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            <State>WI</State>
            <ZIPCode>54405</ZIPCode>
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          <FormAndInfoAndMaterials>SHORT LETTER DESCRIBING ORGANIZATION AND PURPOSE OF GRANT REQUEST. PROVIDE PROOF OF TAX EXEMPT STATUS UNDER IRC 501(C)(3)</FormAndInfoAndMaterials>
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            <ZIPCode>54405</ZIPCode>
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            <ZIPCode>54405</ZIPCode>
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            <State>WI</State>
            <ZIPCode>54401</ZIPCode>
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          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>NEW ROOF</PurposeOfGrantOrContribution>
          <Amount>2000</Amount>
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        <GrantOrContriPaidDuringYear>
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            <BusinessNameLine1>CLARK COUNTY SHERIFF'S DEPARTMENT</BusinessNameLine1>
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            <AddressLine1>517 COURT ST RM 308</AddressLine1>
            <City>NEILLSVILLE</City>
            <State>WI</State>
            <ZIPCode>54456</ZIPCode>
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          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>FORWARD LOOKING INFRA RED UNIT</PurposeOfGrantOrContribution>
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            <BusinessNameLine1>COLBY CHOIR PARENTS INC</BusinessNameLine1>
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            <AddressLine1>521 N 3RD ST</AddressLine1>
            <City>COLBY</City>
            <State>WI</State>
            <ZIPCode>54421</ZIPCode>
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        <GrantOrContriPaidDuringYear>
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          </RecipientBusinessName>
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          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
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        <GrantOrContriPaidDuringYear>
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          </RecipientBusinessName>
          <RecipientUSAddress>
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            <State>WI</State>
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          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>PORTABLE POS FOOD SERVICE SYSTEM</PurposeOfGrantOrContribution>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
            <BusinessNameLine1>JUNIOR ACHIEVEMENT-MEDFORD</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
            <AddressLine1>124 W STATE ST</AddressLine1>
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            <State>WI</State>
            <ZIPCode>54451</ZIPCode>
          </RecipientUSAddress>
          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>CLASSROOM KITS</PurposeOfGrantOrContribution>
          <Amount>1000</Amount>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
            <BusinessNameLine1>JUNIOR ACHIEVEMENT-NORTHCENTRAL DISTRICT</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
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            <City>WAUSAU</City>
            <State>WI</State>
            <ZIPCode>54401</ZIPCode>
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          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>COLOR PRINTER</PurposeOfGrantOrContribution>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
            <BusinessNameLine1>MOUNTAIN BAY ELEMENTARY</BusinessNameLine1>
          </RecipientBusinessName>
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            <State>WI</State>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
            <BusinessNameLine1>PAGE FORWARD ADULT LITERACY OF CLARK COUNTY</BusinessNameLine1>
          </RecipientBusinessName>
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            <State>WI</State>
            <ZIPCode>54456</ZIPCode>
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          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
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        <GrantOrContriPaidDuringYear>
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          <PurposeOfGrantOrContribution>REPLACE WINDOWS IN NORTH ENTRY</PurposeOfGrantOrContribution>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
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          <RecipientUSAddress>
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            <ZIPCode>54421</ZIPCode>
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          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
            <BusinessNameLine1>IDEA FOUNDATION - COLBY SCHOOLS</BusinessNameLine1>
          </RecipientBusinessName>
          <RecipientUSAddress>
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            <State>WI</State>
            <ZIPCode>54421</ZIPCode>
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          <RecipientRelationship>NONE</RecipientRelationship>
          <RecipientFoundationStatus>PUBLIC CHARITY</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>AFTER SCHOOL STUDY TIME PROGRAM</PurposeOfGrantOrContribution>
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        <GrantOrContriPaidDuringYear>
          <RecipientBusinessName>
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          <RecipientBusinessName>
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          <RecipientBusinessName>
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        <ReimbursementArrangements>0</ReimbursementArrangements>
        <LoansOrLoanGuarantees>0</LoansOrLoanGuarantees>
        <PerformanceOfServicesEtc>0</PerformanceOfServicesEtc>
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        <RelationshipsNoncharitableEOs>0</RelationshipsNoncharitableEOs>
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    <IRS990ScheduleB documentId="RetDoc1234500001">
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      <GeneralRule>X</GeneralRule>
      <ContributorInfo>
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        <ContributorAddressUS>
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        <PersonContributionType>X</PersonContributionType>
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        <Category>TAX PREPARATION FEES</Category>
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        <DisbursementsCharitablePrps>725</DisbursementsCharitablePrps>
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        <DisbursementsCharitablePrps>10</DisbursementsCharitablePrps>
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        <NetInvestmentIncome>0</NetInvestmentIncome>
        <DisbursementsCharitablePrps>0</DisbursementsCharitablePrps>
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    </TaxesSchedule>
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