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          <BusinessNameLine1Txt>AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>901 WARRENVILLE ROAD STE 180</AddressLine1Txt>
          <CityNm>LISLE</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60532</ZIPCd>
        </USAddress>
        <RecipientEIN>251687999</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>100000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>CASH</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SUPPORT OUTREACH INITIATIVE</PurposeOfGrantTxt>
      </RecipientTable>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:</FormAndLineReferenceDesc>
        <ExplanationTxt>TO SCREEN AND TREAT SLEEP-DISORDERED BREATHING, INCLUDING SNORING, UPPER AIRWAY RESISTANCE SYNDROME (UARS) AND OBSTRUCTIVE SLEEP APNEA (OSA).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT FUNCTIONS ARE DELEGATED TO AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE UNDER FORMAL MANAGEMENT AGREEMENT CONTRACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CURRENT BOARD RECOMMENDS NEW BOARD MEMBERS AND APPROVES THEM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS EMAILED TO THE EXECUTIVE COMMITTEE OF BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY IS REVIEWED ON A REGULAR BASIS AT BOARD OF DIRECTORS MEETINGS AND MEMBERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST ON A WRITTEN CONFLICT OF INTEREST STATEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS MAY BE MADE AVAILABLE UPON REQUEST TO THE AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE'S OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT FUNCTIONS ARE DELEGATED TO AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE UNDER FORMAL MANAGEMENT AGREEMENT CONTRACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACT SERVICES 33,205. BANK AND CREDIT CARD FEES 10,135. STIPENDS, HONORARIUMS, AWARDS, OR RECOGNITION 19,375. TAXES &amp; LICENSES 11. OTHER G&amp;A EXPENSES 1,250.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>901 WARRENVILLE RD STE 180</AddressLine1Txt>
          <CityNm>LISLE</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60532</ZIPCd>
        </USAddress>
        <EIN>251687999</EIN>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>100000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>120000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>35084</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
