TY 2025 Form 990

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)

(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) Prabhu Emmady......................................................................
Executive Director/CEO

15
.................
0

(2) Prasanth Nandamuri......................................................................
Director

1
.................
0

(3) Ebeneer Gujjarlapudi......................................................................
Director

1
.................
0

(4) Pradep Darivemula......................................................................
Director

1
.................
0

(5) Calvin Devathala......................................................................
Director

1
.................
1

(6) Charwin Abraham......................................................................
Treasurer

5
.................
0

(7) Manoj Kothuri......................................................................
Board President

1
.................
0

(8) Kiran Jagarjamudi......................................................................
Medical Director

5
.................
0

(9) Josephine Jebackumar......................................................................
Board Vice President

1
.................
0

(10) Winsley Peter......................................................................
Secretary

1
.................
0

(11) Jonathan Hernandez......................................................................
Director

0
.................
0

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)

(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)

(F)
Estimated amount of other compensation from the organization and related organizations

(A)
Name and business address

(B)
Description of services

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

- 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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2025

Open to Public
Inspection

Name of the organization

HOPE STREET FREE CLINIC INC

Employer identification number

93-2231392

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 must generally 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) 2025

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) 2021	(b) 2022	(c) 2023	(d) 2024	(e) 2025	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..			5,771	7,115	67,995	80,881
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....			0	0	0	0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..			0	0	0	0
4	Total. Add lines 1 through 3	0	0	5,771	7,115	67,995	80,881
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) ..						44,988
6	Public support. Subtract line 5 from line 4.						35,893

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2021	(b) 2022	(c) 2023	(d) 2024	(e) 2025	(f) Total
7	Amounts from line 4..	0	0	5,771	7,115	67,995	80,881
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...			0	0	0	0
9	Net income from unrelated business activities, whether or not the business is regularly carried on..			0	0	0	0
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..			0	0	0	0
11	Total support. Add lines 7 through 10						80,881

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 ........................................

Section C. Computation of Public Support Percentage

Public support percentage for 2025 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2024 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2025. 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 .......................

33 1/3% support test—2024. 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 .....................

17a

10%-facts-and-circumstances test—2025. 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 ............

10%-facts-and-circumstances test—2024. 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 ............

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

Schedule A (Form 990) 2025

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) 2021	(b) 2022	(c) 2023	(d) 2024	(e) 2025	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.")
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2021	(b) 2022	(c) 2023	(d) 2024	(e) 2025	(f) Total
9	Amounts from line 6
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975
c	Add lines 10a and 10b
11	Net income from unrelated business activities not included 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.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

Section C. Computation of Public Support Percentage

Public support percentage for 2025 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2024 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2025 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2024 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2025. 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 .......

33 1/3 % support tests—2024. 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 .....

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

Schedule A (Form 990) 2025

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) 2025

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 supported organization. Describe in Part VI how you supported a governmental supported organization (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 its supported organization(s)? 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 each of its 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, 3b, and 3c below.

Are the organization and its supported organization(s) part of an integrated system (for example, a hospital system)? If “Yes,” provide details in Part VI.

Did the organization direct 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.

Did the organization have the power to regularly appoint or elect (and remove) a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Schedule A (Form 990) 2025

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) 2025

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
6Total annual distributions. Add lines 1 through 5.	6
7 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	7
8 Distributable amount for 2025 from Section C, line 6	8
9 Line 7 amount divided by Line 8 amount	9

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2025	(iii) Distributable Amount for 2025
1 Distributable amount for 2025 from Section C, line 6
2 Underdistributions, if any, for years prior to 2025 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2025:
a From 2020.......
b From 2021.......
c From 2022.......
d From 2023.......
e From 2024.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2025 distributable amount
i Carryover from 2020 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2025 from Section D, line 6:
$
a Applied to underdistributions of prior years
b Applied to 2025 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2025, 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 2025. 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 2026. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2021.....
b Excess from 2022.....
c Excess from 2023.....
d Excess from 2024.....
e Excess from 2025.....

Schedule A (Form 990) (2025)

Schedule A (Form 990) 2025

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, 3b, and 3c; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5 and 7; 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, Part II, Line 10	Form 990, Schedule A, Part II, Line 10 - Public Support Computation The organization is described in Sections 509(a)(1) and 170(b)(1)(A)(vi). In computing public support, the organization applied the 2% limitation as required by Schedule A instructions. The portion of total contributions from each person (other than governmental units or publicly supported organizations) that exceeded 2% of total contributions for the applicable computation period was excluded from public support and included in total support. For the current year, 2% of total contributions was $1,359.90. The total amount excluded from public support due to the 2% limitation was $39,306.23. The organization continues to satisfy the public support test under the five-year computation method.

Return Reference

Explanation

Schedule A, Part II, Line 10

Form 990, Schedule A, Part II, Line 10 - Public Support Computation The organization is described in Sections 509(a)(1) and 170(b)(1)(A)(vi). In computing public support, the organization applied the 2% limitation as required by Schedule A instructions. The portion of total contributions from each person (other than governmental units or publicly supported organizations) that exceeded 2% of total contributions for the applicable computation period was excluded from public support and included in total support. For the current year, 2% of total contributions was $1,359.90. The total amount excluded from public support due to the 2% limitation was $39,306.23. The organization continues to satisfy the public support test under the five-year computation method.

Schedule A (Form 990) 2025

Additional Data

Software ID:	25022730
Software Version:	v1.00

- TIN:

SCHEDULE O
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

HOPE STREET FREE CLINIC INC

Employer identification number

93-2231392

Return Reference	Explanation
Form 990, Part III, Line 2	2 medical and 2 non-medical charity trips to Uganda. 1 Educational event for students on Nov 1
Form 990, Part VI, Section A, Line 4	Bylaws of Hope Street Free Clinic INC (Approved on 07/22/2025) ________________________________________ Article I: Name and Purpose Section 1: Name The name of this nonprofit organization shall be "Hope Street Free Clinic INC," hereinafter referred to as "HSFC." Section 2: Purpose The purpose of HSFC is to provide free medical care, health education, and other community services to underserved individuals within the community and beyond, regardless of their socio-economic status, ethnicity, gender, or age. ________________________________________ Article II: Board of Directors Section 1: Powers and Responsibilities * HSFC shall be governed by a Board of Directors (the "Board"), responsible for overseeing the operations, financial management, and strategic direction of HSFC. * The Board shall have the authority to establish policies, make decisions, and ensure HSFC's mission and values are upheld. * The Board shall be an active board, with each voting member expected to serve on a committee or participate in operational, fundraising, or strategic initiatives in alignment with HSFC's mission. Section 2: Composition * The Board shall consist of a minimum of seven (7) and a maximum of fifteen (15) voting directors. * In addition, the Executive Director and Medical Director shall serve as ex-officio, nonvoting members of the Board. These ex-officio roles shall not count toward the total number of voting directors. Section 3: Terms of Office * Voting Directors shall serve a term of three (3) years. Directors may be re-elected for successive terms, subject to board approval. * There shall be no automatic reset of terms; all current board members shall retain their original term start dates. * To maintain continuity, a staggered rotation shall be followed with approximately one-third of terms expiring each year. Section 4: Ex-Officio Directors * The Executive Director and Medical Director shall serve without term limits and shall not have voting rights. * These individuals may participate in all Board discussions, attend meetings, and provide reports, but shall not vote on Board decisions. * Their primary role is to provide operational insight and continuity between board governance and HSFC operations. ________________________________________ Article III: Officers Section 1: Officers HSFC shall have the following officers: Chairperson, Vice Chairperson, Secretary, and Treasurer. Section 2: Election and Duties Officers shall be elected by the voting members of the Board from among its voting members. * The Chairperson shall preside over meetings, represent HSFC in official matters, and provide leadership to the Board. * The Vice Chairperson shall assist the Chairperson and assume their duties in their absence. * The Secretary shall be responsible for maintaining accurate records of meetings and official correspondence. * The Treasurer shall oversee HSFC's financial matters, including budgeting, reporting, and financial planning. * When necessary, the Chair of the Board may also have the title as President of the Board to meet regulatory or institutional requirements. Article IV: Executive Director and Medical Director Section 1: Executive Director * The Executive Director shall also serve as the Chief Executive Officer (CEO) and President of HSFC. * This individual shall provide visionary leadership, oversee the day-to-day operations, and guide the overall direction and growth of the organization. * The Executive Director shall implement the strategic goals and objectives of the Board, supervise staff and volunteers, represent HSFC publicly, and be responsible for the execution of board policies. * The Executive Director shall serve as an ex-officio, nonvoting member of the Board. Section 2: Medical Director * The Medical Director shall oversee the clinical quality, protocols, and medical staff performance at HSFC. * They shall advise the Board and Executive Director on clinical matters and ensure that medical services are provided in a safe, ethical, and effective manner. * The Medical Director shall serve as an ex-officio, nonvoting member of the Board. ________________________________________ Article V: Meetings Section 1: Board Meetings * The Board shall meet at least four (4) times a year, with additional meetings as needed. * A quorum shall consist of a majority of voting directors. * Decisions shall be made by a majority vote of the voting directors present, except as otherwise specified in these bylaws. Section 2: Confidentiality * Board members shall maintain the confidentiality of all information discussed during board meetings or related communications, including but not limited to matters involving personnel, finances, donor information, and strategic planning. * Directors shall not disclose such information to individuals outside the board unless legally required or expressly authorized by the board. * This obligation of confidentiality continues even after a board member's term ends. ________________________________________ Article VI: Committees Section 1: Committees The Board may establish committees as necessary to address specific tasks, such as finance, fundraising, governance, operations, and program development. Each board member is expected to actively involve in the operations. ________________________________________ Article VII: Amendments Section 1: Amendment Process These bylaws may be amended by a two-thirds (2/3) majority vote of the voting directors present at a regular or special Board meeting. ________________________________________ Article VIII: Dissolution Section 1: Dissolution Process In the event of dissolution of HSFC, any remaining assets shall be distributed to other nonprofit organizations with similar missions, as determined by the Board. ________________________________________ Article IX: Adoption Section 1: Adoption These bylaws shall become effective upon adoption by a majority vote of the Board of Directors. Approved and adopted on this 22 day of July, 2025. CERTIFICATION We, the undersigned, certify that the above is a true and correct copy of the resolution duly adopted by the Board of Directors of Hope Street Free Clinic at a properly noticed and quorum-filled meeting on the date set forth above, and that said resolution is now in full force and effect. Signed: Manoj Kothuri Winsley Peter Prabhu Emmady Board Chair Board Secretary Executive Director/CEO Date: _______________ Date: _______________ Date: _______________
Form 990, Part VI, Section B, Line 11b	Hope Street Free Clinic has established a process to ensure accurate and complete reporting on Form 990. The draft of Form 990 is initially prepared by the organization's Chief Executive Officer (CEO) using financial records, donation tracking, and program data for the applicable tax year. The draft is then reviewed by the Treasurer and all board members, to verify that all financial information, program service accomplishments, and governance disclosures are accurate and complete. During the review, the board examines IRS filing Form 990 before submission to the IRS. This process ensures transparency, accuracy, and accountability in the organization's annual reporting.
Form 990, Part VI, Section B, Line 12c	Annual discussion in the board of directors meeting.
Form 990, Part VI, Section C, Line 19	On the website

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

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	25022730
Software Version:	v1.00

1	Briefly describe the organization’s mission or most significant activities: This corporation is organized exclusively for religious, charitable, and educational purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code, including but not limited to charitable health services, health education and workforce training programs, and providing humanitarian and medical mission support domestically and internationally. We operate Free Clinics in the United States, offer educational training through Hope Street Community Institute initiative and also perform International Missions including medical clinics, charity work in Uganda and beyond.
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 2025 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	100
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) .........	7,115	67,995
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	0	0
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)	7,115	67,995
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	8,745	53,338
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	8,745	53,338
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,630	14,657
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	999	15,656
21	Total liabilities (Part X, line 26).............	0	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	999	15,656

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 43,218 including grants of $ 0 ) (Revenue $ 0 )
	Program Service Accomplishment - International Medical Missions to Uganda Hope Street Free Clinic conducted multiple charitable medical outreach initiatives in Uganda during 2025, including medical mission trips in March and October, as well as additional charitable outreach trips in May and August. These missions were designed to provide essential healthcare services, medications, and health education to underserved rural communities surrounding Tororo, where access to medical care is severely limited. Volunteer teams from the United States, led by Dr. Prabhu D. Emmady, MD, and supported by qualified medical professionals, operated mobile medical clinics in collaboration with local community leaders and volunteers. Across the four outreach trips, the teams visited multiple villages, conducting patient registration, triage, medical evaluations, diagnosis, and treatment planning. Patients received individualized counseling on medication adherence, nutrition, chronic disease management, and early symptom recognition. Health education sessions were provided to increase health literacy and empower community members to engage in preventive care practices. During these missions, a total of over 4,000 patients were seen and treated. The teams distributed more than 150,000 doses of essential medications, including treatments for malaria, parasitic infections, respiratory illnesses, gastrointestinal disorders, musculoskeletal pain, dermatologic conditions, anemia, hypertension, and other common acute and chronic conditions. All medical services and medications were provided at no cost to recipients and were supported entirely through charitable donations and volunteer participation. These missions emphasized collaboration with local pastors, elders, and regional coordinators to ensure culturally appropriate care and promote sustainability. Local volunteers assisted with translation, patient flow, and follow-up guidance, strengthening the community's capacity to support ongoing health needs. Through these combined efforts, Hope Street Free Clinic advanced its charitable purpose by: Expanding access to medical care for underserved and impoverished populations Delivering essential medications in regions with limited pharmacy access Providing health education to improve preventative care and health literacy Supporting long-term community health through collaboration with local leaders These Uganda medical missions reflect the organization's ongoing commitment to providing compassionate, volunteer-driven healthcare internationally, addressing immediate medical needs, and promoting sustainable health improvements in resource-limited settings.

4b	(Code: ) (Expenses $ 4,187 including grants of $ 0 ) (Revenue $ 0 )
	Program Service Accomplishment Two - Free Clinics in Charlotte, North Carolina Hope Street Free Clinic operates volunteer-driven free medical clinics in the Charlotte area, providing no-cost healthcare services to uninsured and underserved individuals. The clinics are held regularly at accessible locations within the community and are staffed by licensed healthcare professionals, students, and trained volunteers. Services include primary care consultations, chronic disease management, preventive screenings, vaccinations, health education, and access to essential medications. During clinic sessions, patients receive individualized medical evaluations, treatment plans, and counseling on managing chronic conditions such as hypertension, diabetes, and neurological disorders. Volunteers also provide health education on nutrition, exercise, medication adherence, hygiene practices, and preventive care strategies. The clinics serve as both a direct healthcare resource and an educational platform to improve health literacy within the community. All medical services, medications, and educational materials are provided at no cost to recipients. Expenses associated with operating the clinics include medical supplies, medications, equipment, volunteer training, insurance, facility use, and administrative support to ensure safe and effective patient care. These operational expenditures are necessary to maintain consistent, high-quality services and to support the organization's mission of reducing healthcare disparities locally. Through these clinics, Hope Street Free Clinic advances its charitable purpose by: Increasing access to healthcare for individuals who might otherwise go without medical care Providing preventative and chronic care management to improve health outcomes Offering health education to empower patients to make informed healthcare decisions Supporting volunteer engagement and professional development in healthcare services These ongoing domestic clinic operations demonstrate the organization's commitment to promoting equitable healthcare access, improving public health in the Charlotte community, and delivering sustainable, volunteer-driven charitable services.

4c	(Code: ) (Expenses $ 5,933 including grants of $ 0 ) (Revenue $ 0 )
	Program Service Accomplishment - November 1 Community Health & Education Event On November 1, Hope Street Free Clinic conducted a community-based health education and outreach event designed to advance public health awareness, provide preventative education, and connect underserved individuals with free medical services. The event included structured educational sessions addressing common health concerns affecting uninsured and underserved populations, including chronic disease prevention, lifestyle modification, medication adherence, and preventive screening recommendations. Volunteer healthcare professionals and trained student volunteers provided evidence-based instruction on managing hypertension, diabetes risk, nutrition, and early symptom recognition for neurological and general medical conditions. In addition to formal education sessions, attendees received individualized guidance on accessing free clinic services, navigating local healthcare resources, and understanding preventative care options. Educational materials were distributed to reinforce key health concepts and encourage long-term behavior modification. The event also served as a public awareness initiative to inform the broader community about the availability of no-cost medical services offered by the clinic. Outreach efforts emphasized early intervention, preventative care, and reducing avoidable emergency room utilization among uninsured individuals. Through this initiative, the clinic furthered its charitable and educational mission by: Increasing health literacy among underserved community members Promoting preventative healthcare practices Expanding awareness of free medical services Engaging volunteers in community-based public health education Strengthening partnerships with local faith and community organizations The November 1 event represents the organization's ongoing commitment to reducing health disparities through education, outreach, and direct charitable medical services.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses53,338

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	0	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	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	0
e	Government grants (contributions)		1e	0

f	All other contributions, gifts, grants, and similar amounts not included above		1f	67,995

g	Noncash contributions included in lines 1a - 1f:$		1g	0

h Total. Add lines 1a-1f.......		67,995

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

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
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	0	0
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ 0of 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
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See instructions.....			67,995	0	0	0

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0	0
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	0	0	0	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0	0	0	0
7	Other salaries and wages........	0	0	0	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0	0	0	0
9	Other employee benefits .......	0	0	0	0
10	Payroll taxes ...........	0	0	0	0
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	0	0	0	0
c	Accounting ...........	0	0
d	Lobbying ...........	0	0
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....	0	0
13	Office expenses .......	656	656
14	Information technology ......	1,016	1,016
15	Royalties ..	0	0
16	Occupancy ...........	0	0
17	Travel ............	43,218	43,218
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0
19	Conferences, conventions, and meetings ....	5,933	5,933
20	Interest ...........	0	0
21	Payments to affiliates .......	0	0
22	Depreciation, depletion, and amortization ..	0	0
23	Insurance ...	614	614
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	NAFC Membership (Nafcclinics.org)	240	240	0	0
b	Blood Tests	1,340	1,340	0	0
c	Credentialing	309	309	0	0
d	Banking Fees and Supplies	12	12	0	0
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	53,338	53,338	0	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		999	1	15,656
2	Savings and temporary cash investments .........		0	2	0
3	Pledges and grants receivable, net ......		0	3	0
4	Accounts receivable, net .............		0	4	0
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 .......
			0	5	0
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) ...
			0	6	0
7	Notes and loans receivable, net ...........		0	7	0
8	Inventories for sale or use ............		0	8	0
9	Prepaid expenses and deferred charges ......		0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b	0	10c
11	Investments—publicly traded securities .		0	11	0
12	Investments—other securities. See Part IV, line 11 .....		0	12	0
13	Investments—program-related. See Part IV, line 11 ..		0	13	0
14	Intangible assets ...............		0	14	0
15	Other assets. See Part IV, line 11 ...........		0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...		999	16	15,656

17	Accounts payable and accrued expenses .....	0	17	0
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to 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 .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	0	25
26	Total liabilities. Add lines 17 through 25..	0	26	0

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	999	27	15,656
28	Net assets with donor restrictions ...........	0	28	0
	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 ...........	999	32	15,656
33	Total liabilities and net assets/fund balances ........	999	33	15,656

Name of organization HOPE STREET FREE CLINIC INC

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (Rev. 1-2025)

Name of organization HOPE STREET FREE CLINIC INC		Employer identification number 93-2231392

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) (Rev. 1-2025)


Name of organization HOPE STREET FREE CLINIC INC			Employer identification number 93-2231392
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.