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.") .... | 165,207 | 236,302 | 235,084 | 85,786 | 138,456 | 860,835 |
| 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.. | 165,207 | 236,302 | 235,084 | 85,786 | 138,456 | 860,835 |
| 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. | 860,835 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 165,207 | 236,302 | 235,084 | 85,786 | 138,456 | 860,835 |
| 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). | 860,835 | |||||






| 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 |
|---|
| Explanation |
|---|
| Software ID: | 11000215 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| PART VI-LINE 11A-COPIES TO GOVERNING BODY: | ||
| FORM 990 IS AVAILABLE TO ALL MEMBERS OF GOVERNING BODY AT THEIR MAIN | ||
| OFFICE | ||
| FORM 990 IS REVIEWED BY THE TREASURER BEFORE SUBMINTTING TO IRS | ||
| PART VI-LINE 12A-WRITTEN CONFLICT OF INTEREST POLICY: | ||
| THE ORAGIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WITH REGARDS | ||
| TO THE HIRING OF EMPLOYEES | ||
| PART VI-LINE 12B-OFFICERS, DIRECTORS OR TRUSTEES & KEY EMPLOYEES: | ||
| OTHER THAN KEY EMPLOYEES THEY ARE NOT REQUIRED TO DISCLOSE INTERESTS | ||
| THAT ARE IN CONFLICT WITH THE ORAGINIZATIONS WRITTEN POLICY KEY | ||
| EMPLOYEE ARE REQUIRED TO DISCLOSE THIS INFORMATION | ||
| PART VI-LINE 12C-MONITOR & ENFORE COMPLIANE: | ||
| OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLLOYEES MUST DISCLOSE ALL | ||
| ORAGINZATIONS THAT THEY BELONG TO THAT HAVE A DIRECT INTEREST OR | ||
| RELATIONSHIP WITH THIS ORAGINIZATION | ||
| PART VI-LINE 13-WHISTLEBOWER POLICY: THERE IS NO POLICY IN EFFECT. | ||
| PART VI-LINE 14-RETENTION & DISTRUCTION POLICY: | ||
| THE ORAGIZATION FOLLOWS THE IRS GUIDE LINES FOR RETENTION & DESTUCTION | ||
| PART VI-LINE 15-DETERMINING COMPENSATION: | ||
| COMPENSATION FOR DIRECTOR IS DETERMINED BASED ON THE COMPARABLE DATA | ||
| FROM OTHER ORAGNIZATIONS PROVIDING THE SAME DUTIES AS THIS DIRECTOR | ||
| LINE 15A-THE ORAGINIZATIONS MANAGEMENT OFFICALS DO NOT RECEIVE | ||
| COMPENSATION | ||
| PART VI-LINE 16A-JOINT VNETURE: | ||
| THE ORIGANIZATION DID NOT INVEST IN, CINTRIBUTE ASSESTS OR PARTICIPATE | ||
| IN AN JOINT VENTURE OR SIMILAR ARRANGMENT WITH ANY TAXABLE ENTITY | ||
| SECTION C-DISCLOSURE: | ||
| THE ORIGANIZATION PROVIDED ACCESS TO THESE DOCUMENTS WHEN REQUESTED BY | ||
| PUBLIC |
| Software ID: | 11000215 |
| Software Version: |