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) 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.. | 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) 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.") . | 356,671 | 455,017 | 578,848 | 422,540 | 428,242 | 2,241,318 |
| 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...... | 423,110 | 449,421 | 426,813 | 404,414 | 428,183 | 2,131,941 |
| 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. | 779,781 | 904,438 | 1,005,661 | 826,954 | 856,425 | 4,373,259 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 133,426 | 141,876 | 168,923 | 146,382 | 154,129 | 744,736 |
| 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. | 21,675 | 68,128 | 223,963 | 121,579 | 110,194 | 545,539 |
| c | Add lines 7a and 7b.. | 155,101 | 210,004 | 392,886 | 267,961 | 264,323 | 1,290,275 |
| 8 | Public Support (Subtract line 7c from line 6.) | 3,082,984 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 779,781 | 904,438 | 1,005,661 | 826,954 | 856,425 | 4,373,259 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 24,708 | 18,999 | 7,271 | 3,658 | 7,834 | 62,470 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 24,708 | 18,999 | 7,271 | 3,658 | 7,834 | 62,470 |
| 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.) | 2,095 | 1,199 | 396 | 775 | 461 | 4,926 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 4,440,655 | |||||




| Facts And Circumstances Test |
|---|
| DESCRIPTION: SALE SHIRTS/HATS FOR VOLUNTEERS; 2006: 1780; 2007: 2095; 2008: 1199; 2009: 396; 2010: 775; 2011: 461; OTHER INCOME PART III, LINE 12; DESCRIPTION: SALE SHIRTS/HATS FOR VOLUNTEERS; 2007: 2095.; 2008: 1199.; 2009: 396.; 2010: 775.; 2011: 461.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 19 | UPON REQUEST | |
| Pt VI, Line 11a | MEETING WITH PREPARER, PAGE BY PAGE REVIEW | |
| Form 990EZ, Part I, Line 8 | SALE OF HATS, SHIRTS AND JACKETS TO VOLUNTEERS | |
| Form 990EZ, Part I, Line 16 | BUILDING MATERIALS/SUPPLIES TRAVEL FEES/EXPENSES SITE SURVEY/PROJ BUY-OUT TRIPS TEAM EXPENSES/PROJECT FOOD/VBS TEAM HOUSING IN-COUNTRY TEAM TRANSPORTATION IN-COUNTRY CMS EQUIP INSURANCE CMS MEDICATIONS CMS EQUIPMENT/SUPPLIES CMS TRANSLATORS & MED PERSONNAL MEDICAL AND DENTAL INSURANCE PAYROLL TAX EXPENSE GROUP LEADER SEMINAR KITCHEN SUPPLIES MEDICAL EQUIPMENT/SUPPLIES DEVOTION SEMINAR EXPENSES AND SUPPLIES TOOL FOR PROJECTS CONTAINER MAINTENANCE HATS/SHIRTS/JACKETS FOR VOLUNTEERS PROMOTIONAL COR | |
| Form 990, Part III, Line 4d | LOCATION: SANTA CRUZ, BOLIVIA - CONSTRUCTION 67359. 0. 39415. LOCATION: DOMINICAN REPUBLIC - CONSTRUCTION 33983. 0. 14995. LOCATION: SANTA CRUZ, BOLIVIA - MEDICAL 22360. 0. 8230. LOCATION: HONDURAS - MEDICAL 24518. 0. 14052. LOCATION: DOMINICAN REPUBLIC - MEDICAL 13434. 0. 8369. LOCATION: HAITI - CONSTRUCTION 11774. 0. 1800. LOCATION: HAITI - CONSTRUCTION 8028. 0. 500. LOCATION: TOGO, WEST AFRICA - MEDICAL 7053. 0. 21365. LOCATION - HAITI - MEDICAL 2726. 0. 1391. LOCATION: HONDURAS - CONSTRUCTIO | |
| Form 990, Part VI, Line 9 | ALAN GREEN 5809 SPRING LAKE DRIVE LAKELAND FL 33811 MIKE SUTTON 410 W. CHAPMAN RD. LUTZ FL 33548 BRUCE JOHNSON 1591 RED MAPLE RD LAPEER MI 48446 DALE GORDON 1406 POINT CT. LUTZ FL 33549 RANDALL HAY 163 ALEXANDER ST. CHENANGO FORKS NY 13746 COLE, KEITH 336 LOUGHLIN RD. BINGHAMTON NY 13904 SPEARS, RONALD 312 CREEKS EDGE LAKE ORION MI 48362 WOOD, DONALD MARK 8198 E. LIPPINCOTT BLVD. DAVISON MI 48423 | |
| Form 990, Part IX, Line 24f | VOLUNTEER & EQUIP INSURANCE 6885. 6885. 0. 0. CONTAINER SHIPPING TEAM HOUSING 10576. 10576. 0. 0. TEAM TRANSPORT-IN COUNTRY 11341. 11341. 0. 0. NEWSLETTERS 6422. 0. 6422. 0. PROMOTIONAL DISPLAY BOARDS 1007. 0. 1007. 0. INTERNET/WEBSITE 1566. 0. 1566. 0. MEDICAL STUDENT SUPPLEMENTS 11940. 11940. 0. 0. PRINTING 1879. 0. 1879. 0. FILING FEES - LICENSE 61. 0. 61. 0. VOLUNTEERS CLOTHING/PROTECTIVE 888. 5. 883. 0. DEVOTION SUPPLIES 4019. 3. 4016. 0. TOOLS FOR PROJECTS/MAINTENANCE 5429. 173. 5256. 0. P |
| Software ID: | 11000175 |
| Software Version: |