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.") .... | 76,246 | 129,647 | 80,908 | 77,712 | 102,721 | 467,234 |
| 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.. | 76,246 | 129,647 | 80,908 | 77,712 | 102,721 | 467,234 |
| 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).. | 269,276 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 197,958 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 76,246 | 129,647 | 80,908 | 77,712 | 102,721 | 467,234 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 941 | 1,276 | 79 | 6 | 2,302 | |
| 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). | 469,536 | |||||






| 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 |
|---|
| Part II Line 1 The Organzation received an unusual grant that was a one time only opportunity in 2011 in the amount of 161,558 that is excluded from Part II Line 1. |
| 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 | 12c | The organization requires all members of the Board of Directors to sign an annual conflict of interest form. The Board of Directors self monitors conflicts of interest throughout the year and directors declare any conflict of interest on an issue and recues themselves from voting on that issue. |
| Form 990 Part VI | 15a/b | The Organization does not currently pay salaries to any executive directors or officers as these services are donated to the organization. However, the Organization has a formal process in place in which the Board of Directors sets compensation for the executive director or other officers when such positions are hired. The Board of Directors considers the compensation paid to similar positions in similar not-for-profit organizations in setting salaries, as well as, consideration of the level of salaries the organization can afford. |
| Form 990 Part VI | 19 | The Organizations provides copies of its Form 1023 and Form 990 upon request at its office during business hours. |
| Form 990 Part XI | 5 | Book - Tax difference in depreciation of 488. |
| Form 990 Part VI Section B Line 12c The organization requires all members of the Board of Directors to sign an annual conflict of interest form. The Board of Directors self monitors conflicts of interest throughout the year and directors declare any conflict of interest on an issue and recues themselves from voting on that issue. Form 990 Part VI Section B Line 15a/b The Organization does not currently pay salaries to any executive directors or officers as these services are donated to the organization. However, the Organization has a formal process in place in which the Board of Directors sets compensation for the executive director or other officers when such positions are hired. The Board of Directors considers the compensation paid to similar positions in similar not-for-profit organizations in setting salaries, as well as, consideration of the level of salaries the organization can afford. Form 990 Part VI Section C Line 19 The Organizations provides copies of its Form 1023 and Form 990 upon request at its office during business hours. Form 990 Part XI Line 5 Book - Tax difference in depreciation of 488. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |