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.") . | ||||||
| 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) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990-EZ, Part I, Line 16, Other Expenses Travel 1,713 Form 990-EZ, Part I, Line 16, Other Expenses Depreciation 139 Form 990-EZ, Part I, Line 16, Other Expenses Interest 3,017 Form 990-EZ, Part I, Line 16, Other Expenses Supplies 346 Form 990-EZ, Part I, Line 16, Other Expenses Ministries expenses 4,322 Form 990-EZ, Part I, Line 16, Other Expenses Food and kitchen supplies 1,310 Form 990-EZ, Part I, Line 16, Other Expenses Gifts 1,263 Form 990-EZ, Part I, Line 16, Other Expenses Flowers 599 Form 990-EZ, Part I, Line 16, Other Expenses Dry cleaning of pastors vestments 241 Form 990-EZ, Part I, Line 16, Other Expenses Miscellaneous 181 Form 990-EZ, Part I, Line 16, Other Expenses Bank fees 170 Form 990-EZ, Part I, Line 16, Other Expenses Education programs 3,371 Form 990-EZ, Part I, Line 16, Other Expenses Donations 260 Form 990-EZ, Part I, Line 16, Other Expenses Furniture and equipment 446 Form 990-EZ, Part I, Line 16, Other Expenses Principal paid on church property 7,198 Form 990-EZ, Part I, Line 16, Other Expenses Leased equipment 1,617 Form 990-EZ, Part I, Line 16, Other Expenses Vehicle expenses 6,835 Form 990-EZ, Part I, Line 16, Other Expenses Office supplies 1,678 Form 990-EZ, Part II, Line 24, Other Assets computer Beginning of year 400, End of year 400 Form 990-EZ, Part II, Line 24, Other Assets computer Beginning of year 300, End of year 300 Form 990-EZ, Part II, Line 24, Other Assets 4 tables Beginning of year 150, End of year 150 Form 990-EZ, Part II, Line 24, Other Assets amps and sticks Beginning of year 900, End of year 900 Form 990-EZ, Part II, Line 24, Other Assets desks Beginning of year 175, End of year 175 Form 990-EZ, Part II, Line 24, Other Assets chairs Beginning of year 125, End of year 125 Form 990-EZ, Part II, Line 24, Other Assets overhead projector Beginning of year 600, End of year 600 Form 990-EZ, Part II, Line 24, Other Assets instrument Beginning of year 50, End of year 50 Form 990-EZ, Part II, Line 24, Other Assets Sound and Video Projector Beginning of year 900, End of year 900 Form 990-EZ, Part II, Line 24, Other Assets Furniture Beginning of year 437, End of year 437 Form 990-EZ, Part II, Line 24, Other Assets Exit lights Beginning of year 253, End of year 253 Form 990-EZ, Part II, Line 24, Other Assets computer Beginning of year 483, End of year 483 Form 990-EZ, Part II, Line 24, Other Assets audio visual equipment Beginning of year 566, End of year 566 Form 990-EZ, Part II, Line 24, Other Assets furniture Beginning of year 145, End of year 145 Form 990-EZ, Part II, Line 26, Liabilities mortgage on land Beginning of year 68,098, End of year 0 Form 990-EZ, Part III, Line 31 Ministries Grants and allocations 0, Program service expenses 0 |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |