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.") .... | 553,468 | 465,189 | 500,243 | 388,985 | 535,241 | 2,443,126 |
| 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.. | 553,468 | 465,189 | 500,243 | 388,985 | 535,241 | 2,443,126 |
| 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. | 2,443,126 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 553,468 | 465,189 | 500,243 | 388,985 | 535,241 | 2,443,126 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 31,804 | 12,158 | -9,068 | 5,114 | 13,150 | 53,158 |
| 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). | 2,496,284 | |||||






| 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 | Donors who contribute more than $25 become members. | |
| Pt VI-A, Line 7a | Members receive ballots to elect Board of Directors. | |
| Pt VI-B, Line 11a | Organization provides a draft of the prepared 990 to the | |
| Board Members for their review, conducts a Board Meeting | ||
| to discuss the draft form, and formally approves the | ||
| final 990 for filing. | ||
| Pt VI-B, Line 12c | Organization requests and reviews conflict of interest | |
| disclosure representations obtained from Board Members. | ||
| Pt VI-B, Line 15 | Personnel committee of the Board of Directors annually | |
| reviews the Executive Director and key employees | ||
| comparing industry data and compensation. | ||
| Pt VI-C, Line 19 | Organization provides documents available to the public | |
| upon request. | ||
| Form 990EZ, Part I, Line 16 | PURCHASED PERSONNEL VAN TRANSPORTATION COSTS MISCELLANEOUS | |
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE - NET PLEDGES RECEIVABLE - NET INVESTMENTS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES DEFERRED REVENUE BONDS, MORTGAGES & OTHER NOTES | |
| Form 990, Part III, Line 4d | COMPREHENSIVE EMPLOYMENT SERVICES - THE PROGRAM PROVIDES EMPLOYMENT 222535. 0. 211763. ADVOCACY - THE PROGRAM PROVIDES SYTEMS MONITORING 195133. 0. 208161. TRANSPORTATION - PROGRAM PROVIDES TRANSPORTATION. 208879. 0. 101618. | |
| Form 990, Part IX, Line 24f | HOUSING PROGRAM 297062. 297062. 0. 0. ADMIN SUPPLIES AND EQUIPMENT 25592. 24561. 226. 805. EQUIPMENT RENTAL 7101. 5203. 37. 1861. FOOD 127219. 110141. 2272. 14806. PROGRAM EXPENSES (NET) 18323. 18323. 0. 0. OPERATING SUPPLIES AND EQUIPMENT 20533. 19706. 462. 365. MEDICAL SUPPLIES 1405. 1405. 0. 0. |
| Software ID: | 10000104 |
| Software Version: |