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.") .... | ||||||
| 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. | ||||||
| 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). | ||||||






| 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.") . | 85,075 | 88,059 | 87,523 | 86,105 | 96,281 | 443,043 |
| 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.. | 144 | 161 | 244 | 131 | 215 | 895 |
| 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.. | 36,000 | 36,000 | 36,000 | 36,000 | 36,000 | 180,000 |
| 6 | Total. Add lines 1 through 5. | 121,219 | 124,220 | 123,767 | 122,236 | 132,496 | 623,938 |
| 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.) | 623,938 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 121,219 | 124,220 | 123,767 | 122,236 | 132,496 | 623,938 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 13,409 | 16,578 | 12,395 | 9,379 | 6,202 | 57,963 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 13,409 | 16,578 | 12,395 | 9,379 | 6,202 | 57,963 |
| 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.). | 134,628 | 140,798 | 136,162 | 131,615 | 138,698 | 681,901 |




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Officer, directors, etc. family relationship (Part VI, line 2) | President Gregory Neill and Trustee Michael Neill are brothers | |
| 02. Form 990 governing body review (Part VI, line 11) | Accoutant prepares and supplies board trustee with copy of form 990 and financial statements Board consisting of three trustees and four rotating members reviews same and reports to full membership Upon approval by board accountant electronically files form 990 | |
| 03. Conflict of interest policy compliance (Part VI, line 12c) | If a potential conflict is brought to the boards attention the firefighter in question if a board member is asked to remove himself from the board meeting All known facts related to the potential conflict are discussed and the remaining board members will make a decision as to whether the member is in conflict If there is a dissension amoungst the board the member is deemed in conflict and will be prohibited from voting or discussing any issues related to the matter at hand If a conflict is found to have potentially occured after the fact the board will convene a special meeting to discuss said conflict and will make a decision absent the member potentially in conflict Again any dissension on the board will result in a positive finding of conflict | |
| 04. Governing documents, etc, available to public (Part VI, line 19) | Documents are maintained at firehouse and are available to view upon request by appointment | |
| 05. Explanation of other changes in net assets or fund balances (Part XI, line 5) | Gain on change in market value of securities 1151 Rounding 3 |
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