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.") .... | 245,906 | 162,238 | 231,213 | 287,721 | 233,079 | 1,160,157 |
| 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.. | 1,300 | 1,300 | ||||
| 4 | Total. Add lines 1 through 3.. | 245,906 | 163,538 | 231,213 | 287,721 | 233,079 | 1,161,457 |
| 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).. | 396,484 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 764,973 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 245,906 | 163,538 | 231,213 | 287,721 | 233,079 | 1,161,457 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,290 | 1,776 | 381 | 767 | 1,005 | 5,219 |
| 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.. | 273 | 80 | 632 | 657 | 90 | 1,732 |
| 11 | Total support (Add lines 7 through 10). | 1,168,408 | |||||






| 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.) | 0 | |||||
| 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 |
|---|
| OTHER INCOME PART II, LINE 10; DESCRIPTION: MISC. REBATES; 2006: 273.; 2007: 80.; 2008: 632.; 2009: 657.; 2010: 90.; |
| Explanation |
|---|
| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI-A, Line 2 | Executive Director Nicole Bible is a family member of Board | |
| Member Sophie Michael. This board member abstains from voting | ||
| and from participating in any discussion concerning the family | ||
| member's employment, compensation or benefits in accordance | ||
| with the organization's conflict of interest policy. | ||
| Pt VI-B, Line 11a | A completed draft of Form 990 is reviewed by board members at a | |
| regularly scheduled board meeting. If after discussion any | ||
| changes are made, a copy of the final version is emailed to | ||
| all board members for approval before filing. | ||
| Pt VI-B, Line 12c | Each year, all board members are required to sign a statement | |
| disclosing any conflicts of interest or stating that none exist. | ||
| Statements are reviewed, and updated where required, when | ||
| the organization acquires a new board member or employee. | ||
| Pt VI-C, Line 19 | Governing documents, conflict of interest and other written | |
| policies, Form 1023 and Form 990 are stored at the organization's | ||
| office. Upon request, this information is made available | ||
| to the public for viewing by appointment at the organization's | ||
| place of business. | ||
| Form 990EZ, Part I, Line 8 | MISC. NONRECURRING REVENUE | |
| Form 990EZ, Part I, Line 16 | INSURANCE SUPPLIES TRAVEL & MEETINGS OTHER EXPENSES |
| Software ID: | 10000104 |
| Software Version: |