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) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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.. | ||||||
| 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) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 32,557 | 44,393 | 40,841 | 41,469 | 159,260 | |
| 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...... | 1,503,738 | 1,469,283 | 1,285,367 | 1,272,550 | 1,450,688 | 6,981,626 |
| 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. | 1,503,738 | 1,501,840 | 1,329,760 | 1,313,391 | 1,492,157 | 7,140,886 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 14,022 | 4,032 | 18,054 | |||
| 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. | 809,669 | 790,509 | 629,512 | 609,740 | 689,286 | 3,528,716 |
| c | Add lines 7a and 7b.. | 809,669 | 790,509 | 643,534 | 613,772 | 689,286 | 3,546,770 |
| 8 | Public Support (Subtract line 7c from line 6.) | 3,594,116 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,503,738 | 1,501,840 | 1,329,760 | 1,313,391 | 1,492,157 | 7,140,886 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6,394 | 7,838 | 9,264 | 15,484 | 17,072 | 56,052 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 6,394 | 7,838 | 9,264 | 15,484 | 17,072 | 56,052 |
| 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.) | 20,821 | 23,002 | 19,874 | 19,745 | 23,936 | 107,378 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 1,530,953 | 1,532,680 | 1,358,898 | 1,348,620 | 1,533,165 | 7,304,316 |




| Facts And Circumstances Test |
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| Other income Part II line 10 or Part III line 12 Detail of Other Income Income from equity investment 82192 Miscellaneous income 25186 --------------------------------------------- Total Other Income 107378 |
| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Officer, directors, etc. family relationship (Part VI, line 2) | David Miller and Marvin Mast have a family relationship David Miller and Shane Iwashige have a family relationship | |
| 02. Form 990 governing body review (Part VI, line 11) | The executive director reviews Form 990 for accuracy prior to its filing with the Internal Revenue Service Board members are also provided a copy of this form to review as well | |
| 03. CEO, executive director, top management comp (Part VI, line 15a) | The compensation level of the organizations officers was determined by the governing board but the process in doing so did not contain all three elements required to check yes | |
| 04. Governing documents, etc, available to public (Part VI, line 19) | CBK makes its by-laws articles of incorporation and Form 1023 available upon request These documents may also be inspected at CBKs corporate headquarters located in Hutchinson Kansas |
| Software ID: | |
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