Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
UTHOFF VALLEY ELEMENTARY SCHOOL PTO
Employer identification number
43-1556943
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(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
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
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.
Section B. Total Support
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).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
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.") .
506
15
340
861
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......
34,566
8,123
52,949
37,043
33,221
165,902
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.
35,072
8,138
53,289
37,043
33,221
166,763
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.)
166,763
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
35,072
8,138
53,289
37,043
33,221
166,763
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.).
35,072
8,138
53,289
37,043
33,221
166,763
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
100.000 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
100.000 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
UTHOFF VALLEY ELEMENTARY SCHOOL PTO
Employer identification number
43-1556943
Identifier
Return Reference
Explanation
OTHER REVENUE
FORM 990-EZ, PART I, LINE 8
OTHER INCOME 581 MISC INCOME: BRICK DONATION 350 TOTAL 931
OTHER EXPENSES
FORM 990-EZ, PART I, LINE 16
EXPENSES TEACHER/STAFF: CONFERENCE DIN 519 GRADE LEVEL EXPENDITURES 2,425 MISC EXP: MISC SCHOOL EXP 3,152 MISC EXP: ASSIGNMENT BOOK 1,146 MISC EXP: LOUNGE SUPPLIES 25 MISC EXP: VIKING FOLDERS 513 PROG/MISC EXP: LUGGAGE TA 110 PROG/MISC EXP: ORANGE PAP 319 SCHOOL EVENTS: EQUATIONS 241 SCHOOL EVENTS: CHESS CLUB 71 SCHOOL EVENTS: GAS STIPEN 75 SCHOOL EVENTS: BULLY PREV 150 SCHOOL EVENTS: KINDERGART 50 SCHOOL EVENTS: PASTRIES 180 SCHOOL EVENTS: 5TH GRADE 50 SCHOOL EVENTS: 1ST DAY CE 20 SCHOOL EVENTS: FIELD TRIP 3,444 SCHOOL EVENTS: READING WO 1,077 SCHOOL EVENT EXPENSES 35 SCHOOL EVENTS: YOUNG AURT 65 SCHOOL EVENTS: 5TH GRADE 812 SCHOOL EVENTS: GRANDPERSO 426 SCHOOL EVENTS: VARIETY SH 1,127 SCHOOL EVENTS: RED RIBBON 150 SCHOOL PROGRAMS: MAP TEST 354 SCHOOL PROG: SPECIAL PURC 284 SPL PURCHASE: BOXES 215 SPL PURCHASE: DINNERWARE 151 SPL PURCHASE: FLASHDRIVES 1,250 SPL PURCH: LIBRARY SHELVE 2,345 SPL PURCH: READING PUPPET 58 SPL PURCH: SCHOOL BEAUTIF 10,518 SPL PURCH: SCIENCE MACHIN 299 SPL PURCH: UV AUDIO EQUIP 3,500 SCHOOL PROGRAMS: HEALTH/N 135 SCHOOL PROGRAMS: ART SUPP 226 SCHOOL PROGRAMS: MUSIC SU 127 SCHOOL PROGRAMS: T-SHIRTS 1,596 SCHOOL PROGRAMS: AR SUBSC 1,958 SCHOOL ASSEMBLIES 785 SCHOOL PROG: COUNSELING 118 FUNDRAISING EXP: SPIRIT W 3,020 FUNDRAISING EXP: VIKING C 486 FUNDRAISING EXP: ENTERTAI 7,538 FUNDRAISING EXP: FUN FAIR 8,130 FUNDRAISING EXP: BOOK FAI 4,271 FUNDRAISING EXP: FALL MIX 1,004 FUNDRAISING EXP: BUZZ BOO 231 FUNDRAISING EXP: BRICK EX 201 FUNDRAISING EXP: ORIG WOR 1,035 FUNDRAISING EXP: MARKET D 1,280 FUNDRAISING EXP: HOLIDAY 1,330 FUNDRAISING EXP: SCRIPS 33,605 FUNDRAISING EXP: TRIVIA N 6,501 DONATION: ROCKWOOD TRIVIA 57 BANK SERVICE FEES 200 CREDIT CARD FEES 433 PTO OPERATING EXP: BOND 147 PTO OPERATING EXP: MEETIN 39 PTO OPERATING EXP: SPAGHE 436 PTO OPERATING EXP: PRESID 80 TEACHER APPREC: APPRECIAT 250 PTO OPERATING EXP: APPRE 522 PTO OPERATING EXP: CARE T 50 TEACHER APPREC: VOLUNTEER 280 TEACHER APPREC: FALL FEST 153 TEACHER APPREC: MISC 607 TEACHER APPREC: SOCK HOP 357 SPECIAL APPREC WEEKS 375 TEACHER APPREC: WATCH DOG 356 TOTAL 113,075
OTHER ASSETS
FORM 990-EZ, PART II, LINE 24
SCRIP CARDS ON HAND 1,615 980 TOTAL 1,615 980
PRIMARY EXEMPT PURPOSE
FORM 990-EZ, PART III
TO PROVIDE EDUCATIONAL MATERIALS & PROGRAMS TO UTHOFF VALLEY ELEMENTARY SCHOOL STUDENTS & FACULTY WHILE PROMOTING COMMUNICATION AMONG FACULTY, STUDENTS & PARENTS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.