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. | 0 | |||||
| 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.") . | 10,000 | 14,000 | 15,470 | 17,780 | 20,000 | 77,250 |
| 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...... | 55,000 | 152,065 | 115,734 | 281,825 | 434,006 | 1,038,630 |
| 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. | 65,000 | 166,065 | 131,204 | 299,605 | 454,006 | 1,115,880 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 55,000 | 55,000 | ||||
| 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. | 12,000 | 2,094 | 682 | 1,113 | 15,889 | |
| c | Add lines 7a and 7b.. | 55,000 | 12,000 | 2,094 | 682 | 1,113 | 70,889 |
| 8 | Public Support (Subtract line 7c from line 6.) | 1,044,991 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 65,000 | 166,065 | 131,204 | 299,605 | 454,006 | 1,115,880 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,322 | 279 | 28 | 7 | 1,636 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 1,322 | 279 | 28 | 7 | 1,636 | |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | |||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 65,000 | 167,387 | 131,483 | 299,633 | 454,013 | 1,117,516 |




| 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 Part VI | 3 | Management delegated The organization delegated control to a former officer volunteer |
| Form 990 Part VI | 11b | Organizations process to review form 990 The board reviews form 990. |
| Form 990 Part VI | 19 | Governing documents disclosure explanation Governing documents are made available to the public upon request. |
| Form 990 Part VI Section A Line 3 Management delegated The organization delegated control to a former officer volunteer Form 990 Part VI Section B Line 11b Organizations process to review form 990 The board reviews form 990. Form 990 Part VI Section C Line 19 Governing documents disclosure explanation Governing documents are made available to the public upon request. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |