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.") .... | ||||||
| 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. | 0 | |||||
| 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.. | 0 | |||||
| 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.") . | 140,075 | 126,238 | 110,167 | 109,931 | 120,886 | 607,297 |
| 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...... | 477,440 | 520,327 | 573,420 | 531,800 | 552,005 | 2,654,992 |
| 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. | 617,515 | 646,565 | 683,587 | 641,731 | 672,891 | 3,262,289 |
| 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.) | 3,262,289 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 617,515 | 646,565 | 683,587 | 641,731 | 672,891 | 3,262,289 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 8,878 | 6,617 | 4,476 | 3,784 | 2,350 | 26,105 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 8,878 | 6,617 | 4,476 | 3,784 | 2,350 | 26,105 |
| 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.) | 21,795 | 11,495 | 20,571 | 43,925 | 46,205 | 143,991 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 3,432,385 | |||||




| Facts And Circumstances Test |
|---|
| OTHER INCOME PART III, LINE 12; DESCRIPTION: INSURANCE PROCEEDS; 2006: 12081.; 2007: 2804.; 2008: 3281.; 2009: 1525.; 2010: 3097.; DESCRIPTION: MISCELLANEOUS; 2006: 9714.; 2007: 8691.; 2008: 11290.; 2009: 9400.; 2010: 10108.; DESCRIPTION: MANAGEMENT FEES; 2008: 6000.; 2009: 33000.; 2010: 33000.; |
| Explanation |
|---|
| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI-B, Line 11a | There isn't a formal process for reviewing this 990 return. | |
| Pt VI-B, Line 15 | All compensation amounts are subject to the approval by the Directors. | |
| Pt VI-C, Line 19 | Documents are made available during normal business hours. | |
| Pt XII, Line 2c | No changes made. | |
| Pt VI-A, Line 2 | Pamela Berta, Sec'y married to Dale Berta, Director. | |
| Pt VI-A, Line 2 | Beverly Moyer, Director married to Timothy Moyer, Admin. Director. | |
| Pt VI-A, Line 2 | Pamela Berta, Sec'y is aunt to Carl Moyer, PT employee. | |
| Pt VI-A, Line 2 | Deborah Palamar, Pres. married to Christopher Palamar, PT employee. | |
| Pt VI-A, Line 2 | Michael Geisinger, Director married to Robin Geisinger, PT employee. | |
| Pt VI-A, Line 2 | Jaclyn Freed, Director married to Jay Freed FT employee. | |
| Pt VI-A, Line 7a | Members may elect members to the governing body. | |
| Pt VI-A, Line 8b | Minutes are taken at each meeting. | |
| Form 990EZ, Part I, Line 8 | VARIOUS | |
| Form 990EZ, Part I, Line 16 | BILLING SERVICES DUES & LICENSES BUILDING MTCE VEHICLE REP & MTCE INSURANCE - W/C INSURANCE - LIABILITY VEHICLE FUEL MEDICAL COMMAND MEDICAL SUPPLIES UTILITIES UNIFORMS OFFICE SUPPLIES PAYROLL PROCESSING EMPLOYEE MEALS MEMBERSHIP DRIVE | |
| Form 990, Part IX, Line 24f | INSURANCE - LIABILITY 29764. 21747. 8017. 0. VEHICLE FUEL 23295. 23295. 0. 0. VEHICLE EQUIPMENT 6020. 6020. 0. 0. MEDICAL COMMAND 3845. 3845. 0. 0. MEDICAL SUPPLIES 15975. 15975. 0. 0. UTILITIES 19341. 8194. 11147. 0. POSTAGE 2297. 966. 1331. 0. EQUIPMENT RENTAL 2402. 1201. 1201. 0. UNIFORMS 4451. 4451. 0. 0. PAYROLL PROCESSING 2178. 2178. 0. 0. MEMBERSHIP DRIVE 6001. 0. 0. 6001. TRAINING & EDUCATION 3823. 3823. 0. 0. CPR TRAINING EXP 10912. 10912. 0. 0. EQUIPMENT REPAIRS 8137. 8137. 0. 0. |
| Software ID: | 10000104 |
| Software Version: |