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.") .... | 117,298 | 171,549 | 167,619 | 147,918 | 161,498 | 765,882 |
| 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.. | 117,298 | 171,549 | 167,619 | 147,918 | 161,498 | 765,882 |
| 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).. | 21,996 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 743,886 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 117,298 | 171,549 | 167,619 | 147,918 | 161,498 | 765,882 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 5,950 | 10,196 | 6,865 | 4,783 | 4,437 | 32,231 |
| 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.. | 3,093 | 3,709 | 9,525 | 85,000 | 756 | 102,083 |
| 11 | Total support (Add lines 7 through 10). | 900,196 | |||||






| 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. Members or stockholder classes and rights (Part VI, line 6) | THE ORGANIZATION IS SUPPORTED BY VOLUNTARY MEMBERSHIP OF LOCAL BUSINESSES AND INDIVIDUALS THOSE MEMBERS ARE ASSESSED ANNUAL MEMBERSHIP DUES | |
| 02. Member election for additional members (Part VI, line 7a) | THE VOLUNTARY MEMBERSHIP AS A WHOLE HAS THE RIGHT AND OBLIGATION TO PARTICIPATE IN THE ELECTION OF THE GOVERNING BOARD OF DIRECTORS OF THE ORGANIZATION | |
| 03. Form 990 governing body review (Part VI, line 11) | FORM 990 IS PROVIDED TO THE PROGRAM DIRECTORS OF THE ORGANIZATION PRIOR TO FILING AND THE PROGRAM DIRECTORS ARE THEN RESPONSIBLE TO PROVIDE A COPY TO THE GOVERNING BOARD ANY QUESTIONS OR ISSUES FROM THE GOVERNING BOARD REGARDING THE FORM 990 ARE THEN ADDRESSED TO THE TAX RETURN PREPARER BY THE PROGRAM DIRECTORS | |
| 04. Conflict of interest policy compliance (Part VI, line 12c) | COMPLIANCE ISSUES ARE ADDRESSED AND REVIEWED ANNUALLY IN THE PROCESS OF AN ANNUAL PERFORMANCE REVIEW OF THE KEY EMPLOYEES PROGRAM DIRECTORS | |
| 05. CEO, executive director, top management comp (Part VI, line 15a) | COMPENSATION OF THE KEY EMPLOYEES CURRENTLY TWO PROGRAM DIRECTORS IS DETERMINED AND REVIEWED BY THE GOVERNING BOARD ON AN ANNUAL BASIS THE DOCUMENTATION OF THESE DECISIONS ARE RECORDED IN THE REGULAR MEETING MINUTES OF THE GOVERNING BOARD DECISIONS ARE MADE BASED ON PERFORMANCE AND COMPARABILITY TO SIMILAR ORGANIZATIONS IN THE SURROUNDING AREAS | |
| 06. Other officer or key employee compensation (Part VI, line 15b | SAME AS EXPLANATION FOR QUESTION 15A | |
| 07. Governing documents, etc, available to public (Part VI, line 19) | ALL GOVERNING DOCUMENTS POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC REVIEW UPON REQUEST AT THE ORGANIZATION OFFICE IN WEBSTER CITY IOWA |
| Software ID: | |
| Software Version: |