VMLC 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 Thursday, October 23, 2014
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General information
General information | Organization Veterans Medical Leadership Council
General information | Contact First name Sam
General information | Contact Last name Young
General information | Contact e-mail sam.young74@ymail.com
General information | Contact phone number 602 540-7648
Address
Address | Street 3627 E. Indian School Road, Suite 209
Address | City Phoenix
Address | State Arizona
Address | ZIP Code 85018
What is the name of the program or project for which your organization is requesting grant
funds?
Returning Warrior Program
For what grant amount does the organization plan to request funding?
$100,000
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INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P. 0. BOX 2508
CINCINNATI, OH 45201
Employer Identification Number:
Date: uR 13 20m 26-4658030
DLN:
VMLC CHARITIES 17053067355021
C/O SAMUEL G COPPERSMITH Contact Person:
2800 N CENTRAL AVE STE 1200 ROGER W VANCE ID# 31173
PHOENIX, AZ 85004 Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:
June 30
Public Charity Status:
170(b)(1)(A)(vi)
Form 990 Required:
Yes
Effective Date of Exemption:
April 6, 2009
Contribution Deductibility:
Yes
Addendum Applies:
No
Dear Applicant:
We are pleased to inform you that upon review of your application for tax
exempt status we have determined that you are exempt from Federal income tax
under section 501(c)(3) of the Internal Revenue Code. Contributions to you are
deductible under section 170 of the Code. You are also qualified to receive
tax deductible bequests, devises, transfers or gifts under section 2055, 2106
or 2522 of the Code. Because this letter could help resolve any questions
regarding your exempt status, you should keep it in your permanent records.
Organizations exempt under section 501(c)(3) of the Code are further classified
as either public charities or private foundations. We determined that you are
a public charity under the Code section(s) listed in the heading of this
letter.
Please see enclosed Publication 4221-PC, Compliance Guide for 501(c)(3) Public
Charities, for some helpful information about your responsibilities as an
exempt organization.
Letter 947 (DO/CG)

-2-
VMLC CHARITIES
We have sent a copy of this letter to your representative as indicated in your
power of attorney.
Sincerely,
Lois G. Lerner
Director, Exempt Organizations
Enclosure: Publication 4221-PC
Letter 947 (DO/CG)

SALT RIVER PIMA-MARICOPA
INDIAN COMMUNITY
10,005 E. Osborn Road, Scottsdale, Arizona 85256 / Phone 480-362-7520 / Fax 480-362-7593
12% Gaming Contributions Application
Date of Application:
06/17/2014
Organization Name:
Veterans Medical Leadership Council (VMLC)
Organization/Municipal Government Street & Mailing Address:
VMLC Charities
3627 East Indian School Road, Suite 209
Phoenix, AZ 85018
Contact Person and Project Manager if different from Contact Person:
Colonel Sam Young, USAF, Retired
Title: President, VMLC
Address: same as org
Phone:
(602) 540-7648
Fax:
Email Address:
Sam.young74@ymail.com
Project Name:
Returning Warrior Fund (RWF)
In 200 words or less, please provide a brief description of the project submitted to the 12%
SRPMIC Grant program.
Thanks to SRPMIC, we continue to assist Veterans experiencing difficulty in this tough economic
environment. There are 300,000 Veterans in Maricopa County, many at risk for homelessness. In the last
3 years, the Phoenix VA Medical Center Veterans cases have increased almost 20% to over 80,000.
Working primarily with the 160 VAMC case workers, the Returning Warrior Fund provides Veterans
immediate assistance during times of crisis in order to ensure stability and success. The RWF provides
financial assistance for rent, utilities, transportation (including auto repairs), food, and other needs not
provided by the Federal or State government. Checks are written directly to the service agency (landlord,
utility company, etc.) and not the Veterans. Our goal is to help Veterans hold a job, keep medical
appointments, remain in their homes, put food on the table, and keep their families together. In 2013, we
helped 307 Veterans and 637 family members keep their lives together. In addition, VMLC Charities
supports other Veterans centered activities like the Annual Homeless Stand Down and Emergency Dental

Care. During the Maricopa Stand Down which helps over 1,700 Veterans, we’ll continue to provide
special assistance to those female Veterans needing help. Our program is making a difference.
Beginning Date of Project: ongoing (existing) End Date of Project: ongoing (existing)
Geographic Area to be served: Maricopa County (primarily), but RWF serves all AZ Veterans
** Attach Detailed Budget**
Amount of Total Project: $330,000 Amount of 12% Request: $100,000
(No Multi-Year Request will be accepted)
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):
Yes. Because VMLC is primarily operated by all volunteers, the RWF is able to run a virtual zero
budget, requiring only a small amount for administrative services of a bookkeeper. Any amount of
funding received will be used directly to assist AZ Veterans experiencing a financial crisis. All funds
received, whether from events, individuals, foundations, corporations, or tribes goes directly and
completely to Arizona Veterans.
If you receive SRPMIC 12 % funding, will it be spent (Check One):
 Monthly (as needed)
 Quarterly
 Lump Sum
List of SRPMIC 12% funds you have received in the past and a list of other 12 % grants funding
you are seeking from other Tribal Governments for the 2012-2013 12% cycle.
2013: $70,000; RWF
2012: $75,000; RWF
2011: $100,000; RWF
2010: $100,000; RWF
2009: $175,000; RWF
2008: $150,000; RWF
2007: $100,000; RWF
List any other funds you have received from the SRPMIC and identify the source:
N/A
Funding for project/programs may be based on available funding. As such, if funding were not
available for the full the amount of request how would you prioritize funding.
A.) Material support to AZ Veterans in financial crisis (any amount awarded will be directly used to
support Arizona Veterans in financial crisis)
Which municipal governmental entity will serve as your pass through or accept 12% funds on your
behalf?
Maricopa County

By execution of the 12% Gaming Contribution Grant Application the undersigned agrees that the
information contained in the Application is true to the best of the Applicants knowledge. The
Applicant shall notify the SRPMIC if any information in this Application changes.
06/19/2014
Signature for the Applicant Date
Sam Young, President, VMLC
Name and Title
The Application shall be signed by the senior elected official of the local government, or in the case
of a non-profit entity, the Chief Executive Officer authorizes to commit the non-profit entity to
apply for, accept, and implement an award from the SRPMIC utilizing 12% Gaming
Contributions.

2014/2015 VMLC Returning Warriors Fund Budget
Revenue
Source Amount Status
Salt River Pima-Maricopa Indian Community $100,000 Pending
AZ Department of Veterans Services $25,000 Secured
VMLC Fundraising Events (Heroes Luncheon) $25,000 Secured
US Airways $15,000 Secured
Season for Sharing (AZ Republic) $10,000 Secured
AZ Diamondbacks Foundation $5,000 Secured
Private Donors $30,000 Secured
Gila River Indian Community $70,000 Pending
Fort McDowell Yavapai Nation $30,000 Pending
Safeway $10,000 Pending
Wells Fargo $10,000 Pending
Total $330,000
Expenses
Item Cost
Specific Assistance to Individuals $329,000
Administrative costs (process paperwork, checks, etc.) $1,000
Total $330,000