TGEN APPLICATION - SRPM 2014.PDF

Admin Tribe Selection
Created Friday, October 17, 2014
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Please select to which tribe this Organization has applied to:
Salt River
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Created Friday, October 17, 2014
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General information
General information | Organization TGen Foundation
General information | Contact First name Kristen
General information | Contact Last name Elnicky
General information | Contact e-mail kelnicky@tgen.org
General information | Contact phone number (602) 343-8432
Address
Address | Street 445 N. 5th Street, Suite 120
Address | City Phoenix
Address | State AZ
Address | ZIP Code 85004
What is the name of the program or project for which your organization is requesting grant
funds?
Accelerating Personalized Medicine
For what grant amount does the organization plan to request funding?
$150,000
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Deportment of the Treasury
4'1 IRS Infernal Revenue Service In reply refer to: 0248653327
P.O. Cincinnati Box 2508 OH 45201 Sep. 23 7 2009 LTR 4168C E0
33-1092191 000000 00
00013451
BODC: TE
TRANSLATIONAL GENOMICS RESEARCH
INSTITUTE FOUNDATION
TGEN FOUNDATION
400 E VAN BUREN ST STE 850
PHOENIX AZ 85004-2249
L4358
Employer Identification Number: 33-1092191
Person to Contact: Ms. Espelage
Toll Free Telephone Number: 1-877-829-5500
Dear Taxpayer:
This is in response to your request of Sep. 14, 2009, regarding your
tax-exempt status.
Our records indicate that a determination letter was issued in
September 2004, that recognized you as exempt from Federal income tax,
and discloses that you are currently exempt under section 501(c)(3)
of the Internal Revenue Code.
Our records also indicate you are not a private foundation within the
meaning of section 509(a) of the Code because you are described in
section(s) 509(a)(1) and 170(b)(1)(A)(vi).
Donors may deduct contributions to you as provided in section 170 of
the Code. Bequests, legacies, devises, transfers, or gifts to you or
for your use are deductible for Federal estate and gift tax purposes
if they meet the applicable provisions of sections 2055, 2106, and
2522 of the Code.
If you have any questions, please call us at the telephone number
shown in the heading of this letter.
Sincerely yours,
11€2Atie__(-1(_
Michele M. Sullivan, Oper. Mgr.
Accounts Management Operations I

tgenDir
FOUNDATION
May 5, 2014
Ms. Angela Willeford
12% Grant Application
Office of Congressional and Legislative Affairs
10005 E. Osborn Road
Scottsdale, AZ 85256
Dear Ms. Willeford,
We are honored to submit the enclosed application from the Translational Genomics
Research Institute (TGen) for the consideration of the Salt River Pima-Maricopa Indian
Community's 12 percent Gaming Contributions Committee. We appreciate the
opportunity to apply for funding and are grateful for your support.
This proposal continues to build upon the previous generous contributions from SRP-
MIC to enhance TGen's commitment to develop, refine and apply the latest tools of
genomic medicine to the diagnosis and treatment of patients. On behalf of Dr. Jeffrey
Trent and TGen's scientists and clinicians, thank you for your visionary support of our
cutting-edge research. We are honored to partner with you and hope that you are
pleased with the continued return on your investment.
If you have any questions regarding the enclosed proposal or would like additional
information about our research programs, please contact me directly by phone at (602)
343-8432 or via email at kelnickvPtgen.org .
Kristen J. Elnicky, M.B.A.
Director of Foundation Operations
TGen Foundation 445 North Fifth Street, Suite 120 Phoenix, Arizona 85004
602.343.8411 1.866.370.8436 x 602.343.8441 helptgen.org

SALT RIVER PIMA-MARICOPA INDIAN COMMUNITY
10005 E. Osborn Road, Scottsdale, Arizona 85256 / (480) 362-7400
12% GAMING CONTRIBUTIONS
APPLICATION
Date of Application: May 15, 2014
Organization name: Translational Genomics Research Institute (TGen)
Organization/Municipal Government Street & Mailing Address: Maricopa County,
Government Relations, 301 W. Jefferson, 10 th Floor, Phoenix, Arizona 85255
Contact person and Project Manager if different from Contact Person: Kristen Elnicky
Title: Director of Foundation Operations
Address: 445 N. 5th Street, Suite 120, Phoenix, AZ 85004
Phone: (602) 343-8432
Fax: (602) 343-8441
Email Address: kelnicky g
Project Name: Accelerating Personalized Medicine
In 200 words or less, please provide a brief description of the project and how you intend to
spend 12% revenue on this project:
TGen is continuing to build on the investment that Salt River Pima-Maricopa Indian Community
has made and is bringing hope and answers to patients with various types of cancer,
neurological disorders, and metabolic diseases. We are providing molecularly informed
treatment decisions for these patients and extending this innovative research to the prevention
and control of disease by utilizing cutting-edge genomic tools and technologies, such as Next
Generation Sequencing. From studies of early indicators of concussions in football players, to
helping men understand their risk to prostate cancer, to diagnosing and treating children with
rare disorders, genomics plays a critical role in the future of medicine – today!
By using Next Generational Sequencing to find molecular targets before treating a patient, not
only does medicine become more rational, it becomes more personalized — and it drives down
costs. TGen's research is designed to foster an innovative approach to facilitate a wide range of
genetic discoveries and to accelerate those discoveries to the patients where they can have the
most impact.

This funding will be used to support the highly specialized people, equipment, and materials
needed to quickly move discoveries from the "bench to bedside."
Beginning Date of Project: Ongoing Research
End Date of the Project: Ongoing Research
Geographic Area: Maricopa County, as well as the State of Arizona
Amount of Total Project: Scalable Project Amount of 12% Request: $150,000
Budget
Cost
Sequencing Costs $ 100,000
Data Administration $ 20,000
IT and Technology Support $ 20,000
Project Management $ 10,000
Total: $ 150,000
If the Amount of funding received is less than the amount needed for the project, do you
have other funds to complete the project? (Please explain)
TGen will continue to rely on funding from grants, contracts, and additional philanthropic gifts.
If you receive SRPMIC 12% funding, will it be spent (Check One):
IZI Monthly 0 Quarterly El Lump Sum
List SRPMIC 12% monies you have received in the past and a list of other 12% grant monies
you are seeking from other Tribal Governments for the 2012-2013 12% cycle.
Year Amount Purpose
June 2003 $5 million pledge Diabetes research
October 2003 $1 million payment Diabetes research
November 2004 $1 million payment Diabetes research
December 2005 $1 million payment Diabetes research
November 2004 $2 million payment Diabetes research
January 2010 $200,000 Key technologies
December 2010 $175,000 Next generation sequencing
December 2011 $175,000 Next generation sequencing
December 2012 $150,000 Next generation sequencing
December 2013 $125,000 Next generation sequencing

TGen is not currently seeking 12% grant monies from any other Tribal Governments.
List any other monies you have received from the SRPMIC and identify the source:
N/A
Which municipal governmental entity will serve as your pass through or accept 12% funds on
your behalf?
Maricopa County
By execution of this 12% Gaming Contributions Grant Application, the undersigned agrees
that the information contained in the Application is true to the best of the Applicant's
knowledge. The Applicant shall notify the SRPMIC if any information in this Application
changes.
1/45/s-li
Date
Michael Bassoff — President, TGen Foundation
Name and Title
The Application shall be signed by the senior elected official of the local government, or in the
case of a nonprofit entity, the Chief Executive Officer authorized to commit the nonprofit
entity to apply for, accept and implement an award from the SRPMIC utilizing 12% Gaming
Contributions.