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        <RemainingDistriFromCorpusAmt>36692542</RemainingDistriFromCorpusAmt>
        <TotalCorpusAmt>36692542</TotalCorpusAmt>
        <UndistributedIncomeCYAmt>0</UndistributedIncomeCYAmt>
      </UndistributedIncomeGrp>
      <PrivateOperatingFoundationsGrp>
        <LessorAdjNetIncmMinInvstRetGrp>
          <CurrentYearAmt>0</CurrentYearAmt>
          <TotalAmt>0</TotalAmt>
        </LessorAdjNetIncmMinInvstRetGrp>
        <QualifyingDistributionsGrp>
          <CurrentYearAmt>36692542</CurrentYearAmt>
          <Year1Amt>34942215</Year1Amt>
          <Year2Amt>29640277</Year2Amt>
          <Year3Amt>40097469</Year3Amt>
          <TotalAmt>141372503</TotalAmt>
        </QualifyingDistributionsGrp>
        <QualifyingDistriMadeDrtGrp>
          <CurrentYearAmt>36692542</CurrentYearAmt>
          <Year1Amt>34942215</Year1Amt>
          <Year2Amt>29640277</Year2Amt>
          <Year3Amt>40097469</Year3Amt>
          <TotalAmt>141372503</TotalAmt>
        </QualifyingDistriMadeDrtGrp>
        <TotalAssetsGrp>
          <CurrentYearAmt>18290020</CurrentYearAmt>
          <Year1Amt>16523359</Year1Amt>
          <Year2Amt>12787805</Year2Amt>
          <Year3Amt>11871384</Year3Amt>
          <TotalAmt>59472568</TotalAmt>
        </TotalAssetsGrp>
        <TotalAssetsSect4942j3BiGrp>
          <CurrentYearAmt>18290020</CurrentYearAmt>
          <Year1Amt>16523359</Year1Amt>
          <Year2Amt>12787805</Year2Amt>
          <Year3Amt>11871384</Year3Amt>
          <TotalAmt>59472568</TotalAmt>
        </TotalAssetsSect4942j3BiGrp>
      </PrivateOperatingFoundationsGrp>
      <SupplementaryInformationGrp>
        <OnlyContriToPreselectedInd>X</OnlyContriToPreselectedInd>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Akron Childrens Hospital</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Perkins Square 5th Floor</AddressLine1>
            <City>Akron</City>
            <State>OH</State>
            <ZIPCode>44308</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>146401</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Barbara Ann Karmanos Cancer Institute</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>4100 John R</AddressLine1>
            <City>Detroit</City>
            <State>MI</State>
            <ZIPCode>48201</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>105737</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Cincinnati Childrens Hospital Medical Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>3333 Burnet Avenue ML 7015</AddressLine1>
            <City>Cincinnati</City>
            <State>OH</State>
            <ZIPCode>45229</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>81443</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Helen DeVos Childrens Coagulation Disorders ProgramSpectrum Health</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>100 Michigan St NE MC 85</AddressLine1>
            <City>Grand Rapids</City>
            <State>MI</State>
            <ZIPCode>49503</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>53838</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Henry Ford Hospital</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2799 West Grand Boulevard</AddressLine1>
            <City>Detroit</City>
            <State>MI</State>
            <ZIPCode>48202</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>120238</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hurley Medical Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Hurley Plaza 6W</AddressLine1>
            <City>Flint</City>
            <State>MI</State>
            <ZIPCode>48503</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>95771</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Michigan State University</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2900 Hannah Blvd</AddressLine1>
            <City>East Lansing</City>
            <State>MI</State>
            <ZIPCode>48823</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>101853</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Nationwide Childrens Hospital</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>700 Childrens Drive</AddressLine1>
            <City>Columbus</City>
            <State>OH</State>
            <ZIPCode>43205</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>97276</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Northern Regional Bleeding Disorder Ctr</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1105 Sixth Street</AddressLine1>
            <City>Traverse City</City>
            <State>MI</State>
            <ZIPCode>49684</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>150000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Ohio State University Hemophilia Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>320 West 10th Avenue</AddressLine1>
            <City>Columbus</City>
            <State>OH</State>
            <ZIPCode>43210</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>119353</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Toledo Children's Hospital Northwest Ohio Hemophilia Treatment Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2150 W Central Avenue</AddressLine1>
            <City>Toledo</City>
            <State>OH</State>
            <ZIPCode>43606</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>110466</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University of Cincinnati</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>231 Albert Sabin Way ML 562</AddressLine1>
            <City>Cincinnati</City>
            <State>OH</State>
            <ZIPCode>45267</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>35496</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University Hospitals of ClevelandCase Western</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>11100 Euclid Avenue</AddressLine1>
            <City>Cleveland</City>
            <State>OH</State>
            <ZIPCode>44106</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>88822</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University of Michigan Hemophilia Treatment Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1500 East Medical Center Drive</AddressLine1>
            <City>Ann Arbor</City>
            <State>MI</State>
            <ZIPCode>48109</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>88644</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University Pediatricians</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>3901 Beaubien Blvd</AddressLine1>
            <City>Detroit</City>
            <State>MI</State>
            <ZIPCode>48201</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>175753</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>West Central Ohio Hemophilia Center at Dayton Children's</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Childrens Plaza</AddressLine1>
            <City>Dayton</City>
            <State>OH</State>
            <ZIPCode>45404</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>79440</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>West Michigan Cancer Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>200 North Park Street</AddressLine1>
            <City>Kalamazoo</City>
            <State>MI</State>
            <ZIPCode>49007</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>44930</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Central Ohio Chapter of the National Hemophilia Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>P O Box 345</AddressLine1>
            <City>Worthington</City>
            <State>OH</State>
            <ZIPCode>43085</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Camperships to Camp Bold Eagle, support for educational programming, and medical needs fund</GrantOrContributionPurposeTxt>
          <Amt>18000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>FAMOHIO Inc</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2425 Roscoe Court</AddressLine1>
            <City>Dublin</City>
            <State>OH</State>
            <ZIPCode>43016</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Lodging and meal support for FAMOHIO meeting</GrantOrContributionPurposeTxt>
          <Amt>11000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hemophilia Foundation of Michigan</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1921 W Michigan Avenue</AddressLine1>
            <City>Ypsilanti</City>
            <State>MI</State>
            <ZIPCode>48197</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for SpringFest, Camp Bold Eagle, NHF annual meeting, Eagle Expedition, and other Regional Core Services</GrantOrContributionPurposeTxt>
          <Amt>76500</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hemophilia of Indiana</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>5170 E 65th St Suite 106</AddressLine1>
            <City>Indianapolis</City>
            <State>IN</State>
            <ZIPCode>46220</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for annual meeting, Camp Brave Eagle, Doug Thompson Teen Leadership Program, Medical Assistance Fund, and Delta Dental program</GrantOrContributionPurposeTxt>
          <Amt>58000</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Northern Ohio Hemophilia Foundation Inc</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Independence Place</AddressLine1>
            <City>Independence</City>
            <State>OH</State>
            <ZIPCode>44131</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for Delta Dental program and educational newsletter printing, mailing, and postage costs</GrantOrContributionPurposeTxt>
          <Amt>15970</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Northwest Ohio Hemophilia Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>P O Box 12606</AddressLine1>
            <City>Toledo</City>
            <State>OH</State>
            <ZIPCode>43606</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for camp program, outreach to women with bleeding disorders, and support to attend NHF meeting</GrantOrContributionPurposeTxt>
          <Amt>8477</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Tri-State Bleeding Disorder Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>635 W Seventh Street Suite 407</AddressLine1>
            <City>Cincinnati</City>
            <State>OH</State>
            <ZIPCode>45203</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Camperships, assistance to attend NHF annual meeting, and support for medical needs fund</GrantOrContributionPurposeTxt>
          <Amt>9493</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Various</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>517 West William Street</AddressLine1>
            <City>Ann Arbor</City>
            <State>MI</State>
            <ZIPCode>48103</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for dental program</GrantOrContributionPurposeTxt>
          <Amt>82863</Amt>
        </GrantOrContributionPdDurYrGrp>
        <GrantOrContributionPdDurYrGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hemophilia Foundation of Michigan</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1921 W Michigan Avenue</AddressLine1>
            <City>Ypsilanti</City>
            <State>MI</State>
            <ZIPCode>48197</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>HFM share of HTC grants</GrantOrContributionPurposeTxt>
          <Amt>694489</Amt>
        </GrantOrContributionPdDurYrGrp>
        <TotalGrantOrContriPdDurYrAmt>2670253</TotalGrantOrContriPdDurYrAmt>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Akron Childrens Hospital</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Perkins Square 5th Floor</AddressLine1>
            <City>Akron</City>
            <State>OH</State>
            <ZIPCode>44308</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>371563</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Barbara Ann Karmanos Cancer Institute</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>4100 John R</AddressLine1>
            <City>Detroit</City>
            <State>MI</State>
            <ZIPCode>48201</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>410254</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Cincinnati Childrens Hospital Medical Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>3333 Burnet Avenue ML 7015</AddressLine1>
            <City>Cincinnati</City>
            <State>OH</State>
            <ZIPCode>45229</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>184115</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Helen DeVos Childrens Coagulation Disorders ProgramSpectrum Health</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>100 Michigan St NE MC 85</AddressLine1>
            <City>Grand Rapids</City>
            <State>MI</State>
            <ZIPCode>49503</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>21614</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Henry Ford Hospital</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2799 West Grand Boulevard</AddressLine1>
            <City>Detroit</City>
            <State>MI</State>
            <ZIPCode>48202</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>214259</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hurley Medical Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Hurley Plaza 6W</AddressLine1>
            <City>Flint</City>
            <State>MI</State>
            <ZIPCode>48503</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>249209</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Michigan State University</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2900 Hannah Blvd</AddressLine1>
            <City>East Lansing</City>
            <State>MI</State>
            <ZIPCode>48823</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>312840</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Nationwide Childrens Hospital</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>700 Childrens Drive</AddressLine1>
            <City>Columbus</City>
            <State>OH</State>
            <ZIPCode>43205</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>184116</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Northern Regional Bleeding Disorder Ctr</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1105 Sixth Street</AddressLine1>
            <City>Traverse City</City>
            <State>MI</State>
            <ZIPCode>49684</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>436588</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Ohio State University Hemophilia Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>320 West 10th Avenue</AddressLine1>
            <City>Columbus</City>
            <State>OH</State>
            <ZIPCode>43210</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>361335</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Toledo Children's Hospital Northwest Ohio Hemophilia Treatment Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2150 W Central Avenue</AddressLine1>
            <City>Toledo</City>
            <State>OH</State>
            <ZIPCode>43606</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>214471</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University of Cincinnati</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>231 Albert Sabin Way ML 562</AddressLine1>
            <City>Cincinnati</City>
            <State>OH</State>
            <ZIPCode>45267</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>107884</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University Hospitals of ClevelandCase Western</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>11100 Euclid Avenue</AddressLine1>
            <City>Cleveland</City>
            <State>OH</State>
            <ZIPCode>44106</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>227115</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University of Michigan Hemophilia Treatment Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1500 East Medical Center Drive</AddressLine1>
            <City>Ann Arbor</City>
            <State>MI</State>
            <ZIPCode>48109</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>210023</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>University Pediatricians</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>3901 Beaubien Blvd</AddressLine1>
            <City>Detroit</City>
            <State>MI</State>
            <ZIPCode>48201</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>315000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>West Central Ohio Hemophilia Center at Dayton Children's</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Childrens Plaza</AddressLine1>
            <City>Dayton</City>
            <State>OH</State>
            <ZIPCode>45404</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>191187</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>West Michigan Cancer Center</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>200 North Park Street</AddressLine1>
            <City>Kalamazoo</City>
            <State>MI</State>
            <ZIPCode>49007</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Provision for medical services</GrantOrContributionPurposeTxt>
          <Amt>153244</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Central Ohio Chapter of the National Hemophilia Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>P O Box 345</AddressLine1>
            <City>Worthington</City>
            <State>OH</State>
            <ZIPCode>43085</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Camperships to Camp Bold Eagle, support for educational programming, and medical needs fund</GrantOrContributionPurposeTxt>
          <Amt>10000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>FAMOHIO Inc</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>2425 Roscoe Court</AddressLine1>
            <City>Dublin</City>
            <State>OH</State>
            <ZIPCode>43016</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Lodging and meal support for FAMOHIO meeting</GrantOrContributionPurposeTxt>
          <Amt>14000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hemophilia Foundation of Michigan</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1921 W Michigan Avenue</AddressLine1>
            <City>Ypsilanti</City>
            <State>MI</State>
            <ZIPCode>48197</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for SpringFest, Camp Bold Eagle, NHF annual meeting, Eagle Expedition, and other Regional Core Services</GrantOrContributionPurposeTxt>
          <Amt>78675</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hemophilia of Indiana</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>5170 E 65th St Suite 106</AddressLine1>
            <City>Indianapolis</City>
            <State>IN</State>
            <ZIPCode>46220</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for annual meeting, Camp Brave Eagle, Doug Thompson Teen Leadership Program, Medical Assistance Fund, and Delta Dental program</GrantOrContributionPurposeTxt>
          <Amt>65000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Northern Ohio Hemophilia Foundation Inc</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>One Independence Place</AddressLine1>
            <City>Independence</City>
            <State>OH</State>
            <ZIPCode>44131</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for Delta Dental program and educational newsletter printing, mailing, and postage costs</GrantOrContributionPurposeTxt>
          <Amt>61950</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Northwest Ohio Hemophilia Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>P O Box 12606</AddressLine1>
            <City>Toledo</City>
            <State>OH</State>
            <ZIPCode>43606</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support for camp program, outreach to women with bleeding disorders, and support to attend NHF meeting</GrantOrContributionPurposeTxt>
          <Amt>21000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Tri-State Bleeding Disorder Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>635 W Seventh Street Suite 407</AddressLine1>
            <City>Cincinnati</City>
            <State>OH</State>
            <ZIPCode>45203</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Camperships, assistance to attend NHF annual meeting, and support for medical needs fund</GrantOrContributionPurposeTxt>
          <Amt>10000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>World Federation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>PMB 142 911 Central Ave</AddressLine1>
            <City>Albany</City>
            <State>NY</State>
            <ZIPCode>122061304</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support of mission</GrantOrContributionPurposeTxt>
          <Amt>7000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>World AIDS Day Detroit</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>c/o HFM 1921 W Michigan Avenue</AddressLine1>
            <City>Ypsilanti</City>
            <State>MI</State>
            <ZIPCode>48197</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Support of mission</GrantOrContributionPurposeTxt>
          <Amt>5000</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Hemophilia Foundation of Michigan</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>1921 W Michigan Avenue</AddressLine1>
            <City>Ypsilanti</City>
            <State>MI</State>
            <ZIPCode>48197</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>HFM share of HTC grants</GrantOrContributionPurposeTxt>
          <Amt>978750</Amt>
        </GrantOrContriApprvForFutGrp>
        <GrantOrContriApprvForFutGrp>
          <RecipientBusinessName>
            <BusinessNameLine1>Southwestern Ohio Hemophilia Foundation</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>82 Elva Court Suite B</AddressLine1>
            <City>Vandalia</City>
            <State>OH</State>
            <ZIPCode>45377</ZIPCode>
          </RecipientUSAddress>
          <GrantOrContributionPurposeTxt>Camperships to Bold Eagle and transportation to camp</GrantOrContributionPurposeTxt>
          <Amt>14000</Amt>
        </GrantOrContriApprvForFutGrp>
        <TotalGrantOrContriApprvFutAmt>5430192</TotalGrantOrContriApprvFutAmt>
      </SupplementaryInformationGrp>
      <AnalysisIncomeProducingActyGrp>
        <IntOnSavAndTempCashInvstGrp>
          <BusinessCd>900099</BusinessCd>
          <ExclusionCd>14</ExclusionCd>
          <ExclusionAmt>22276</ExclusionAmt>
        </IntOnSavAndTempCashInvstGrp>
        <GrossProfitLossSlsOfInvntryGrp>
          <RelatedOrExemptFunctionIncmAmt>6163348</RelatedOrExemptFunctionIncmAmt>
        </GrossProfitLossSlsOfInvntryGrp>
        <OtherRevenueDescribedGrp>
          <Desc>Other income</Desc>
          <BusinessCd>900099</BusinessCd>
          <RelatedOrExemptFunctionIncmAmt>377200</RelatedOrExemptFunctionIncmAmt>
        </OtherRevenueDescribedGrp>
        <SubtotalsIncmProducingActyGrp>
          <ExclusionAmt>22276</ExclusionAmt>
          <RelatedOrExemptFunctionIncmAmt>6540548</RelatedOrExemptFunctionIncmAmt>
        </SubtotalsIncmProducingActyGrp>
        <TotalIncomeProducingActyAmt>6562824</TotalIncomeProducingActyAmt>
      </AnalysisIncomeProducingActyGrp>
      <RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>10</LineNumberTxt>
          <RelationshipStatementTxt>Sale of blood products, HIV and Hepatitis C related therapies and other medications, at reduced prices.</RelationshipStatementTxt>
        </RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>10</LineNumberTxt>
          <RelationshipStatementTxt>Cascades exempt purpose is to enhance the system of care for hemophilia patients by providing these products.</RelationshipStatementTxt>
        </RlnOfActyToAccomOfExmptPrpsGrp>
        <RlnOfActyToAccomOfExmptPrpsGrp>
          <LineNumberTxt>11a</LineNumberTxt>
          <RelationshipStatementTxt>Other related income.</RelationshipStatementTxt>
        </RlnOfActyToAccomOfExmptPrpsGrp>
      </RlnOfActyToAccomOfExmptPrpsGrp>
      <TrnsfrTransRlnNonchrtblEOGrp>
        <TrnsfrOfCashToNonchrtblEOInd>false</TrnsfrOfCashToNonchrtblEOInd>
        <TrnsfrOtherAssetNonchrtblEOInd>false</TrnsfrOtherAssetNonchrtblEOInd>
        <SalesOrExchangesOfAssetsInd>false</SalesOrExchangesOfAssetsInd>
        <PurchaseOfAssetsNonchrtblEOInd>false</PurchaseOfAssetsNonchrtblEOInd>
        <RentalOfFacilitiesOthAssetsInd>false</RentalOfFacilitiesOthAssetsInd>
        <ReimbursementArrangementsInd>false</ReimbursementArrangementsInd>
        <LoansOrLoanGuaranteesInd>false</LoansOrLoanGuaranteesInd>
        <PerformanceOfServicesEtcInd>false</PerformanceOfServicesEtcInd>
        <SharingOfFacilitiesEtcInd>false</SharingOfFacilitiesEtcInd>
        <RelationshipsNonchrtblEOInd>false</RelationshipsNonchrtblEOInd>
      </TrnsfrTransRlnNonchrtblEOGrp>
    </IRS990PF>
    <AccountingFeesSchedule documentId="990PF:81" softwareId="13000230" softwareVersion="13.6.0.0">
      <AccountingFeesDetail>
        <CategoryTxt>Accounting fees</CategoryTxt>
        <Amt>14100</Amt>
        <DisbursementsCharitablePrpsAmt>14100</DisbursementsCharitablePrpsAmt>
      </AccountingFeesDetail>
    </AccountingFeesSchedule>
    <CashDeemedCharitableExplnStmt documentId="990PF:185" softwareId="13000230" softwareVersion="13.6.0.0">
      <ShortExplanationTxt>Because of the immediate need of clotting factor and other medical supplies, it is necessary for Cascade to retain a sufficient amount of cash to purchase these supplies when they become available. Payment must be made immediately.</ShortExplanationTxt>
    </CashDeemedCharitableExplnStmt>
    <GeneralExplanationAttachment documentId="990PF:131" softwareId="13000230" softwareVersion="13.6.0.0"></GeneralExplanationAttachment>
    <LandEtcSchedule2 documentId="990PF:138" softwareId="13000230" softwareVersion="13.6.0.0">
      <LandEtcGrp>
        <CategoryOrItemTxt>Equipment</CategoryOrItemTxt>
        <CostOrOtherBasisAmt>82580</CostOrOtherBasisAmt>
        <AccumulatedDepreciationAmt>49573</AccumulatedDepreciationAmt>
        <BookValueAmt>33007</BookValueAmt>
        <EOYFMVAmt>33007</EOYFMVAmt>
      </LandEtcGrp>
    </LandEtcSchedule2>
    <LegalFeesSchedule documentId="990PF:80" softwareId="13000230" softwareVersion="13.6.0.0">
      <LegalFeesGrp>
        <CategoryTxt>Legal fees</CategoryTxt>
        <LegalFeesAmt>49209</LegalFeesAmt>
        <DisbursementsCharitablePrpsAmt>49209</DisbursementsCharitablePrpsAmt>
      </LegalFeesGrp>
    </LegalFeesSchedule>
    <OtherExpensesSchedule documentId="990PF:84" softwareId="13000230" softwareVersion="13.6.0.0">
      <OtherExpensesScheduleGrp>
        <Desc>Insurance</Desc>
        <RevenueAndExpensesPerBooksAmt>63820</RevenueAndExpensesPerBooksAmt>
        <DisbursementsCharitablePrpsAmt>63820</DisbursementsCharitablePrpsAmt>
      </OtherExpensesScheduleGrp>
      <OtherExpensesScheduleGrp>
        <Desc>Office expenses</Desc>
        <RevenueAndExpensesPerBooksAmt>354670</RevenueAndExpensesPerBooksAmt>
        <DisbursementsCharitablePrpsAmt>354670</DisbursementsCharitablePrpsAmt>
      </OtherExpensesScheduleGrp>
      <OtherExpensesScheduleGrp>
        <Desc>Other</Desc>
        <RevenueAndExpensesPerBooksAmt>400</RevenueAndExpensesPerBooksAmt>
        <DisbursementsCharitablePrpsAmt>400</DisbursementsCharitablePrpsAmt>
      </OtherExpensesScheduleGrp>
    </OtherExpensesSchedule>
    <OtherIncomeSchedule2 documentId="990PF:79" softwareId="13000230" softwareVersion="13.6.0.0">
      <OtherIncomeDetail>
        <Desc>Other income</Desc>
        <RevenueAndExpensesPerBooksAmt>377200</RevenueAndExpensesPerBooksAmt>
        <AdjustedNetIncomeAmt>377200</AdjustedNetIncomeAmt>
      </OtherIncomeDetail>
    </OtherIncomeSchedule2>
    <OtherProfessionalFeesSchedule documentId="990PF:82" softwareId="13000230" softwareVersion="13.6.0.0">
      <OtherProfessionalFeesDetail>
        <CategoryTxt>Other professional fees</CategoryTxt>
        <Amt>93140</Amt>
        <DisbursementsCharitablePrpsAmt>93140</DisbursementsCharitablePrpsAmt>
      </OtherProfessionalFeesDetail>
    </OtherProfessionalFeesSchedule>
    <SalesOfInventoryList documentId="990PF:78" softwareId="13000230" softwareVersion="13.6.0.0">
      <InventorySaleGrp>
        <CategoryTxt>Reduced price factor sales</CategoryTxt>
        <GrossSalesAmt>39369616</GrossSalesAmt>
        <CostOfGoodsSoldAmt>33206268</CostOfGoodsSoldAmt>
        <NetAmt>6163348</NetAmt>
      </InventorySaleGrp>
    </SalesOfInventoryList>
    <TaxesSchedule documentId="990PF:83" softwareId="13000230" softwareVersion="13.6.0.0">
      <TaxesDetail>
        <CategoryTxt>Payroll taxes</CategoryTxt>
        <Amt>47468</Amt>
        <DisbursementsCharitablePrpsAmt>47468</DisbursementsCharitablePrpsAmt>
      </TaxesDetail>
    </TaxesSchedule>
  </ReturnData>
</Return>