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
HAY CREEK VALLEY HISTORICAL ASSOCIATION
Employer identification number
23-2090348
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.") .
6,837
26,091
90,059
77,500
33,784
234,271
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......
83,678
192,938
171,729
157,038
220,646
826,029
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.
90,515
219,029
261,788
234,538
254,430
1,060,300
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
6,542
11,542
18,084
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..
6,542
11,542
18,084
8
Public Support (Subtract line 7c from line 6.)
1,042,216
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...
90,515
219,029
261,788
234,538
254,430
1,060,300
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
7,298
11,907
11,181
9,613
4,298
44,297
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
7,298
11,907
11,181
9,613
4,298
44,297
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.)
1,629
1,629
13
Total support (Add lines 9, 10c, 11 and 12.).
97,813
232,565
272,969
244,151
258,728
1,106,226
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
94.210 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
92.750 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
4.000 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
5.060 %
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
HAY CREEK VALLEY HISTORICAL ASSOCIATION
Employer identification number
23-2090348
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
ANYONE OF GOOD MORAL CHARACTER MAY BECOME A MEMBER OF THE "ASSOCIATION" AND SHALL PAY ANNUAL DUES OF $15 FOR MEMBERS AGE 18 YEARS OR OLDER; EACH RECEIVING ONE VOTE; OR $25 PER COUPLE AGES 18 YEARS OR OLDER; EACH COUPLE RECEIVING 2 VOTES. THE ANNUAL DUES SHALL BE $10 FOR JUNIOR MEMBERS, UNDER 18 YEARS OF AGE, RECEIVING NO VOTE. LIFE MEMBERSHIP DUES SHALL BE $250 PER MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A
AN ELECTION COMMITTEE OF THREE MEMBERS APPOINTED BY THE PRESIDENT AT THE MAY GENERAL MEMBERSHIP MEETING SHALL BE IN CHARGE OF THE NOMINATION AND ELECTION OF THE OFFICERS AND DIRECTORS. THE NAMES OF THE MEMBERS OF THE ELECTION COMMITTEE SHALL BE ANNOUNCED AT THE JULY MEMBERSHIP MEETING AND IN THE ASSOCIATION'S AUGUST NEWSLETTER. ALL MEMBERS SHALL BE INVITED TO THE ELECTION MEETING AND THE ANNUAL MEETING BY A WRITTEN NOTICE FROM THE RECORDING SECRETARY, OR THROUGH THE ASSOCIATION'S NEWSLETTER. THE ELECTION COMMITTEE SHALL POST THE SLATE OF NOMINEES AS THEY BECOME CONFIRMED IN A NEWSLETTER IN SEPTEMBER, OCTOBER, AND AGAIN AT THE NOVEMBER GENERAL MEMBERSHIP MEETING WITH ANY ADDITIONS OR DELETIONS NOTED. THE NOMINATION OF OFFICERS AND DIRECTORS SHALL TAKE PLACE AT THE NOVEMBER MEETING, AND THE ELECTION SHALL BE BY BALLOT, AFTER ALL NOMINATIONS ARE CLOSED. A MAJORITY OF ALL MEMBERS PRESENT IS NECESSARY FOR THE ELECTION OF NEW OFFICERS AND DIRECTORS, WHO SHALL ENTER UPON THEIR DUTIES ON THE FIRST OF JANUARY. ONLY MEMBERS IN GOOD STANDING CAN VOTE OR BE ELECTED TO OFFICE.
FORM 990, PART VI, SECTION A, LINE 7B
BYLAWS: THE BYLAWS CANNOT BE ALTERED, EXCEPT BY A MOTION (TO ALTER, AMEND, OR IMPROVE) THAT HAS BEEN PREVIOUSLY INTRODUCED AT A GENERAL MEMBERSHIP MEETING IN WRITING AND SIGNED BY THREE (3) MEMBERS. SUCH A MOTION SHALL BE PRESENTED TO THE GENERAL MEMBERSHIP IN TWO (2) CONSECUTIVE NEWSLETTERS, AND SUBMITTED FOR DISCUSSION IN TWO (2) CONSECUTIVE GENERAL MEMBERSHIP MEETINGS. AT THE THIRD GENERAL MEMBERSHIP MEETING A VOTE OF THREE QUARTERS OF THE MEMBERSHIP PRESENT SHALL BE REQUIRED FOR ADOPTION. APPENDIX: THREE MEMBERS AT A GENERAL MEMBERSHIP MEETING MAY PROPOSE ANY CHANGES TO SECTIONS IN THIS APPENDIX IN WRITING. IF THE MEMBERS PRESENT DEEM THE CHANGES NECESSARY, THE CHANGES ARE TO BE PRINTED IN THE NEXT ASSOCIATION NEWSLETTER, AND ACTION SHALL BE TAKEN IN THE FOLLOWING GENERAL MEMBERSHIP MEETING, AT WHICH TIME A VOTE OF THREE QUARTERS OF MEMBERS PRESENT SHALL BE REQUIRED FOR ITS ADOPTION.
FORM 990, PART VI, SECTION B, LINE 11
THE TAX PREPARER SUBMITS A DRAFT COPY FOR REVIEW TO THE TREASURER AND EXECUTIVE DIRECTOR OF THE ORGANIZATION -- THE APPOINTED PERSONS BY THE BOARD OF DIRECTORS FOR REVIEW OF THE 990. ONCE THESE APPOINTED PERSONS ARE SATISFIED WITH THE TAX RETURN, IT IS MADE AVAILABLE TO THE ENTIRE BOARD OF DIRECTORS. FAILING ANY CHANGES MADE BY THE DIRECTORS, THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
ANNUALLY EACH DIRECTOR, OFFICER, EMPLOYEE, PROGRAM CHAIR AND COMMITTEE CHAIR SHALL COMPLETE A DISCLOSURE FORM INDENTIFYING ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES IN WHICH THEY ARE INVOLVED THAT THEY BELIEVE COULD GIVE RISE TO A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION HAS AN OPEN BOOK POLICY OF DISCLOSURE OF INFORMATION TO THE PUBLIC. GOVERNING DOCUMENTS ARE MADE AVAILABLE TO ANY ONE WHO ASKS FOR THEM.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 2,286.
FORM 990, PART XII, LINE 1:
THE FINANCIAL STATEMENTS HAVE BEEN PREPARED ON THE MODIFIED CASH BASIS OF ACCOUNTING. UNDER THIS BASIS, REVENUES AND RELATED ASSETS ARE RECOGNIZED WHEN RECEIVED AND EXPENSES ARE RECOGNIZED WHEN PAID RATHER THAN WHEN THE OBLIGATION IS INCURRED. THIS BASIS DIFFERS FROM GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRIMARILY BECAUSE THE ORGANIZATION HAS NOT RECOGNIZED ACCOUNTS RECEIVABLE FROM MEMBERS AND ACCOUNTS PAYABLE TO VENDORS AND THEIR RELATED EFFECTS ON THE CHANGE IN NET ASSETS IN THE FINANCIAL STATEMENTS. LONG-LIVED PROPERTY AND EQUIPMENT IS RECORDED AS AN ASSET AT THE TIME OF PURCHASE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.