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? |
|||
|---|---|---|---|---|---|---|---|---|---|
| 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. | 0 | |||||
| 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.. | 0 | |||||
| 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.") . | 74,060 | 33,890 | 40,043 | 39,155 | 49,805 | 236,953 |
| 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...... | 790,304 | 751,974 | 831,102 | 554,624 | 660,356 | 3,588,360 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 25 | 7,349 | 6,639 | 215 | 2,648 | 16,876 |
| 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. | 864,389 | 793,213 | 877,784 | 593,994 | 712,809 | 3,842,189 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 12,390 | 3,090 | 3,030 | 525 | 502 | 19,537 |
| 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.. | 12,390 | 3,090 | 3,030 | 525 | 502 | 19,537 |
| 8 | Public Support (Subtract line 7c from line 6.) | 3,822,652 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 864,389 | 793,213 | 877,784 | 593,994 | 712,809 | 3,842,189 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 12,826 | 16,155 | 13,580 | 8,505 | 10,303 | 61,369 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 12,826 | 16,155 | 13,580 | 8,505 | 10,303 | 61,369 |
| 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.) | 1,027 | 93 | 1,120 | |||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 3,904,678 | |||||




| Facts And Circumstances Test |
|---|
| OTHER INCOME PART III, LINE 12; DESCRIPTION: LITIGATION CLAIMS; 2009: 1012.; 2010: 93.; DESCRIPTION: REFUND SURPLUS TEXAS WORKFORCE; 2009: 15.; |
| Explanation |
|---|
| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI-B, Line 11a | Board members were given a copy of Form 990 and | |
| allowed time to review and ask questions before filing. | ||
| Pt VI-B, Line 12c | All employees sign a written policy requiring them to | |
| disclose conflicts of interest. The Board of Directors | ||
| are currently working on board policy to be put into | ||
| effect in 2011. | ||
| Pt VI-B, Line 15 | The administrator and select members of the board | |
| do a salary review every 3-5 years. | ||
| Pt VI-C, Line 19 | A copy of the Form 990 is kept at the main office and | |
| at the CPA's office for anyone who request a copy. | ||
| Form 990EZ, Part I, Line 16 | ADVERTISING ANSWERING SERVICES BANK SERVICE CHARGES ELECTRONIC BILLING INSURANCE LICENSES, FEES, DUES MISCELLANEOUS NURSING HOME REIMB | |
| Form 990, Part IX, Line 24f | ANSWERING & PAGING BOOKS & SUBSCRIBTIONS ELECTRONIC BILLING MISCELLANEOUS RECOGNITION & RECRUITMENT STORAGE RENTAL |
| Software ID: | 10000104 |
| Software Version: |