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.") .... | 254,142 | 230,339 | 293,320 | 213,652 | 171,851 | 1,163,304 |
| 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.. | 254,142 | 230,339 | 293,320 | 213,652 | 171,851 | 1,163,304 |
| 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. | 1,163,304 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 254,142 | 230,339 | 293,320 | 213,652 | 171,851 | 1,163,304 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 162 | 332 | 454 | 4 | 952 | |
| 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). | 1,164,256 | |||||






| 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 |
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| Explanation |
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| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt V, Line 3b | The organization did not have any unrelated business income. | |
| Pt VI-B, Line 11a | The Executive Director reviews form 990 prior and after the filing. | |
| Pt VI-C, Line 19 | Documents available on request. | |
| Form 990EZ, Part I, Line 16 | PUBLIC RELATIONS MISC BOOKS DURABLE SUPPLIES DUES & SUBSCRIPTIONS FUNDRAISING INSURANCE SPECIAL EVENTS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES | |
| Form 990, Part VI, Line 9 | DR. TOM GREEN 634 LULAVILLE RD FITZGERALD GA 31750 ANDY JOHNSON 137 WELDON WAY FITZGERALD GA 31750 BETH FOWLER PO BOX 667 FITZGERALD GA 31750 WANDA MCLEMORE PO BOX 630 FITZGERALD GA 31750 JOHNELIA GRAHAM 128 NEWCOMER TRAIL FITZGERALD GA 31750 CAM JORDAN 1113 N MAIN STREET FITZGERALD GA 31750 JILL PRUITT 111 HAMPTON CT FITZGERALD GA 31750 PHILIP JAY P O BOX 436 FITZGERALD GA 31750 APRIL MCDUFFIE 226 EL HARRIS RD FITZGERALD GA 31750 KIM MELTON 111 CATO STREET FITZGERALD GA 31750 MIKE RUFFIN P O BO | |
| Form 990, Part IX, Line 24f | INSURANCE 1943. 0. 1943. 0. SPECIAL EVENTS 3110. 0. 3110. 0. FUNDRAISING 8913. 0. 8913. 0. TRAINING 439. 0. 439. 0. REPAIRS & MAINTENANCE 775. 0. 775. 0. TECHNOLOGY 64. 0. 64. 0. MEALS 944. 358. 586. 0. SUPPLIES 21814. 21814. 0. 0. TELEPHONE 3606. 0. 3606. 0. OTHER 154. 154. 0. 0. POSTAGE 233. 0. 233. 0. BANK FEES LEASE 581. 0. 581. 0. |
| Software ID: | 10000104 |
| Software Version: |