Healthcare/Insura	IA	CVS Pharmacy	CORP			Yes
(135) Aetna Health of Michigan Inc 151 Farmington Avenue Hartford,CT06156 23-2861565	Healthcare/Insura	MI	CVS Pharmacy	CORP			Yes
(136) Aetna Health of Utah Inc 151 Farmington Avenue Hartford,CT06156 87-0345631	Healthcare/Insura	UT	CVS Pharmacy	CORP			Yes
(137) Aetna HealthAssurance Pennsylvania Inc 151 Farmington Avenue Hartford,CT06156 47-4352768	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(138) Aetna Holdco (UK) Limited 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	UK	CVS Pharmacy	CORP			Yes
(139) Aetna Holdings (Thailand) Limited 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	TH	CVS Pharmacy	CORP			Yes
(140) Aetna Inc 151 Farmington Avenue Hartford,CT06156 23-2229683	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(141) Aetna Insurance Company Limited 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	UK	CVS Pharmacy	CORP			Yes
(142) Aetna Insurance Company of Connecticut 151 Farmington Avenue Hartford,CT06156 06-1286276	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(143) Aetna Integrated Informatics Inc 151 Farmington Avenue Hartford,CT06156 23-2604867	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(144) Aetna International Inc 151 Farmington Avenue Hartford,CT06156 06-1571642	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(145) Aetna Ireland Inc 151 Farmington Avenue Hartford,CT06156 22-3187443	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(146) Aetna Life & Casualty (Bermuda) Ltd 151 Farmington Avenue Hartford,CT06156 98-0211470	Healthcare/Insura	BD	CVS Pharmacy	CORP			Yes
(147) Aetna Life Assignment Company 151 Farmington Avenue Hartford,CT06156 06-1373153	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(148) Aetna Life Insurance Company 151 Farmington Avenue Hartford,CT06156 06-6033492	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(149) Aetna Risk Assurance Company of Connecti 151 Farmington Avenue Hartford,CT06156 47-2049117	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(150) Aetna Student Health Agency Inc 151 Farmington Avenue Hartford,CT06156 04-2708160	Healthcare/Insura	MA	CVS Pharmacy	CORP			Yes
(151) AHP Holdings Inc 151 Farmington Avenue Hartford,CT06156 06-1270755	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(152) Allina Health and Aetna Insurance Compan 151 Farmington Avenue Hartford,CT06156 82-2091197	Healthcare/Insura	MN	CVS Pharmacy	CORP			Yes
(153) American Continental Insurance Company 151 Farmington Avenue Hartford,CT06156 20-2901054	Healthcare/Insura	TN	CVS Pharmacy	CORP			Yes
(154) American Health Holding Inc 151 Farmington Avenue Hartford,CT06156 31-1368946	Healthcare/Insura	OH	CVS Pharmacy	CORP			Yes
(155) AUSHC Holdings Inc 151 Farmington Avenue Hartford,CT06156 06-1481308	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(156) Banner Health and Aetna Health Insurance 151 Farmington Avenue Hartford,CT06156 81-5281115	Healthcare/Insura	AZ	CVS Pharmacy	CORP			Yes
(157) Banner Health and Aetna Health Plan Inc 151 Farmington Avenue Hartford,CT06156 81-5290023	Healthcare/Insura	AZ	CVS Pharmacy	CORP			Yes
(158) Broadspire National Services Inc 151 Farmington Avenue Hartford,CT06156 59-2108747	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(159) Carefree Insurance Services Inc 151 Farmington Avenue Hartford,CT06156 59-3750548	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(160) Claims Administration Corp 151 Farmington Avenue Hartford,CT06156 52-1320522	Healthcare/Insura	MD	CVS Pharmacy	CORP			Yes
(161) Cofinity Inc 151 Farmington Avenue Hartford,CT06156 20-1274723	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(162) Contact Int'l Legal-Spinnaker Topco Limi 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	BD	CVS Pharmacy	CORP			Yes
(163) Continental Life Insurance Company of Br 151 Farmington Avenue Hartford,CT06156 62-1181209	Healthcare/Insura	TN	CVS Pharmacy	CORP			Yes
(164) Coventry Consumer Advantage Inc 151 Farmington Avenue Hartford,CT06156 26-1293772	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(165) Coventry Health and Life Insurance Compa 151 Farmington Avenue Hartford,CT06156 75-1296086	Healthcare/Insura	MO	CVS Pharmacy	CORP			Yes
(166) Coventry Health Care National Accounts 151 Farmington Avenue Hartford,CT06156 20-8070994	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(167) Coventry Health Care National Network I 151 Farmington Avenue Hartford,CT06156 20-5185442	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(168) Coventry Health Care of Florida Inc 151 Farmington Avenue Hartford,CT06156 65-0986441	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(169) Coventry Health Care of Illinois Inc 151 Farmington Avenue Hartford,CT06156 37-1241037	Healthcare/Insura	IL	CVS Pharmacy	CORP			Yes
(170) Coventry Health Care of Kansas Inc 151 Farmington Avenue Hartford,CT06156 48-0840330	Healthcare/Insura	KS	CVS Pharmacy	CORP			Yes
(171) Coventry Health Care of Missouri Inc 151 Farmington Avenue Hartford,CT06156 43-1372307	Healthcare/Insura	MO	CVS Pharmacy	CORP			Yes
(172) Coventry Health Care of Nebraska Inc 151 Farmington Avenue Hartford,CT06156 42-1308659	Healthcare/Insura	NE	CVS Pharmacy	CORP			Yes
(173) Coventry Health Care of Virginia Inc 151 Farmington Avenue Hartford,CT06156 54-1576305	Healthcare/Insura	VA	CVS Pharmacy	CORP			Yes
(174) Coventry Health Care of West Virginia I 151 Farmington Avenue Hartford,CT06156 55-0712129	Healthcare/Insura	WV	CVS Pharmacy	CORP			Yes
(175) Coventry Health Care Workers Compensatio 151 Farmington Avenue Hartford,CT06156 20-8376354	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(176) Coventry Health Plan of Florida Inc 151 Farmington Avenue Hartford,CT06156 65-0453436	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(177) Coventry Healthcare Management Corporati 151 Farmington Avenue Hartford,CT06156 62-1411933	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(178) Coventry Prescription Management Service 151 Farmington Avenue Hartford,CT06156 47-0854096	Healthcare/Insura	NV	CVS Pharmacy	CORP			Yes
(179) Coventry Rehabilitation Services Inc 151 Farmington Avenue Hartford,CT06156 87-0443226	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(180) Coventry Transplant Network Inc 151 Farmington Avenue Hartford,CT06156 01-0646056	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(181) CVS Pharmacy Inc 151 Farmington Avenue Hartford,CT06156 05-0340626	Healthcare/Insura	RI	CVS Pharmacy	CORP			Yes
(182) Delaware Physicians Care Incorporated 151 Farmington Avenue Hartford,CT06156 73-1702435	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(183) Echo Merger Sub Inc 151 Farmington Avenue Hartford,CT06156 47-4556274	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(184) First Health Group Corp 151 Farmington Avenue Hartford,CT06156 20-1736437	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(185) First Health Life & Health Insurance Com 151 Farmington Avenue Hartford,CT06156 38-2242132	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(186) First Script Network Services Inc 151 Farmington Avenue Hartford,CT06156 20-4096903	Healthcare/Insura	NV	CVS Pharmacy	CORP			Yes
(187) FOCUS HealthCare Management Inc 151 Farmington Avenue Hartford,CT06156 62-1266888	Healthcare/Insura	TN	CVS Pharmacy	CORP			Yes
(188) Goodhealth Worldwide (Asia) Limited 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	HK	CVS Pharmacy	CORP			Yes
(189) Group Dental Service of Maryland Inc 151 Farmington Avenue Hartford,CT06156 52-2056201	Healthcare/Insura	MD	CVS Pharmacy	CORP			Yes
(190) Group Dental Service Inc 151 Farmington Avenue Hartford,CT06156 52-1801446	Healthcare/Insura	MD	CVS Pharmacy	CORP			Yes
(191) Health and Human Resource Center Inc 151 Farmington Avenue Hartford,CT06156 33-0052273	Healthcare/Insura	CA	CVS Pharmacy	CORP			Yes
(192) Health Care Management Co Ltd 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	TH	CVS Pharmacy	CORP			Yes
(193) Health Data & Management Solutions Inc 151 Farmington Avenue Hartford,CT06156 47-0970432	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(194) Health Re Inc 151 Farmington Avenue Hartford,CT06156 27-2192415	Healthcare/Insura	VT	CVS Pharmacy	CORP			Yes
(195) HealthAssurance Pennsylvania Inc 151 Farmington Avenue Hartford,CT06156 23-2366731	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(196) Innovation Health Insurance Company 151 Farmington Avenue Hartford,CT06156 46-0674828	Healthcare/Insura	VA	CVS Pharmacy	CORP			Yes
(197) Innovation Health Plan Inc 151 Farmington Avenue Hartford,CT06156 46-0682197	Healthcare/Insura	VA	CVS Pharmacy	CORP			Yes
(198) Managed Care Coordinators Inc 151 Farmington Avenue Hartford,CT06156 23-2670015	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(199) Medical Examinations of New York PC 151 Farmington Avenue Hartford,CT06156 74-2879984	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(200) Mental Health Associates Inc 151 Farmington Avenue Hartford,CT06156 72-1106596	Healthcare/Insura	LA	CVS Pharmacy	CORP			Yes
(201) Mental Health Network of New York IPA I 151 Farmington Avenue Hartford,CT06156 37-1448790	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(202) Meritain Health Inc 151 Farmington Avenue Hartford,CT06156 16-1264154	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(203) MetraComp Inc 151 Farmington Avenue Hartford,CT06156 06-1095987	Healthcare/Insura	CT	CVS Pharmacy	CORP			Yes
(204) MHNet Life and Health Insurance Company 151 Farmington Avenue Hartford,CT06156 20-2516317	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(205) MHNet of Florida Inc 151 Farmington Avenue Hartford,CT06156 20-4276336	Healthcare/Insura	FL	CVS Pharmacy	CORP			Yes
(206) Minor Health Enterprise Co Ltd 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	TH	CVS Pharmacy	CORP			Yes
(207) Niagara Re Inc 151 Farmington Avenue Hartford,CT06156 20-0438576	Healthcare/Insura	NY	CVS Pharmacy	CORP			Yes
(208) PayFlex Holdings Inc 151 Farmington Avenue Hartford,CT06156 20-5216478	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(209) PayFlex Systems USA Inc 151 Farmington Avenue Hartford,CT06156 91-1774434	Healthcare/Insura	NE	CVS Pharmacy	CORP			Yes
(210) Performax Inc 151 Farmington Avenue Hartford,CT06156 52-2200070	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(211) PHPSNE Parent Corporation 151 Farmington Avenue Hartford,CT06156 06-1182176	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(212) Precision Benefit Services Inc 151 Farmington Avenue Hartford,CT06156 27-1760756	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(213) Prime Net Inc 151 Farmington Avenue Hartford,CT06156 34-1670299	Healthcare/Insura	OH	CVS Pharmacy	CORP			Yes
(214) Prodigy Health Group Inc 151 Farmington Avenue Hartford,CT06156 16-1471176	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(215) Professional Risk Management Inc 151 Farmington Avenue Hartford,CT06156 34-1348032	Healthcare/Insura	OH	CVS Pharmacy	CORP			Yes
(216) Schaller Anderson Medical Administrators 151 Farmington Avenue Hartford,CT06156 01-0826783	Healthcare/Insura	DE	CVS Pharmacy	CORP			Yes
(217) SilverScript Insurance Company 151 Farmington Avenue Hartford,CT06156 20-2833904	Healthcare/Insura	TN	CVS Pharmacy	CORP			Yes
(218) Spinnaker Bidco Limited 151 Farmington Avenue Hartford,CT06156	Healthcare/Insura	UK	CVS Pharmacy	CORP			Yes
(219) Sutter Health and Aetna Insurance Compan 151 Farmington Avenue Hartford,CT06156 82-2567822	Healthcare/Insura	CA	CVS Pharmacy	CORP			Yes
(220) Texas Health Aetna Health Insurance Co 151 Farmington Avenue Hartford,CT06156 81-4749336	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(221) Texas Health Aetna Health Plan Inc 151 Farmington Avenue Hartford,CT06156 47-5548221	Healthcare/Insura	TX	CVS Pharmacy	CORP			Yes
(222) The Vasquez Group Inc 151 Farmington Avenue Hartford,CT06156 36-3681261	Healthcare/Insura	IL	CVS Pharmacy	CORP			Yes
(223) US Healthcare Properties Inc 151 Farmington Avenue Hartford,CT06156 23-2354500	Healthcare/Insura	PA	CVS Pharmacy	CORP			Yes
(224) Work & Family Benefits Inc 151 Farmington Avenue Hartford,CT06156 22-3178125	Healthcare/Insura	NJ	CVS Pharmacy	CORP			Yes
(225) AETNA BETTER HEALTH OF MISSOURI LLC 151 FARMINGTON AVENUE HARTFORD,CT06156 43-1702094	HEALTHCARE/INSURA	MO	CVS PHARMACY	CORP			Yes
(226) AETNA (SHANGHAI) ENTERPRISE SERVICES CO 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	CH	CVS PHARMACY	CORP			Yes
(227) AETNA GLOBAL BENEFITS (BAHAMAS) LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	BF	CVS PHARMACY	CORP			Yes
(228) AETNA GLOBAL BENEFITS (BERMUDA) LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	BD	CVS PHARMACY	CORP			Yes
(229) AETNA GLOBAL BENEFITS (EUROPE) LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	UK	CVS PHARMACY	CORP			Yes
(230) AETNA GLOBAL BENEFITS (SINGAPORE) PTE LT 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	SN	CVS PHARMACY	CORP			Yes
(231) AETNA GLOBAL BENEFITS LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	AE	CVS PHARMACY	CORP			Yes
(232) AETNA GLOBAL HOLDINGS LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	UK	CVS PHARMACY	CORP			Yes
(233) AETNA HEALTH INSURANCE CO OF EUROPE DAC 151 FARMINGTON AVENUE HARTFORD,CT06156 75-3270039	HEALTHCARE/INSURA	EI	CVS PHARMACY	CORP			Yes
(234) AETNA INSURANCE (SINGAPORE) PTE LTD 151 FARMINGTON AVENUE HARTFORD,CT06156 98-1210265	HEALTHCARE/INSURA	SN	CVS PHARMACY	CORP			Yes
(235) GOODHEALTH WORLDWIDE (GLOBAL) LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	BD	CVS PHARMACY	CORP			Yes
(236) HEALTHAGEN INTERNATIONAL LIMITED 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	UK	CVS PHARMACY	CORP			Yes
(237) INDIAN HEALTH ORGANISATION PRIVATE LIMIT 151 FARMINGTON AVENUE HARTFORD,CT06156	HEALTHCARE/INSURA	IN	CVS PHARMACY	CORP			Yes

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	5
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	725
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,048,803	3,787,181
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	195	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-3,512,231	-3,081,840
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	536,767	705,341
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,000,000	885,600
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	0	0
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,000,000	885,600
19	Revenue less expenses. Subtract line 18 from line 12.......	-463,233	-180,259
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	817,917	755,365
21	Total liabilities (Part X, line 26).............	159,084	276,791
22	Net assets or fund balances. Subtract line 21 from line 20.....	658,833	478,574

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 885,600 including grants of $ 885,600 ) (Revenue $ )
	THE CVS HEALTH CHARITY CLASSIC, INC. WAS ESTABLISHED TO RAISE MONEY VIA A WORLD CLASS GOLF VENUE FOR THE SUPPORT OF OTHER NON-PROFIT AGENCIES THROUGHOUT NEW ENGLAND. SINCE 1999, THE CVS HEALTH CHARITY CLASSIC, INC HAS ALLOCATED OVER $23.80 MILLION IN CHARITABLE DONATIONS TO HUNDREDS OF ORGANIZATIONS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses885,600

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) EILEEN H BOONE...................................................................... PRESIDENT/DIRECTOR	0.5 ................. 41.5	X	X	0	0	0
(2) WAYNE CHARNESS...................................................................... DIRECTOR	0.5 ................. 0.0	X		0	0	0
(3) MARK G KOLLIGIAN...................................................................... DIRECTOR	0.5 ................. 0.0	X		0	0	0
(4) SCOTT COWPER...................................................................... DIRECTOR	0.5 ................. 0.0	X		0	0	0
(5) FAITH WEINER...................................................................... DIRECTOR	40.5 ................. 0.0	X		0	0	0
(6) CAROL A DENALE...................................................................... VICE PRESIDENT/TREASURER	0.5 ................. 41.0		X	0	0	0
(7) THOMAS S MOFFATT...................................................................... SECRETARY	0.5 ................. 41.5		X	0	0	0
(8) MELANIE K LUKER...................................................................... ASSISTANT SECRETARY	0.5 ................. 41.0		X	0	0	0
(9) JEFFREY E CLARK...................................................................... ASSISTANT TREASURER	0.5 ................. 41.5		X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	0	0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	2,970,824
d	Related organizations		1d	816,357
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	0

g	Noncash contributions included in lines 1a - 1f:$ 498,705
h Total. Add lines 1a-1f.......		3,787,181

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		0

3 Investment income (including dividends, interest, and othersimilar amounts) ......			0
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....			0
8a	Gross income from fundraising events (not including $ 2,970,824of contributions reported on line 1c). See Part IV, line 18 ....
	a		3,901,227
b	Less: direct expenses ...b		6,983,067
c	Net income or (loss) from fundraising events..			-3,081,840	-3,081,840
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			705,341	-3,081,840

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	885,600	885,600
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	0
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	0
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	0
23	Insurance ...	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a
b
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	885,600	885,600	0	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		632,815	1	157,417
2	Savings and temporary cash investments .........		0	2	0
3	Pledges and grants receivable, net ......		0	3	0
4	Accounts receivable, net .............		156,645	4	589,631
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
			0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
			0	6	0
7	Notes and loans receivable, net ....		0	7	0
8	Inventories for sale or use ........		3,463	8	8,317
9	Prepaid expenses and deferred charges ......		0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b	0	10c	0
11	Investments—publicly traded securities .		0	11	0
12	Investments—other securities. See Part IV, line 11 .....		0	12	0
13	Investments—program-related. See Part IV, line 11 ..		0	13	0
14	Intangible assets ...............		0	14	0
15	Other assets. See Part IV, line 11 ...........		24,994	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...		817,917	16	755,365

17	Accounts payable and accrued expenses .....	159,084	17	276,723
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	0	25	68
26	Total liabilities. Add lines 17 through 25..	159,084	26	276,791

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	610,226	27	478,574
28	Temporarily restricted net assets ...........	48,607	28	0
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	658,833	33	478,574
34	Total liabilities and net assets/fund balances ........	817,917	34	755,365