TY 2021 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) ANGIE MCLAUGHLIN...................................................................... BOARD MEMBER	3.00 .................	X			0
(2) ARIANA GORDILLO...................................................................... DIRECTOR OF OUTREACH	40.00 .................	X			85,020
(3) BOBBY KAPUR MD...................................................................... BOARD MEMBER	3.00 .................	X			0
(4) ISI IKHAREBHA GREEN...................................................................... SECRETARY	3.00 .................	X	X		0
(5) KERRY THOMPSON...................................................................... VICE PRESIDENT	40.00 .................	X			125,313
(6) LARRY ROBINS...................................................................... BOARD MEMBER	3.00 .................	X			0
(7) MAUREEN TOMOSCHUK...................................................................... VICE CHAIRMAN	3.00 .................	X	X		0
(8) NANCY W HUDSON...................................................................... BOARD MEMBER	3.00 .................	X			0
(9) SHANNON WATSON...................................................................... BOARD MEMBER	3.00 .................	X			0
(10) STEPHANIE NELSON GARRIS JD...................................................................... CHAIRMAN	3.00 .................	X	X		0
(11) BETH ARMSTRONG...................................................................... TREASURER	3.00 .................	X	X		0
(12) ADAM BRADLEY...................................................................... BOARD MEMBER	3.00 .................	X			0
(13) KAT MASTRANGELO...................................................................... BOARD MEMBER	3.00 .................	X			0
(14) DR HINA AZAM...................................................................... BOARD MEMBER	3.00 .................	X			0
(15) GISELA BRETONES...................................................................... BOARD MEMBER	3.00 .................	X			0
(16) AVONTE JACKSON...................................................................... BOARD MEMBER	3.00 .................	X			0
(17) NICOLE LAMOUREUX...................................................................... PRESIDENT/CHIEF EXECUTIVE	40.00 .................			X	206,032

- TIN:

SCHEDULE A
(Form 990)

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 instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

NATIONAL ASSOCIATION OF FREE AND
CHARITABLE CLINICS INC

Employer identification number

56-2273242

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
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) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	1,377,807	3,517,698	3,180,507	4,631,838	7,108,792	19,816,642
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	1,377,807	3,517,698	3,180,507	4,631,838	7,108,792	19,816,642
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons						0
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.						0
c	Add lines 7a and 7b..						0
8	Public support. (Subtract line 7c from line 6.)						19,816,642

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...	1,377,807	3,517,698	3,180,507	4,631,838	7,108,792	19,816,642
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	16,366	16,704	42,284	30,323	25,335	131,012
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	16,366	16,704	42,284	30,323	25,335	131,012
11	Net income from unrelated business activities not included on 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.) ..				299,573		299,573
13	Total support. (Add lines 9, 10c, 11, and 12.)..	1,394,173	3,534,402	3,222,791	4,961,734	7,134,127	20,247,227

First 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

97.870 %

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

96.890 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

0.650 %

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

0.960 %

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2021

Name of the organization

NATIONAL ASSOCIATION OF FREE AND
CHARITABLE CLINICS INC

Employer identification number

56-2273242

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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC

Part I Contributors	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) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC		Employer identification number 56-2273242

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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC			Employer identification number 56-2273242
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) (2021)

Additional Data

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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 instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

NATIONAL ASSOCIATION OF FREE AND
CHARITABLE CLINICS INC

Employer identification number

56-2273242

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 FASB 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 FASB 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 FASB 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) 2021

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

Term 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 ....	29,180	13,815	15,365
e	Other .....	36,286	33,461	2,825
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				18,190

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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) INVESTMENTS	692,378	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	692,378

Part VIII

Investments - Program 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2021

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	8,345,135
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
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e	0
3	Subtract line 2e from line 1..................		3	8,345,135
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	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	8,345,135

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	7,710,445
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e	0
3	Subtract line 2e from line 1...................		3	7,710,445
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	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	7,710,445

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
PART X, LINE 2:	THE ASSOCIATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITION TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ASSOCIATION FILES ITS FORMS 990 IN THE U.S. FEDERAL JURISDICTION AND VARIOUS STATES. THE ASSOCIATION IS GENERALLY NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2015.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	STOCK SALES
PART XII, LINE 2D - OTHER ADJUSTMENTS:	BOOK TO TAX DEPRECIATION

Schedule D (Form 990) 2021

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
NATIONAL ASSOCIATION OF FREE AND
CHARITABLE CLINICS INC

Employer identification number
56-2273242

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	(h) Purpose of grant or assistance
(1) UBUNTU BLACK FAMILY WELLNESS COLLECTIVE 2611 GOVERNOR PRINTZ BLVD WILMINGTON,DE19702	84-4234815	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(2) BRAZOS MATERNAL & CHILD HEALTH CLINIC INC (THE PRENATAL CLINIC) 3370 S TEXAS AVE STE G BRYAN,TX77802	74-2397671	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(3) FREE CLINIC OF CENTRAL VIRGINIA 1016 MAIN STREET LYNCHBURG,VA24505	54-1420756	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(4) IMANI CLINIC 1213 ALVARADO AVE APT 30 DAVIS,CA95616	35-2505613	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(5) CENTER FOR BLACK WOMEN'S WELLNESS 477 WINDSOR STREET SW SUITE 309 ATLANTA,GA30312	58-2212203	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(6) VIDA INC 720 W ASSOCIATION DRIVE APPLETON,WI549141482	39-1446370	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(7) THE LUKE CLINIC 9615 MAI STREET SUITE B WHITMORE LAKE,MI48189	81-2779813	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(8) HEALING HANDS MINISTRIES INC 8515 GREENVILLE AVENUE N-112 DALLAS,TX75243	65-1259379	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(9) CHIKARE HEALTH SERVICES INC 915 WEST CHICAGO AVENUE EAST CHICAGO,IN46312	83-3895922	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(10) ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DR RALEIGH,NC276102593	56-2168673	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(11) APPNA COMMUNITY HEALTH CENTER OF SAN FRANCISCO BAY AREA 1505 GRANT ROAD LOS ALTOS,CA94024	82-1166053	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(12) BPSOS-ATLANTA 6107 OAKBROOK PKWY NORCROSS,GA30093	30-0737900	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(13) CAMINO COMMUNITY DEVELOPMENT CORPORATION 131 STETSON DR CHARLOTTE,NC28262	56-2015959	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(14) CARE RING 601 E 5TH ST SUITE 140 CHARLOTTE,NC28202	56-0621073	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(15) CASA EL BUEN SAMARITANO PO BOX 20487 HOUSTON,TX77225	37-1546805	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(16) CENTER FOR BLACK WOMEN'S WELLNESS 477 WINDSOR STREET SW SUITE 309 ATLANTA,GA30312	58-2212203	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(17) CHICAGO WOMEN'S HEALTH CENTER 1025 W SUNNYSIDE SUITE 201 CHICAGO,IL60626	36-2922469	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(18) CLARA'S HOUSE 2700 L STREET SACRAMENTO,CA95816	61-1591265	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(19) COMMUNITYHEALTH 2611 W CHICAGO AVE CHICAGO,IL60622	36-3831793	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(20) FOUNDATION FOR BETTER EDUCATION 11006 LANDON LN HOUSTON,TX77024	90-0849273	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(21) GET UP PROJECT 8101 CAMERON RD SUITE 101 AUSTIN,TX78759	45-4931906	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(22) GRACE MEDICAL HOME 1417 E CONCORD STREET ORLANDO,FL32803	26-1817966	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(23) IBN SINA FOUNDATION INC 11226 S WILCREST DR HOUSTON,TX77099	76-0698464	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(24) INDIAN AMERICAN MEDICAL ASSOCIATION CHARITABLE FOUNDATION 2645 WEST PETERSON CHICAGO,IL60659	36-3910201	501(C)(3)	40,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(25) JUDEO CHRISTIAN HEALTH CLINIC 4118 N MACDILL AVENUE TAMPA,FL33607	59-1605647	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(26) LATINO LEADERSHIP INC 8617 E COLONIAL DRIVE SUITE 1600 ORLANDO,FL32817	59-3702613	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(27) MIAMI RESCUE MISSION CLINIC INC 2015 NW 1ST AVENUE MIAMI,FL33127	45-1481860	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(28) MINISTRY CENTER COMMUNITY CLINIC 5516 REDLAND DRIVE SAN DIEGO,CA92115	27-1840491	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(29) PROJECT 658 3646 CENTRAL AVE CHARLOTTE,NC28205	46-2956418	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(30) ROOTS COMMUNITY HEALTH CENTER 7272 MACARTHUR BLVD OAKLAND,CA94605	26-2583954	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(31) SAN JOSE CLINIC 2615 FANNIN STREET HOUSTON,TX77002	76-0373703	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(32) SHEPHERDS CLINIC INC 2800 KIRK AVENUE BALTIMORE,MD21218	52-1739001	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(33) SHIFA HEALTHCARE & COMMUNITY SERVICES USA 9494 SOUTHWEST FREEWAY SUITE 450 HOUSTON,TX77074	32-0325331	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(34) THE GOOD SAMARITAN HEALTH CENTER INC 1015 DONALD LEE HOLLOWELL PKWY ATLANTA,GA30318	58-2373395	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(35) THE TEXAS INTERNATIONAL INSTITUTE OF HEALTH PROFESSIONS 8121 BROADWAY ST STE 103 HOUSTON,TX770611341	46-1267820	501(C)(3)	100,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(36) UHPHEALTH 6846 ANTOINE DR HOUSTON,TX77091	61-1757254	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(37) UNDERGROUND NETWORK INC PO BOX 75157 TAMPA,FL33675	20-4722214	501(C)(3)	75,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(38) UNIVERSAL HERITAGE INSTITUTE INC 4745 NW 183RD STREET MIAMI,FL33055	65-0268904	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(39) VOLUNTEER HEALTHCARE CLINIC 4215 MEDICAL PKWY AUSTIN,TX78756	74-6082464	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(40) VOLUNTEERS IN MEDICINE SAN FRANCISCO - DBA CLINIC BY THE BAY 4877 MISSION STREET SAN FRANCISCO,CA94112	26-2593712	501(C)(3)	65,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(41) AL-SHIFA CLINIC 2334 NORTH SIERRA WAY SAN BERNARDINO,CA92405	33-0855769	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(42) BERKELEY COMMUNITY HEALTH PROJECT 2339 DURANT AVE BERKELEY,CA94704	94-1697002	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(43) CLARA'S HOUSE 2700 L STREET SACRAMENTO,CA95816	61-1591265	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(44) CLINICA TEPATI 513 ISLA PLACE DAVIS,CA95616	94-2324682	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(45) COACHELLA VALLEY VOLUNTEERS IN MEDICINE 45805 FARGO STREET 10090 INDIO,CA92202	26-3312826	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(46) COMMUNITY SERVICE EDUCATION AND RESEARCH FUND OF SEDMS 5380 ELVAS AVENUE SUITE 219 SACRAMENTO,CA95819	23-7003581	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(47) CONEJO FREE CLINIC 80 E HILLCREST DRIVE SUITE 102 THOUSAND OAKS,CA91360	95-3177953	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(48) HEALING GROVE HEALTH CENTER INC A SOCIAL PURPOSE CORPORATION 226 W ALMA AVE STE 10 SAN JOSE,CA95110	84-4194962	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(49) IMANI CLINIC 2425 ALHAMBRA BLVD SACRAMENTO,CA95817	35-2505613	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(50) JEWISH COMMUNITY FREE CLINIC 50 MONTGOMERY DRIVE SANTA ROSA,CA95404	94-3386103	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(51) KNIGHTS LANDING ONE HEALTH CENTER 513 ISLA PLACE DAVIS,CA95616	94-2324682	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(52) MCCC MINISTRY CENTER COMMUNITY CLINIC 5516 REDLAND DR CARLSBAD,CA92115	27-1840491	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(53) NADEZHDA CLINIC CSI BOX 795 UC DAVIS 1 SHIELDS AVE DAVIS,CA95616	82-2852928	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(54) NAPA ACUPUNCTURE PRACTICE 411 FREEWAY DR NAPA,CA94558	81-4145087	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(55) ONE LOVE CENTER FOR HEALTH 826 CARLSTON AVE OAKLAND,CA94610	27-3215926	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(56) SAMARITAN HOUSE 4031 PACIFIC BLVD SAN MATEO,CA94403	23-7416272	501(C)(3)	22,266	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(57) SAVIE HEALTH 136 N THIRD STREET LOMPOC,CA93436	86-1668790	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(58) SHIFA COMMUNITY CLINIC 419 V STREET SACRAMENTO,CA95818	94-3398901	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(59) SOUTHERN CALIFORNIA CARE COMMUNITY 1249 E OHIO AVE ESCONDIDO,CA92009	85-0858493	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(60) ST JEANNE DE LESTONNAC FREE CLINIC 1215 E CHAPMAN AVENUE ORANGE,CA92866	95-3499011	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(61) STANFORD CARDINAL FREE CLINICS ALWAY BUILDING SUITE M116 MC 5629 300 PASTEUR DRIVE STANFORD,CA94305	94-1156365	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(62) SYMBA CENTER 20601 HWY 18 SUITE 171 APPLE VALLEY,CA92307	84-3729902	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(63) UCSD STUDENT-RUN FREE CLINIC PROJECT 9500 GILMAN DR DEPT 0696 LA JOLLA,CA920930696	95-6006144	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(64) UMI COMMUNITY IMAGING CLINIC 24901 VIA VERDE LAGUNA NIGUEL,CA92677	83-2309570	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(65) VIDA MOBILE CLINIC 10718 WHITE OAK AVE GRANADA HILLS,CA91344	81-4209248	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(66) VINEYARD FREE CLINIC 935 N MCKINLEY STREET CORONA,CA92879	33-0655628	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(67) VOLUNTEERS IN MEDICINE - SAN DIEGO 1457 E MADISON AVE EL CAJON,CA92019	26-0057391	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(68) VOLUNTEERS IN MEDICINE SAN FRANCISCO DBA CLINIC BY THE BAY 4877 MISSION ST SAN FRANCISCO,CA94112	26-2593712	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(69) WELL-ONE HEALTH INC 300 E 5TH ST PERRIS,CA925702006	47-3356072	501(C)(3)	20,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(70) WESTMINSTER FREE CLINIC 2673 SAN MIGUEL CIRCLE THOUSAND OAKS,CA91360	77-0563241	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(71) WOMEN & INFANTS MOBILE HEALTH - CAL POLY SAN LUIS OBISPO 1 GRAND AVENUE 43A-456 SAN LUIS OBISPO,CA93407	95-1648180	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(72) MEDICAL MISSION ADVENTURES 425 SIERRA MADRE VILLA AVE PASADENA,CA91107	04-3661520	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(73) OPTIONS FOR WOMEN OF CA (DBA OPTIONS HEALTH) 5167 CLAYTON RD SUITE H CONCORD,CA94521	68-0026753	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(74) CALIFORNIA ASSOCIATION OF FREE AND CHARITABLE CLINICS 2752 ABEJORRO STREET CARLSBAD,CA920095803	20-2198446	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(75) ROOTS COMMUNITY HEALTH CENTER 7272 MACARTHUR BLVD OAKLAND,CA94605	26-2583954	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(76) ARLINGTON FREE CLINIC 2921 11TH STREET SOUTH ARLINGTON,VA22204	54-1671883	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(77) COMMUNITY HEALTH CENTER OF WEST PALM BEACH 2100 W 45TH STREET WEST PALM BEACH,FL33407	26-3611337	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(78) GRACE MEDICAL HOME 1417 E CONCORD STREET ORLANDO,FL32803	26-1817966	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(79) JFK GLOBAL PRAYER MINISTRY 9494 SOUTHWEST FREEWAY SUITE 450-R HOUSTON,TX77074	47-5269630	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(80) PLACE OF HOPE 5405 JONESBORO ROAD LAKE CITY,GA30260	58-2656313	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(81) PREMIER MOBILE HEALTH SERVICE CORPORATION 317 PENNFIELD STREET LEHIGH ACRES,FL33974	82-5372257	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(82) SERVOLUTION HEALTH SERVICES 181 POWELL VALLEY SCHOOL LANE SPEEDWELL,TN37870	45-4486454	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(83) SYMBA CENTER 20601 HWY 18 SUITE 171 APPLE VALLEY,CA92307	84-3729902	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(84) THE GOOD SAMARITAN HEALTH CENTER 1015 DONALD LEE HOLLOWELL PARKWAY ATLANTA,GA30318	58-2373395	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(85) UH FOUNDATION 651 ILALO STREET MEB-OME HONOLULU,HI96813	99-0085260	501(C)(3)	30,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(86) BOAT PEOPLE SOS-ATLANTA 6107 OAKBROOK PARKWAY NORCROSS,GA30093	30-0737900	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(87) BRADLEY FREE CLINIC 1240 THIRD STREET ROANOKE,VA24016	23-7380491	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(88) BREAD OF HEALING CLINIC 1821 N 16TH ST MILWAUKEE,WI53205	81-0669867	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(89) C-ASIST 24513 FORD ROAD DEARBORN,MI48128	81-3386484	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(90) CARE BEYOND THE BOULEVARD 3617 N 112TH TERRACE KANSAS CITY,KS66109	83-1122028	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(91) CARE CLINIC 906 COLLEGE AVENUE RED WING,MN55066	27-0540410	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(92) CARING HEARTS FREE CLINIC OF PATRICK COUNTY 835 WOODLAND DRIVE SUITE 101 STUART,VA24171	14-1909014	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(93) CENTRE VOLUNTEERS IN MEDICINE 2520 GREEN TECH DRIVE STATE COLLEGE,PA16803	25-1897969	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(94) CHURCH HEALTH CENTER OF MEMPHIS INC 1350 CONCOURSE AVE STE 142 MEMPHIS,TN38104	58-1716113	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(95) CITY ON A HILL MINISTRIES 100 PINE ST ZEELAND,MI49464	20-3901260	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(96) CLINICA COLORADO 8300 ALCOTT ST SUITE 300 WESTMINSTER,CO80031	27-3794068	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(97) CLINICA ESPERANZA HOPE CLINIC 60 VALLEY ST STE 104 PROVIDENCE,RI02909	26-1714340	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(98) COMMUNITY CARE CENTER FOR FORSYTH COUNTY INC 2135 NEW WALKERTOWN ROAD WINSTONSALEM,NC27101	58-1403699	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(99) COMMUNITY CLINIC OF SHELBYVILLE AND BEDFORD COUNTY INC 200 DOVER STREET SUITE 202 SHELBYVILLE,TN37160	34-1974609	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(100) COMMUNITY CLINIC OF SWMO 701 SOUTH JOPLIN AVE JOPLIN,MO64801	43-1643962	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(101) COMMUNITY HEALTH PARTNERS PO BOX 2853 LONGVIEW,WA98632	91-2016542	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(102) COMMUNITY HEALTH-IN-PARTNERSHIP SERVICES 2431 N GRAND BLVD ST LOUIS,MO63106	43-1589851	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(103) COMMUNITY HELPING PLACE FREE CLINIC PO BOX 712 DAHLONEGA,GA30533	37-1554432	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(104) COMMUNITY VOLUNTEERS IN MEDICINE 300 B LAWRENCE DR WEST CHESTER,PA19380	23-2944553	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(105) COMMUNITYHEALTH 2611 W CHICAGO AVE CHICAGO,IL60622	36-3831793	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(106) CROSSOVER HEALTHCARE MINISTRY 8600 QUIOCCASIN RD SUITE 101 RICHMOND,VA23229	54-1371067	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(107) FAITH FAMILY MEDICAL CENTER 326 21ST AVE N NASHVILLE,TN27303	62-1816811	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(108) FAMILY HEALTH PARTNERSHIP CLINIC 401 E CONGRESS PARKWAY CRYSTAL LAKE,IL60014	36-4277029	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(109) FREE CLINIC OF CENTRAL VIRGINIA 1016 MAIN STREET LYNCHBURG,VA24504	54-1420756	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(110) GOOD SHEPHERD CLINIC OF DAWSON COINC 452 HIGHWAY 53 E 1009 DAWSONVILLE,GA30534	54-0927792	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(111) GRAPEVINE RELIEF AND COMMUNITY EXCHANGE PO BOX 412 GRAPEVINE,TX76099	36-3145764	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(112) GRASSROOTS HEALTHCARE FOUNDATION 732 PLACER CIRCLE VACAVILLE,CA95687	32-0600776	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(113) GREENVILLE FREE MEDICAL CLINIC PO BOX 8993 GREENVILLE,SC29604	57-0855205	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(114) HEALTH AND HOPE CLINIC INC 1718 E OLIVE ROAD PENSACOLA,FL32514	52-2257585	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(115) HEALTH BRIGADE 1010 N THOMPSON STREET RICHMOND,VA23230	20-1020941	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(116) HEALTH FOR ALL PO BOX 5913 BRYAN,TX77805	74-2624477	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(117) HEALTHFINDERS COLLABORATIVE INC PO BOX 731 NORTHFIELD,MN55057	20-1805262	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(118) HEALTHNET OF ROCK COUNTY INC 23 W MILWAUKEE STREET JANESVILLE,WI53548	39-1778804	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(119) HEALTHREACH COMMUNITY CLINIC PO BOX 1265 MOORESVILLE,NC28115	20-1942444	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(120) HELPING HANDS OF TENNESSEE 1408 N HIGHLAND AVE STE 102 JACKSON,TN38301	81-1043752	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(121) HOPE MEDICAL CLINIC 150 BEACH DRIVE DESTIN,FL32541	26-3811078	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(122) IBN SINA FOUNDATION 11226 S WILCREST DR HOUSTON,TX77099	76-0698464	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(123) JEWISH COMMUNITY FREE CLINIC 50 MONTGOMERY DRIVE SANTA ROSA,CA95404	94-3386103	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(124) JOHNSTOWN FREE MEDICAL CLINIC 315 LOCUST STREET 2ND FLOOR JOHNSTOWN,PA15901	23-2922409	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(125) LIFESPRING COMMUNITY HEALTH 1042 E 3RD ST STE 103 CHATTANOOGA,TN37404	27-3856741	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(126) LOWER RIO GRANDE VALLEY COMMUNITY HEALTH MANAGEMENT CORPORATION INC 901 E VERMONT AVE MCALLEN,TX78503	74-2784427	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(127) MERCI CLINIC INC 1315 TATUM DR NEW BERN,NC28560	56-2034052	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(128) MIDVALE COMMUNITY BUILLDING COMMUNITY INC 49 W CENTER STREET MIDVALE,UT84103	46-0548747	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(129) MOUNTAIN HOPE GOOD SHEPHERD CLINIC INC PO BOX 5937 SEVIERVILLE,TN37864	62-1747037	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(130) NEIGHBORHOOD HEALTH CLINIC 88 12TH STREET NORTH SUITE 100 NAPLES,FL34102	59-3546884	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(131) PARKER FAMILY HEALTH CENTER 211 SHREWSBURY AVENUE RED BANK,NJ07701	22-3619518	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(132) PEDIPLACE 502 S OLD ORCHARD LANE SUITE 126 LEWISVILLE,TX75067	75-2512752	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(133) SHEEP INC HEALTH CARE CENTER 11817 FRANKSTOWN ROAD PENN HILLS,PA15235	45-5532140	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(134) SHEPHERDS CLINIC INC 2800 KIRK AVENUE BALTIMORE,MD21218	30-0272954	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(135) SHIFRA FREE CLIMIC 1092 JOHNNIE DODDS BLVD STE 108 MT PLEASANT,SC29464	43-8101610	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(136) SOCIETY OF ST VINCENT DE PAUL PO BOX 13600 PHOENIX,AZ850023600	86-0096789	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(137) ST CLAIR COMMUNITY HEALTH CLINIC 205 EDWIN HOLLADAY PLACE STE 125 PELL CITY,AL35125	85-0632695	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(138) THE GOOD SAMARITAN HEALTH CENTER 1015 DONALD LEE HOLLOWELL PARKWAY ATLANTA,GA30318	58-2373395	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(139) THE HEALTH HUT 310 WEST MISSISSIPPI AVE RUSTON,LA71270	27-3764078	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(140) THE NIGHT MINISTRY 1735 NORTH ASHLAND AVENUE SUITE 2000 CHICAGO,IL60622	36-3145764	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(141) THE OLYMPIA FREE CLINIC PO BOX 6310 OLYMPIA,WA98507	27-1606329	501(C)(3)	10,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(142) THE TEXAS INTERNATIONAL INSTITUTE OF HEALTH PROFESSIONS 8121 BROADWAY ST STE 103 HOUSTON,TX770611341	46-1267820	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(143) TRS HEALTH 12805 CAPRICORN STREET HOUSTON,TX77477	84-2546001	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(144) UBI CARITAS 4450 HIGHLAND AVE BEAUMONT,TX77705	56-1322973	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(145) UHPHEALTH 6846 ANTOINE DR HOUSTON,TX77091	61-1757254	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(146) WILL-GRUNDY MEDICAL CLINIC 213 E CASS JOLIET,IL60432	36-3492306	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(147) WV HEALTH RIGHT INC 1520 WASHINGTON ST E CHARLESTON,WV25311	31-1066881	501(C)(3)	50,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(148) CROSSOVER HEALTHCARE MINISTRY 8600 QUIOCCASIN RD SUITE 101 RICHMOND,VA23229	54-1371067	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(149) OPEN ARMS CLINIC 109 BIG A ROAD TOCCOA,GA30577	20-3296577	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(150) CHURCH HEALTH CENTER OF MEMPHIS INC 1350 CONCOURSE AVE STE 142 MEMPHIS,TN38112	58-1716113	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(151) ROPHE FREE CLINIC INC 4374 WEST 52ND STREET INDIANAPOLIS,IN46245	81-2339063	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(152) SINCLAIR HEALTH CLINIC 301 N CAMERON STREET SUITE,VA22601	54-1373296	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(153) LAHAI HEALTH 19820 SCRIBER LAKE ROAD SUITE 2 LYNNWOOD,WA98036	33-1052418	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(154) FAITH FAMILY MEDICAL CENTER 326 21ST AVE N NASHVILLE,TN37203	62-1816811	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(155) OUTREACH FREE CLINIC AND RESOURCE CENTER 517 N PARSONS AVENUE BRANDON,FL33510	59-2917499	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(156) VOLUNTEERS IN MEDICINE 190 N PENNSYLVANIA AVE WILKESBARRE,PA18702	20-3531527	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(157) WEST VIRGINIA HEALTH RIGHT INC 1520 WASHINGTON STREET EAST CHARLESTON,WV25311	31-1066881	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(158) C-ASSIST 24513 FORD RD DEARBORN,MI48128	81-3386484	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.
(159) WESTMINSTER FREE CLINIC 2673 SAN MIGUEL CIRCLE THOUSAND OAKS,CA91360	77-0563241	501(C)(3)	25,000	TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS.

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) 2021

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	GRANT FUNDING CLINICS MUST SIGN A LETTER THAT STATES THEY UNDERSTAND THE REQUIREMENTS OF THE GRANT AND THEY MUST REPORT TWO TIMES A YEAR USING AN ELECTRONIC PORTAL. THEN, WE MAKE A REPORT SUMMARIZING THE FUNDS STATUS.

Schedule I (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

NATIONAL ASSOCIATION OF FREE AND
CHARITABLE CLINICS INC

Employer identification number

56-2273242

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1NICOLE LAMOUREUX PRESIDENT/CHIEF EXECUTIVE	(i) (ii)	206,032 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	206,032 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

NATIONAL ASSOCIATION OF FREE AND
CHARITABLE CLINICS INC

Employer identification number

56-2273242

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERSHIP IS COMPOSED OF FREE CLINICS AROUND THE COUNTRY THAT PAY DUES TO BE A MEMBER. THE BOARD IS ELECTED AT AN ANNUAL MEETING OF THE MEMBERSHIP OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBERS ELECT OFFICERS AT THE ANNUAL MEETING OF THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11B	DURING THE IRS'S DEVELOPMENT OF THIS FORM, THE AICPA SUGGESTED THAT COMPLIANCE AND FIDUCIARY DUTIES WOULD BE BEST MET IF A NON-PROFIT BOARD OF DIRECTORS, AUDIT COMMITTEE OR OTHER APPROPRIATE COMMITTEE RECEIVED CONFIRMATION FROM THE PARTY OR PARTIES RESPONSIBLE FOR FILING THE TAX RETURN THAT IT HAD BEEN PREPARED BY A QUALIFIED PERSON(S) OR FIRM AND HAD BEEN FILED IN A TIMELY MANNER, RATHER THAN REVIEWING THE FORM IN LINE-BY-LINE DETAIL WITH MANAGEMENT. WE ARE CONCERNED THAT THE VAST MAJORITY OF NON-PROFIT BOARD MEMBERS ARE NOT IN A POSITION TO REVIEW A FORM 990 AND FURTHER CONCERNED AS TO WHAT A REQUEST OF THIS NATURE MAY IMPLY ABOUT COMPLIANCE. MOST NON-PROFITS HIRE CPA FIRMS OR OTHER TAX PROFESSIONALS TO PREPARE FORMS 990 AND BOARD MEMBERS GENERALLY FEEL THIS IS THE APPROPRIATE FIDUCIARY PROCESS. THE BOARD OR AUDIT COMMITTEE'S ROLE THEN IS TO EVALUATE THE COMPETENCY OF THE PERSON(S) OR FIRM HIRED TO PREPARE THE RETURN AND TO DETERMINE IT IS APPROPRIATELY FILED. WE HAVE TAKEN THESE STEPS WITH OUR BOARD.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD MUST SIGN THE CONFLICT OF INTEREST FORM AND BOARD COMMITMENT FORM ANNUALLY AND RETURN TO THE NAFC STAFF.
FORM 990, PART VI, SECTION B, LINE 15	THERE IS AN EXECUTIVE COMMITTEE ESTABLISHED WHO REVIEWS AND SETS THE GOALS FOR THE CEO POSITION. THE CEO IS THEN ASSESSED AND EVALUATED ANNUALLY BASED ON THESE GOALS. THE COMMITTEE RESEARCHES INDUSTRY WAGE REPORTS AND ANNUALLY REVIEWS SALARY LEVELS FOR COMPARABILITY. OTHER TOP MANAGEMENT POSITIONS ARE REVIEWED BY THE BOARD MEMBERS BASED ON ANNUAL GOAL CRITERIA.
FORM 990, PART VI, SECTION C, LINE 19	ALL DOCUMENTS ARE MADE AVAILABLE AT THE OFFICES OF THE ORGANIZATION UPON REQUEST.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO ENSURE THAT THE MEDICALLY UNDERSERVED HAVE ACCESS TO AFFORDABLE QUALITY HEALTH CARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,600,284	7,703,358
9	Program service revenue (Part VIII, line 2g) .........	103,010	616,955
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	30,323	24,822
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	5,733,617	8,345,135
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,969,265	5,685,359
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)	450,858	532,486
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 59,407
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	650,954	1,492,600
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	5,071,077	7,710,445
19	Revenue less expenses. Subtract line 18 from line 12.......	662,540	634,690
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,423,329	2,287,397
21	Total liabilities (Part X, line 26).............	254,481	483,859
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,168,848	1,803,538

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 792,433 including grants of $ 93 ) (Revenue $ 514,591 )
	THE NAFC ANNUAL SYMPOSIUM AND ADDITIONAL EDUCATION SERVICES ARE THE ONLY NATIONAL MEETING SOLELY DEDICATED TO PROVIDING HEALTH EDUCATION AND TRAINING FOR NAFC STAFF AND VOLUNTEERS WHO PROVIDE HEALTH CARE TO THE MEDICALLY UNDERSERVED.

4b	(Code: ) (Expenses $ 6,437,434 including grants of $ 5,685,266 ) (Revenue $ 60,000 )
	CLINICS ESTABLISH AND MAINTAIN SERVICES THAT SUPPORT AND BENEFIT THE WORK OF THE MEMBERS IN THEIR EFFORTS TO PROVIDE HEALTH CARE TO THE UNINSURED AND UNDERINSURED.

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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses7,229,867

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	416,365	0	0

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	7,703,358

g	Noncash contributions included in lines 1a - 1f:$		1g	653,870

h Total. Add lines 1a-1f.......		7,703,358

		Business Code
2a	MEMBERSHIP DUES	621400	397,079	397,079
b	SYMPOSIUM	621400	117,512	117,512
c	BIOGEN	621400	60,000	60,000
d
e
f	All other program service revenue.		42,364		42,364
g	Total. Add lines 2a–2f .....		616,955

3 Investment income (including dividends, interest, and othersimilar amounts) ......			24,822			24,822
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			8,345,135	574,591	0	67,186

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	5,685,359	5,685,359
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	416,365	288,286	128,079
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	64,298	20,623	11,817	31,858
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	51,823	33,206	15,222	3,395
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	279,178	132,672	129,906	16,600
b	Legal .........
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	653,870	653,870
12	Advertising and promotion ....	116,318	63,464	52,854
13	Office expenses .......	1,378	371	1,007
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	120,364	67,656	45,154	7,554
17	Travel ............	9,226	9,138	88
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,159		3,159
23	Insurance ...	8,294		8,294
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	SYMPOSIUM EXPENSE	227,563	227,563
b	TELEPHONE & WEBSITE	46,248	35,231	11,017
c	BANK FEES	13,599		13,599
d	POSTAGE/SHIPPING	10,815	10,815
e	All other expenses	2,588	1,613	975
25	Total functional expenses. Add lines 1 through 24e	7,710,445	7,229,867	421,171	59,407
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 ........			264,662	1	538,605
2	Savings and temporary cash investments .........			290,824	2	826,273
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			58,963	4	146,048
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			207,344	9	24,620
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	65,467
b	Less: accumulated depreciation	10b	47,277	13,939	10c	18,190
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			553,527	12	692,378
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			34,070	15	41,283
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,423,329	16	2,287,397

17	Accounts payable and accrued expenses .....	54,714	17	220,994
18	Grants payable ...	10,000	18	10,000
19	Deferred revenue .........	189,767	19	252,865
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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		25
26	Total liabilities. Add lines 17 through 25..	254,481	26	483,859

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,168,848	27	1,803,538
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	1,168,848	32	1,803,538
33	Total liabilities and net assets/fund balances ........	1,423,329	33	2,287,397