Public Inspection Copy

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?

Employer identification

Describe in Part IV the organization’s procedures for monitoring the use of grant funds in the United States. Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered “Yes” on Form 990, Part II Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name and address of organization or government

(1) (2) (3) (4) (5) (6) (7) (8) (9)

2

For

(b) EIN

(c) IRC (if applicable)

(g) Description of (h) Purpose of grant or assistance section grant

(f) Method of valuation (book, FMV, appraisal, other) noncash assistance

OZARKS FOOD HARVEST, INC. 43-1426384 SAMARITAN OUTREACH CENTER - PANTRY 715 MISSOURI AVENUE WEST PLAINS MO 65775-0311 43-1502024 501C3 15,400 28,963 COST FOOD INVENTORY FOOD ASSISTANCE SENECA FOOD PANTRY 821 CHEROKEE AVE. SENECA MO 64865 27-0855567 501C3 34,400 139,946 COST FOOD INVENTORY FOOD ASSISTANCE SENIOR CITIZENS OF MOUNTAIN VIEW 903 E. 5TH ST. MOUNTAIN VIEW MO 65548-8338 44-6000228 501C3 17,200 55,380 COST FOOD INVENTORY FOOD ASSISTANCE SENIORAGE - BUFFALO 303 N. MAPLE BUFFALO MO 65622 43-1372123 501C3 26,233 COST FOOD INVENTORY FOOD ASSISTANCE SENIORAGE - CABOOL 910 CHERRY ST. CABOOL MO 65689 43-1067220 501C3 3,200 8,288 COST FOOD INVENTORY FOOD ASSISTANCE SENIORAGE - CASSVILLE 1111 FAIR ST. CASSVILLE MO 65625 43-1221410 501C3 7,181 COST FOOD INVENTORY FOOD ASSISTANCE SENIORAGE - MTN. GROVE 700 E. STATE STREET MOUNTAIN GROVE MO 65711 43-1018538 501C3 5,968 664,861 COST FOOD INVENTORY FOOD ASSISTANCE SENIORAGE - ROGERSVILLE 197 MARSHALL ST. ROGERSVILLE MO 65742-9372 43-1677637 501C3 5,858 COST FOOD INVENTORY FOOD ASSISTANCE SENIORAGE - SEYMOUR 205 S. COMMERCIAL ST. SEYMOUR MO 65746 43-1647814 501C3 9,706 COST FOOD INVENTORY FOOD ASSISTANCE 10139900 05/12/2023 10:58 AM Pg 42 u u

Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2021)

Governments, and Individuals in the United States (Form 990)

Grants and Other Assistance to Organizations, 2021

u Attach to Form 990.