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? |
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|---|---|---|---|---|---|---|---|---|---|
| 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. | 0 | |||||
| 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.. | 0 | |||||
| 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.") . | 7,302 | 7,302 | ||||
| 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...... | 4,185 | 4,185 | ||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 11,487 | 11,487 | ||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | 11,487 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 11,487 | 11,487 | ||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 11,487 | |||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt III, Line 2 | During the fall of 2010, Georgia Bikes experienced a | |
| revitalization. A new board of directors took control | ||
| of the organization, which was dormant for much of | ||
| 2009-10. Also, the organization was awarded a grant | ||
| by the Georgia Governor's Office of Highway Safety, the | ||
| purpose of which is to reduce bicycle-related injuries | ||
| and fatalities in Georgia. This grant was awarded | ||
| October 1, 2010. At that time, Georgia Bikes hired a full | ||
| time executive director, who began updating and improving | ||
| the org. website, contacts, database, and business | ||
| processes. In October 2010, Georgia Bikes also hosted | ||
| the state's first ever Georgia Bike Summit, a one-day | ||
| conference for transportation planners, bicycle safety | ||
| advocates, bicycle retailers, and elected officials. | ||
| Pt VI-B, Line 11a | The Executive Director and the board treasurer both | |
| read and approve the Form 990 before it is submitted. | ||
| Pt VI-B, Line 12c | The Executive Director reviews the annual disclosure forms | |
| filed by the board members and reports on any potential | ||
| conflicts of interest. | ||
| Pt VI-B, Line 15 | The hiring committee reviewed the compensation of similar | |
| positions in similar organizations. The compensation | ||
| was established in the GOHS grant, which is the primary | ||
| funding for the position. | ||
| Pt VI-C, Line 19 | Such documentation is available upon request. | |
| Pt XI | In late 2009, Kaiser Permanente awarded a grant to | |
| Safe Routes to Schools to fund a regional coordinator's position. | ||
| Form 990, Part III, Line 4d | THROUGH A GRANT FROM THE NATIONAL TRUST FOR HISTORIC 5332. 0. 4000. | |
| SRTS did not have a regional organization in place to | ||
| receive the funding, so Georgia Bikes agreed to facilitate | ||
| payments for the position. Georgia Bikes was contractually | ||
| bound to use the funds for that purpose; therefore, they | ||
| were categorized as permanently restricted funds, rather | ||
| than flowing them through the Georgia Bikes income | ||
| statement. The independent contractor filling the | ||
| regional coordinator's position failed to fulfill all | ||
| of his duties, and in early 2011, the remaining grant | ||
| funds were returned to Kaiser Permanente. |
| Software ID: | 10000104 |
| Software Version: |