Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
|||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 433,314 | 405,651 | 455,860 | 544,029 | 582,977 | 2,421,831 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 0 | 0 | 0 | 0 | 0 | 0 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | 0 | 0 | 0 | 0 | 0 |
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 6 | Total. Add lines 1 through 5. | 433,314 | 405,651 | 455,860 | 544,029 | 582,977 | 2,421,831 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 0 |
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public Support (Subtract line 7c from line 6.) | 2,421,831 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 433,314 | 405,651 | 455,860 | 544,029 | 582,977 | 2,421,831 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 866 | 18,101 | 26,064 | 25,815 | 24,773 | 95,619 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 10a and 10b. | 866 | 18,101 | 26,064 | 25,815 | 24,773 | 95,619 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | 0 | 0 | 0 | 0 | 0 |
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | 0 | 0 | 0 | 0 | 0 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 434,180 | 423,752 | 481,924 | 569,844 | 607,750 | 2,517,450 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 10000077 |
| Software Version: | v1.00 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| F990_P06_S0A_L02 | Form 990, Part VI, Section A, Line 2 | Some of the Trustees are related. They are or their parents grew up in the same small farming community of Armstrong Wisconsin (Fond du Lac County). * Maggie Shea is a cousin * Sam Mueller is married to a cousin. * Michael John Shea is a nephew of Kevin Shea * Barbara O'Brien, R. N., is a cousin. * Attorney Kevin G. Shea is a cousin to O'Brien, uncle to Mike Shea, and a brother-in law to Maggie Shea. There are NO business realations amongst the members of the Board of Trustees. |
| F990_P06_S0A_L07a | Form 990, Part VI, Section A, Line 7a | Only as provided for in the articles of association: Elect Trustees. |
| F990_P06_S0B_L11a | Form 990, Part VI, Section B, Line 11a | It is prepared by the agent/trustee Kevin Shea, reviewed by the Treasuer, Maggie Shea and then transmitted to the Trustees for their comments if any. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | The Trustees discuss their activities at their meetings to ensure that there is no conflicts and that their is full disclosure of all activiites associated with this Charity. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Upon request. We have no website at this time. However we have always furnished whatever documents requested with a very quick turnaround, and always to the satisfaction of the requester. |
| Software ID: | 10000077 |
| Software Version: | v1.00 |