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.") . | 97,629 | 148,696 | 158,953 | 115,716 | 118,796 | 639,790 |
| 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. | 97,629 | 148,696 | 158,953 | 115,716 | 118,796 | 639,790 |
| 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.) | 639,790 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 97,629 | 148,696 | 158,953 | 115,716 | 118,796 | 639,790 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,228 | 1,184 | 1,177 | 3,589 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,228 | 1,184 | 1,177 | 3,589 | ||
| 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.). | 97,629 | 148,696 | 160,181 | 116,900 | 119,973 | 643,379 |




| Facts And Circumstances Test |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Officer, directors, etc. family relationship (Part VI, line 2) | D Ryan Doty who serves as treasurer is also engaged by the entity through his company Moapa Valley Tax Planning LLC to prepare their annual Form 990 All amounts are billed at time at standard and are billed at normal rates | |
| 02. Governing body meeting documentation (Part VI, line 8a) | THE BOARD OF DIRECTORS HOLDS QUARTERLY MEETINGS AT WHICH OPEN MEETING RULES PURSUANT TO THE NEVADA REVISED STATUTES ARE FOLLOWED AND MEETING MINUTES ARE KEPT AND APPROVED AT SUBSEQUENT MEETINGS | |
| 03. Committee meeting documentation (Part VI, line 8b) | COMMITTEES IF FORMED CONFORM TO THE SAME RULES AS DESCRIBED FOR PART IV LINE 8a FORM 990 IS REVIEWED BY THE TREASURER OF THE ORGANIZATION AND WITH THE DIRECTOR TO ASSURE ALL ITEMS OF INCOME AND EXPENSE HAVE BEEN PROPERLY CLASSIFED ON THE RETURN IT IS THEN OPEN FOR REVIEW AS REQUESTED BY ALL MEMBERS OF THE BOARD AND THE GENERAL PUBLIC | |
| 04. Form 990 governing body review (Part VI, line 11) | The 2009 Form 990 was presented to all of the members of the governing body namely the board of directors and the facility Director for their review and approval by unanimous vote on March 17 2010 | |
| 05. Conflict of interest policy compliance (Part VI, line 12c) | The board of directors on an annual basis following annual elections discusses the conflict of interest policy during its quarterly meeting following the elections At that time all persons having a conflict of interest with the entity explain the conflict and it is documented and entered into the meeting minutes The policy regarding the need to abstain from any votes with which a member of the board of directors is in conflict with is discussed | |
| 06. CEO, executive director, top management comp (Part VI, line 15a) | Compensation for the entitys executive director is determined annually in the board meeting following elections by the volunteer community board of directors The executive director is asked to leave the meeting during the discussions and is not allowed to vote on his or her own salary | |
| 07. Governing documents, etc, available to public (Part VI, line 19) | All of the governing documents of the entity are available for public inspection upon personal request at the entitys main location in Overton NV Indiviuals are permitted to review the documents during normal business hours |
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