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.") .... | 162,380 | 127,479 | 190,921 | 144,841 | 204,705 | 830,326 |
| 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.. | 162,380 | 127,479 | 190,921 | 144,841 | 204,705 | 830,326 |
| 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. | 830,326 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 162,380 | 127,479 | 190,921 | 144,841 | 204,705 | 830,326 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 67,694 | 71,261 | 65,997 | 53,764 | 48,025 | 306,741 |
| 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.. | 3,070 | 3,070 | ||||
| 11 | Total support (Add lines 7 through 10). | 1,140,137 | |||||






| 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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| OTHER INCOME PART II, LINE 10; DESCRIPTION: MISCELLANEOUS; 2008: 3070.; |
| Explanation |
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| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI-B, Line 11a | ORGANIZATION COMPLETES A FORM 990 QUESTIONNAIRE PROVIDED | |
| BY THE PREPARING ACCOUNTING FIRM; THE COMPLETED | ||
| QUESTIONNAIRE IS DISTRUTED TO THE BOARD FOR COMMENT. | ||
| AFTER COMPLETION OF FORM 990, THE EXECUTIVE DIRECTOR | ||
| REVIEWS THE FORM TO ENSURE ACCURACY. FORM 990 IS MADE | ||
| AVAILABLE TO ANY BOARD MEMBER UPON REQUEST. | ||
| Pt VI-B, Line 12c | ORGANIZATION REQUIRES NEW BOARD MEMBERS AND KEY EMPLOYEES | |
| TO SIGN A CONFLICT OF INTEREST POLICY. THE POLICY IS | ||
| DISCUSSED AT THE ORGANIZATION'S ANNUAL MEETING. BOARD | ||
| MEMBERS SIGN A BOARD MEMBER EXPECTATION STATEMENT. | ||
| Pt VI-B, Line 15 | ORGANIZATION IMPLEMENTED A PERFORMANCE EVALUATION PLAN | |
| MODELED AFTER METHODOLGY DEVELOPED BY THE ZIGON PERFORMANCE | ||
| GROUP. THE PLAN'S EMPHASIS IS ON CREATING PERFORANCE STANDARDS | ||
| FOR HARD-TO-MEASURE JOBS AND RESULTS IN AN OBJECTIVE | ||
| APPRAISAL ACCORDING TO WHETHER OR NOT CERTAIN | ||
| ORGANIZATIONAL RESULTS ARE BEING ACHIEVED. THE BOARD | ||
| THEN UTILIZES THESE OBJECTIVE EVALUATIONS AND DETERMINES | ||
| COMPENSATION. BENEFITS ARE THE SAME FOR ALL EMPLOYEES. | ||
| Pt VI-C, Line 19 | WRITTEN REQUESTS FOR COPIES ARE GIVEN TO THE EXECUTIVE | |
| DIRECTOR, WHO WILL THEN AUTHORIZE A COPY OF THE | ||
| REQUESTED DOCUMENT BE SHOWN TO THE PERSON MAKING THE REQUEST. | ||
| Pt XI | LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES | |
| NET UNREALIZED GAINS ON INVESTMENTS |
| Software ID: | 10000104 |
| Software Version: |