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.") .... | 70,196 | 71,653 | 73,208 | 80,898 | 84,055 | 380,010 |
| 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.. | 70,196 | 71,653 | 73,208 | 80,898 | 84,055 | 380,010 |
| 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).. | 24,050 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 355,960 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 70,196 | 71,653 | 73,208 | 80,898 | 84,055 | 380,010 |
| 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). | 380,010 | |||||






| 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 | 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. | ||||||
| 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.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 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.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | OFFICIERS AND DIRECTORS REVIEW FORMS PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION C, LINE 19 | COPY OF THE FORM IS FILED WITH THE TENNESSEE ATTORNEY GENERAL OFFICE AND IS OPEN FOR PUBLIC INSPECTION AT ANY TIME. | |
| CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | FORM 990, PART VII | CHARLES "TOONIE" CASH - 171 ROCKINGHAM RD, GRAY, TN 37615. JAMES BARKER - 143 GREENBRIAR LANE, JOHNSON CITY, TN 37615. DIANNE BARKER - 143 GREENBRIAR LANE, JOHNSON CITY, TN 37615. BOBBY SNYDER - 163 RICHARD STREET, GRAY, TN 37615. BRAD STREET - 5 BLUEGRASS COURT, JONESBOROUGH, TN 37659. ALANA STREET - 5 BLUEGRASS COURT, JONESBOROUGH, TN 37659. DAN BLALOCK - 311 BULAH DRIVE, KINGSPORT, TN 37663. TWALLA BLALOCK - 311 BULAH DRIVE, KINGSPORT, TN 37663. LEE BOWSER - 255 LAKE MEADOW DRIVE, GRAY, TN 37615. JESSIE BOWSER - 255 LAKE MEADOW DRIVE, GRAY, TN 37615. HUGH COFFMAN - 309 CORALWOOD STREET, KINGSPORT, TN 37663. JOANNE COFFMAN - 309 CORALWOOD STREET, KINGSPORT, TN 37663. LEE COFFMAN - 410 LAKERIDGE STREET, KINGSPORT, TN 37663. WILMA COFFMAN - 410 LAKERIDGE STREET, KINGSPORT, TN 37663. LEON COX - 112 LEON COX DRIVE, JONESBOROUGH, TN 37659. J.D. LAY - 226 OLD DUNLAP ROAD, KINGSPORT, TN 37663. HELEN LAY - 226 OLD DUNLAP ROAD, KINGSPORT, TN 37663. RON LITTON - 1015 LAURELWOOD DRIVE, KINGSPORT, TN 37660. ANN LITTON - 1015 LAURELWOOD DRIVE, KINGSPORT, TN 37660. BUD PATE - 126 CROCKETT CT., GRAY, TN 37615. HELEN PATE - 126 CROCKETT CT., GRAY, TN 37615. PAUL RENFRO - 3014 S. HILLS DR., JOHNSON CITY, TN 37601. JEAN RENFRO - 3014 S. HILLS DR., JOHNSON CITY, TN 37601. JUNE SNYDER - 163 RICHARD STREET, GRAY, TN 37615. BENNY WHEELOCK - 768 HARMONY RD, JONESBOROUGH, TN 37659. VANESSA WHEELOCK - 768 HARMONY RD, JONESBOROUGH, TN 37659. |
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