TY 2010 Form 990EZ

- TIN:

Form990-EZ
Click to see attachment

Department of the Treasury
Internal Revenue Service

Short Form
Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)

Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-1150

2010

Open to Public
Inspection

For the 2010 calendar year, or tax year beginning 01-01-2010, and ending 12-31-2010

Check if applicable:

Address change

Name change

Initial return

Terminated

Amended return

Application pending

C Name of organization
DONNELLY FIREFIGHTER'S RELIEF
ASSOCIATION

Number and street (or P. O. box, if mail is not delivered to street address)BOX 6
Room/suite

City or town, state or country, and ZIP + 4 DONNELLY, MN56235

D Employer identification number

41-1565469

E Telephone number

(320) 287-0615

F Group Exemption
Number. . bullet

G Accounting method: CashAccrualOther (specify) bullet

H Check bullet

required to attach Schedule B
(Form 990, 990-EZ, or 990-PF).I Website: bullet

N/AJ Tax-Exempt status(check only one)501(c)(3) 501(c)( 4) bullet

(insert no.) 4947(a)(1) or 527

K Check

if the organization is not a section 509(a)(3) supporting organization and its gross receipts are normally not more than $50,000. A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.

L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ.. . bullet

$ 29,055


1	Contributions, gifts, grants, and similar amounts received . . . . . . . . .			1	12,480
2	Program service revenue including government fees and contracts . . . . . . .			2
3	Membership dues and assessments . . . . . . . . . . . . . .			3	115
4	Investment income . . . . . . . . . . . . . . . . . .			4	1,798
5a	Gross amount from sale of assets other than inventory . . . .	5a
b	Less: cost or other basis and sales expenses . .	5b
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . .			5c
6	Gaming and fundraising events
a	Gross income from gaming (attach Schedule G if greater than $15,000)	6a
b	Gross income from fundraising events (not including $ 14,662 of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceed $15,000) . . . . . . .
c	Less: direct expenses from gaming and fundraising events . . .	6c	7,685
d	Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c)			6d	6,977
7a	Gross sales of inventory, less returns and allowances . . . .	7a
b	Less: cost of goods sold . . . . . . . . . .	7b
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . .			7c
8	Other revenue (describe in Schedule O) . . . . . . . . .			8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . .			9	21,370
10	Grants and similar amounts paid (list in Schedule O) . . . . . . . .			10
11	Benefits paid to or for members . . . . . . . . . . . . . . .			11	5,456
12	Salaries, other compensation, and employee benefits . . . . . . . . . . .			12
13	Professional fees and other payments to independent contractors . . . . . . . .			13	1,540
14	Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . .			14
15	Printing, publications, postage, and shipping . . . . . . . . . . . .			15
16	Other expenses (describe in Schedule O) . . . . . . . . . .			16	5,048
17	Total expenses. Add lines 10 through 16 . . . . . . . . . . . .			17	12,044
18	Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . .			18	9,326
19	Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
	end-of-year figure reported on prior year’s return) . . . . . . . . . . .			19	11,958
20	Other changes in net assets or fund balances (explain in Schedule O) . . . . . . .			20	-5,999
21	Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . .			21	15,285

Part IIBalance Sheets Check if the organization used Schedule O to respond to any question in this Part II. . . . . . . . .

(See the instructions for Part II.)(A) Beginning of year(B) End of year

22Cash, savings, and investments . . . . . . . . . .

146,758

169,151

23Land and buildings . . . . . . . . . . . . .

24Other assets (describe in Schedule O) . . . . . .

730

496

25Total assets . . . . . . . . . . . . . .

147,488

169,647

Total liabilities (describe in Schedule O) . . . . .

135,530

154,362

27Net assets or fund balances (line 27 of column (B) must agree with line 21) .

11,958

15,285

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 10642I Form 990-EZ (2010)

Form 990-EZ (2010)

Page 2

Part IIIStatement of Program Service Accomplishments Check if the organization used Schedule O to respond to any question in this Part III .	Expenses (Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? FIRE DEPARTMENT RELIEF ASSOCIATION
Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 PROVIDE PENSION BENEFITS TO VESTED FIREFIGHTERS (Grants $ ) If this amount includes foreign grants, check here ...			28a	5,456
29 (Grants $ ) If this amount includes foreign grants, check here ...			29a
30 (Grants $ ) If this amount includes foreign grants, check here ...			30a
31 Other program services (describe in Schedule O) . . . . . . . . . . . . (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a) . . . . . . . . .	32	5,456

Part IVList of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (See the instructions for Part IV.) Check if the organization used Schedule O to respond to any question in this Part IV . . . . . . . .

(a) Name and address	(b) Title and average hours per week devoted to position	(c) Compensation (If not paid, enter -0-.)	(d) Contributions to employee benefit plans & deferred compensation	(e) Expense account and other allowances
DOUGLAS CARDWELL 300 EDINBOURGH AVE DONNELLY,MN56235	TRUSTEE1.00	0
JOE EHLEN 52503 150TH ST DONNELLY,MN56235	TREASURER4.00	0
ALLEN REIMERS 13261 480TH AVE DONNELLY,MN56235	TRUSTEE1.00	0
HOWARD HENNEN 309 E 6TH ST DONNELLY,MN56235	MAYOR1.00	0
MAYNARD MAU 206 ATLANTIC AVE DONNELLY,MN56235	VICE PRESIDE1.00	0
CHAD SMITH 24872 100TH ST HERMAN,MN56248	SECRETARY2.00	0
LOLA SMITH CITY BUILDING DONNELLY,MN56248	CITY CLERK1.00	0
JEFF STALLMAN 15965 520TH AVE DONNELLY,MN56235	FIRE CHIEF1.00	0
GEOFFREY VOLKER 20775 464TH AVE MORRIS,MN56267	PRESIDENT2.00	0

Form 990-EZ (2010)

Page 3

Part VOther Information(Note the statement requirements in the instructions for Part V.)YesNo Check if the organization used Schedule O to respond to any question in this Part V . . . .

Did the organization engage in any activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ..............

Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the change on Schedule O (see instructions). ...................

If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not reported on Form 990-T, explain in Schedule O why the organization did not report the income on Form 990-T. ........................

Did the organization have unrelated business gross income of $1,000 or more or was it a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements?

35a

If "Yes," has it filed a tax return on Form 990-T for this year? (see instructions) ........

35b

Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N .............

37a

Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet

37a

Did the organization file Form 1120-POL for this year? ...............

37b

38a

Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were

any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?

38a

If “Yes,” complete Schedule L, Part II and enter the total amount involved .

38b

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on line 9 ......

39a

Gross receipts, included on line 9, for public use of club facilities ....

39b

40a

Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:

section 4911 bullet

; section 4912 bullet

; section 4955 bullet

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ....

40b

Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 .. bullet

Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization ................... bullet

All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. .................

40e

41List the states with which a copy of this return is filed. bullet

42aThe organization's books are in care of bullet

CHAD SMITH Telephone no. bullet

(320) 287-0683

Located at bullet

24872 100TH ST
HERMAN,MN ZIP + 4 bullet

56248

At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?

Yes

42b

If “Yes,” enter the name of the foreign country: bullet

See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

At any time during the calendar year, did the organization maintain an office outside of the U.S.?

42c

If “Yes,” enter the name of the foreign country: bullet

43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041Check here ....... bullet

and enter the amount of tax-exempt interest received or accrued during the tax year . . . bullet

44a

Did the organization maintain any donor advised funds? If "Yes", Form 990 must be completed instead of

Yes

Form 990-EZ.. . . . . . . . . . . . . . . . . . . .

44a

Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completed instead of Form990-EZ. . . . . . . . .

44b

Did the organization receive any payments for indoor tanning services during the year? . . . . . . .

44c

If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanation in Schedule O. . . . . . . . .

44d

Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. . . . . . . . .

45a

Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. .

45a

Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I. . . . . . . . . .

Form 990-EZ (2010)

Page 4

Part VI

Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI . . . . . . . .

Yes

Did the organization engage in lobbying activities? If "Yes," complete Schedule C, Part II . . . .

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E . . .

49a

Did the organization make any transfers to an exempt non-charitable related organization? . . . .

49a

If "Yes," was the related organization a section 527 organization? . . . . . . . . .

49b

Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and address of each employee paid more than $100,000	(b) Title and average hours per week devoted to position	(c) Compensation	(d) Contributions to employee benefit plans & deferred compensation	(e) Expense account and other allowances

50(f)

Total number of other employees paid over $100,000 . . . . . . . . . . . . . bullet

Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and address of each independent contractor paid more than $100,000	(b) Type of service	(c) Compensation

51(d)

Total number of other independent contractors each receiving over $100,000 . . . . . . . bullet

Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A .................... Yes No

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (See instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.

May the IRS discuss this return with the preparer shown above? See instructions ......... bullet

YesNo

Form 990-EZ (2010)

Additional Data

Software ID:
Software Version:

Form 990-EZ, Special Condition Description:

Special Condition Description

- 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.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

DONNELLY FIREFIGHTER'S RELIEF
ASSOCIATION

Employer identification number

41-1565469

Identifier	Return Reference	Explanation
OTHER EXPENSES	FORM 990-EZ, PART I, LINE 16	EXPENSES BOND FEE 100 OTHER EXPENSES 211 SUPPLIES 717 BANQUET 592 EQUIPMENT 3,142 FOREIGN TAX EXPENSE 46 TAX PAYMENT 100 DUES 140 TOTAL 5,048
OTHER CHANGES IN NET ASSETS OR FUND BALANCES	FORM 990-EZ, PART I, LINE 20	UNREALIZED APPRECIATION IN FMV OF INVESTMENTS 12,762 NET CHANGE IN ACCRUED PENSION LIABILITY -18,761
OTHER ASSETS	FORM 990-EZ, PART II, LINE 24	ACCOUNTS RECEIVABLE 730 496 TOTAL 730 496
OTHER LIABILITIES	FORM 990-EZ, PART II, LINE 26	ACCRUED PENSION LIABILITY 134,755 154,347 TAXES WITHHOLDING PAYABLE 775 15

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

TY 2010 CompensationExplanation

Name:

DONNELLY FIREFIGHTER'S RELIEF

ASSOCIATION

EIN: 41-1565469

Person Name	Explanation
DOUGLAS CARDWELL
JOE EHLEN
ALLEN REIMERS
HOWARD HENNEN
MAYNARD MAU
CHAD SMITH
LOLA SMITH
JEFF STALLMAN
GEOFFREY VOLKER