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. | ||||||
| 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.") . | 1,100 | 1,715 | 1,305 | 730 | 688 | 5,538 |
| 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...... | ||||||
| 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. | 1,100 | 1,715 | 1,305 | 730 | 688 | 5,538 |
| 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.) | 5,538 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,100 | 1,715 | 1,305 | 730 | 688 | 5,538 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 597 | 275 | 161 | 88 | 39 | 1,160 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 597 | 275 | 161 | 88 | 39 | 1,160 |
| 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.). | 1,697 | 1,990 | 1,466 | 818 | 727 | 6,698 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | EXPENSES 4TH GRADE PIZZA PARTY 242 ARTIST IN RESIDENCE 2,500 FIELD TRIPS 750 GOOD PROGRAM 425 MUSIC WEEK 1,833 PE ASSEMBLY 2,000 SCIENCE ENRICHMENT 293 TIGER TICKET PRIZES 300 PE FUND DAY 1,000 LIBRARY 1,000 BANK CHARGES 150 SUNSHINE 443 WORKROOM SUPPLIES 243 KISS LUNCHES 130 DILLY NIGHT 728 STAFF APPRECIATION 850 VOLUNTEER APPRECIATION 168 TEACHER ACCOUNTS 6,327 FITNESS TRAIL 2,921 LEVY/BOND 300 DISNEY LICENSE 350 TOTAL 22,953 |
| PRIMARY EXEMPT PURPOSE | FORM 990-EZ, PART III | CHARITABLE PURPOSE IS TO SUPPORT THE EDUCATIONAL ENHANCEMENT OF THE PICKERINGTON ELEMENTARY SUTDENTS THROUGH FUNDRAISING EVENTS AND THE ORGANIZATION OF EDUCATIONAL PROGRAMS. |
| ALL OTHER ACHIEVEMENTS | FORM 990-EZ, PART III, LINE 31 | FUNDS SPENT ON STUDENTS, SCHOOL ACTIVITIES AND IMPROVEMENTS |
| Software ID: | |
| Software Version: |
| Person Name | Explanation |
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HEIDI BURKEY NA |
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WENDY HUX NA |
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LARA WHITE NA |
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SANDY ILER NA |
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STACY VEGA NA |
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KRISTIE ONDAYKO NA |
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TRISH REED NA |
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ROXANNE WALKER NA |