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.") .... | 322,452 | 419,205 | 420,161 | 439,168 | 420,161 | 2,021,147 |
| 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.. | 322,452 | 419,205 | 420,161 | 439,168 | 420,161 | 2,021,147 |
| 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. | 2,021,147 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 322,452 | 419,205 | 420,161 | 439,168 | 420,161 | 2,021,147 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 116 | 239 | 2,247 | 899 | 186 | 3,687 |
| 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). | 2,024,834 | |||||






| 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 VI-A, Line 6 | The entity consists of members who elect the Board | |
| Pt VI-A, Line 6 | of Directors. A member is any indiviudal who shares the stated | |
| Pt VI-A, Line 6 | Mission Statement of the entity and attends one membership | |
| Pt VI-A, Line 6 | meeting during the year. | |
| Pt VI-A, Line 6 | Space | |
| Pt VI-A, Line 7a | The members as stated in Line 6 elect the Board of Directors | |
| Pt VI-A, Line 7a | on an annual basis. | |
| Pt VI-A, Line 7a | Space | |
| Pt VI-B, Line 11a | The Certified Public Accountant who prepared this | |
| Pt VI-B, Line 11a | return on a pro bono basis provided a copy of this return to | |
| Pt VI-B, Line 11a | the Executive Director and the Treasurer for review and | |
| Pt VI-B, Line 11a | comments before the 2009 Form 990 was filed. | |
| Pt VI-B, Line 11a | Space | |
| Pt VI-B, Line 12c | The conflict of interest policy is reviewed by the Board of | |
| Pt VI-B, Line 12c | Directors at the monthly Board or Directors meeting. | |
| Pt VI-B, Line 12c | Space | |
| Pt VI-B, Line 15 | The only Officer or Director who receives compensation is the | |
| Pt VI-B, Line 15 | Executive Director. An annual review of performance is done | |
| Pt VI-B, Line 15 | on a yearly basis by an individual selected by the Board of | |
| Pt VI-B, Line 15 | Directors. The Board of Directors reviews salary data | |
| Pt VI-B, Line 15 | and other information to determine the compensation of the | |
| Pt VI-B, Line 15 | Executive Director. | |
| Pt VI-B, Line 15 | Space | |
| Pt VI-C, Line 19 | All required information is made available upon request | |
| Pt VI-C, Line 19 | of any interested party. All required information is kept | |
| Pt VI-C, Line 19 | in the Executive Director's office and is available during | |
| Form 990EZ, Part I, Line 16 | INSURANCE AFTERCARE EXPENSES CLIENT ASSIST EXPENSES CLOTHING CENTER EXPENSES MILEAGE REIMBURSEMENT PAS EXPENSE UTILITIES ADVERTISING DUES & SUBSCRIPTIONS MISCELLANEOUS EXP. | |
| Form 990, Part IX, Line 24f | OTHER FUNDRAISING EXPENSES 34796. 0. 0. 34796. ORGANIZATION DEVELOPMENT 496. 372. 124. 0. POSTAGE 5450. 3270. 1090. 1090. DUES & SUBSCRIPTIONS 1090. 824. 266. 0. OTHER PROGRAM EXPENSES 11860. 11860. 0. 0. COPIER EXPENSES 7437. 4463. 1487. 1487. TELEPHONE 14717. 10301. 2944. 1472. | |
| Pt VI-C, Line 19 | posted office hours. |
| Software ID: | 10000104 |
| Software Version: |