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.") .... | 220,262 | 211,662 | 121,800 | 120,632 | 130,280 | 804,636 |
| 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.. | 220,262 | 211,662 | 121,800 | 120,632 | 130,280 | 804,636 |
| 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. | 804,636 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 220,262 | 211,662 | 121,800 | 120,632 | 130,280 | 804,636 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 186 | 1,069 | 1,036 | 701 | 182 | 3,174 |
| 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). | 807,810 | |||||






| 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 |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Form 990 governing body review (Part VI, line 11) | OUR ACCOUNTANT PREPARES A COPY OF OUR TAX RETURN THE OFFICERS OF THE ORGANIZATION REVIEW THE RETURN BEFORE IT IS EFILED | |
| 02. Conflict of interest policy compliance (Part VI, line 12c) | WE HAVE A WRITTEN CONFLICT OF INTEREST POLICY THAT REQUIRES OUR OFFICERS DIRECTORS AND EMPLOYEES TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF THEMSELVES AND THEIR FAMILY MEMBERS ON A QUESTIONNAIRE DISTRIBUTED BY OUR OPERATIONS MANAGER THE OPERATIONS MANAGER ENSURES THAT ALL QUESTIONNAIRES ARE COMPLETED REVIEWS THEM FOR CONFLICTS AND SUBMITS TO THE BOARD FOR REVIEW ANY QUESTIONNAIRES THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS | |
| 03. CEO, executive director, top management comp (Part VI, line 15a) | SEE REPONSE TO PART VI LINE 4 ABOVE | |
| 04. Other officer or key employee compensation (Part VI, line 15b | THERE ISNT ANY OTHER OFFICE THAT RECEIVES ANY COMPENSATION OTHER THAN THE EXECUTIVE DIRECTOR AND SHE IS NOT A VOTING MEMBER OF THE BOARD OF DIRECTORS | |
| 05. Governing documents, etc, available to public (Part VI, line 19) | ALL GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST TO THE MAIN OFFICE | |
| 06. Explanation of other changes in net assets or fund balances (Part XI, line 5) | THIS CHANGE IS THE RESULT OF ASSETS BEING OVER DEPRECIATED IN PRIOR YEARS THIS IS TO CORRECT THE BALANCE TO WHAT IT SHOULD BE |
| Software ID: | |
| Software Version: |