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
NICOLLET CONSERVATION CLUB INC
Employer identification number
41-1526165
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.") .
11,706
41,959
20,051
14,325
13,279
101,320
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......
66,366
64,611
68,053
65,317
64,171
328,518
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.
78,072
106,570
88,104
79,642
77,450
429,838
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
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
c
Add lines 7a and 7b..
0
8
Public Support (Subtract line 7c from line 6.)
429,838
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...
78,072
106,570
88,104
79,642
77,450
429,838
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
5,354
6,178
3,547
13
8
15,100
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
5,354
6,178
3,547
13
8
15,100
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
-936
-4,824
-1,017
8,545
7,992
9,760
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
31,055
31,055
13
Total support (Add lines 9, 10c, 11 and 12.).
82,490
107,924
90,634
88,200
116,505
485,753
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
88.490 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
93.780 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
3.110 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
4.540 %
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, PART IV, SUPPLEMENTAL INFORMATION: OTHER INCOME - PROCEEDS FROM INSURANCE FOR DAMAGE DUE TO HAIL STORM. REPAIRS TO BE COMPLETED IN 2011.
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
NICOLLET CONSERVATION CLUB INC
Employer identification number
41-1526165
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
MEMBERS HAVE ACCESS TO THE CONSERVATION FACILITY, BOAT LANDING & DOG TRAINING PONDS. THEY VOTE ON DECISIONS AFFECTING THE CONSERVATION CLUB OPERATIONS, FINANCIAL MATTERS & CAPITAL IMPROVEMENTS.
FORM 990, PART VI, SECTION A, LINE 7A
MEMBERS ELECT BOARD MEMBERS AT THE ANNUAL MEETING
FORM 990, PART VI, SECTION A, LINE 7B
DECISIONS OF THE BOARD OF DIRECTORS RELATED TO FINANCIAL MATTERS, CAPITAL IMPROVEMENTS, DONATIONS, ETC. ARE VOTED ON BY THE MEMBERS
FORM 990, PART VI, SECTION B, LINE 11
A COPY OF THE 990, 990T AND ANNUAL CHARITABLE REPORT ARE AVAILABLE FOR REVIEW BY THE BOARD & MEMBERS AT LARGE. THE PRESIDENT REVIEWS THE RETURN PRIOR TO SIGNING AND RECOMMENDS THE BOARD APPROVE SUBMISSION OF THE RETURN.
FORM 990, PART VI, SECTION C, LINE 19
DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
FORM 990, PART VII
MIKE HULKE - 49661 US HWY 14, COURTLAND, MN 56021. JAKE ZINS - 825 HILLSIDE CT, NICOLLET, MN 56074. JASON HOFFMAN - PO BOX 138, NICOLLET, MN 56074. JASON WILKING - 41836 451ST AVE, NICOLLET, MN 56074. MIKE STEVENSEN - 49107 506TH STREET, COURTLAND, MN 56021. DAN THEOBALD - 1813 SUNRAY AVE, MANKATO, MN 56001. CRAIG STEVENSEN - 310 MAIN ST, NICOLLET, MN 56074. TOM RIEKE - 808 NICOLLET AVE, NICOLLET, MN 56074. BRUCE KRAMER - 46002 471ST LANE, NICOLLET, MN 56074. MATT HOFFMAN - 931 SADDLEBROOK TRL, CHANHASSEN, MN 55317. MELVIN WAHL - 45645 CO RD 13, ST PETER, MN 56082. TERRY GAPPA - 41293 441ST AVE, NICOLLET, MN 56074. FRED FROEHLICH - 406 HEIDEMAN AVE, NICOLLET, MN 56074. DAVE WAGNER - 804 NICOLLET AVE, NICOLLET, MN 56074. RICK MEURER - 50267 461ST AVE, NICOLLET, MN 56074. AL BONNIFIELD - 914 N GERMAN ST, NEW ULM, MN 56073. DUANE OTTO - 44152 STATE HWY 99, NICOLLET, MN 56074. KRISTY ZAJAC - 422 4TH ST, NICOLLET, MN 56074.
ALL OTHER FUNCTIONAL EXPENSES
FORM 990, PART X, LINE 24F
CLEANING: PROGRAM SERVICE EXPENSES 4,485. MANAGEMENT AND GENERAL EXPENSES 1,416. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,901. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 3,875. MANAGEMENT AND GENERAL EXPENSES 1,224. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,099. SALES TAX: PROGRAM SERVICE EXPENSES 5,049. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,049. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,353. MANAGEMENT AND GENERAL EXPENSES 743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,096. OUTSIDE LABOR: PROGRAM SERVICE EXPENSES 1,158. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,158. DONATIONS: PROGRAM SERVICE EXPENSES 1,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,050. DUES & LICENSES: PROGRAM SERVICE EXPENSES 857. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 857. NEWSLETTER: PROGRAM SERVICE EXPENSES 700. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 700. PEST CONTROL: PROGRAM SERVICE EXPENSES 590. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 590. TELEPHONE: PROGRAM SERVICE EXPENSES 416. MANAGEMENT AND GENERAL EXPENSES 131. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 547. BANK CHARGES: PROGRAM SERVICE EXPENSES 209. MANAGEMENT AND GENERAL EXPENSES 66. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 275. TRAINING - FIREARMS: PROGRAM SERVICE EXPENSES 188. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 188. TRAVEL: PROGRAM SERVICE EXPENSES 70. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 70. WILDLIFE EXPENSE: PROGRAM SERVICE EXPENSES 64. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64. CASH OVER/SHORT: PROGRAM SERVICE EXPENSES -358. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -358.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.