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.. | 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.") . | 343,639 | 315,380 | 12,937 | 32,228 | 43,172 | 747,356 |
| 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...... | 60,821 | 62,191 | 68,669 | 191,681 | ||
| 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. | 343,639 | 315,380 | 73,758 | 94,419 | 111,841 | 939,037 |
| 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.) | 939,037 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 343,639 | 315,380 | 73,758 | 94,419 | 111,841 | 939,037 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 36 | 18 | 1 | 55 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 36 | 18 | 1 | 55 | ||
| 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.). | 939,092 | |||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 6 | The organization has members | |
| Pt VI, Line 7a | The members elect the board and officers at an annual meeting | |
| Pt VI, Line 7b | The day to day operations are governed by the board. | |
| Pt VI, Line 11a | The 990 was presented to the managagement committee at | |
| its August meeting. | ||
| Pt VI, Line 12c | Board members are asked annually to sign a conflict of | |
| interest statement and disclose any conflicts. The | ||
| management committee is charged with monitoring conflict | ||
| of interest. | ||
| Pt VI, Line 15 | The organization has no employees. | |
| Pt VI, Line 19 | The organization makes these documents available on its | |
| website and also at the organization's office on request. | ||
| Form 990EZ, Part I, Line 16 | OFFICE EXPENSE OFFICE SUPPLIES INTEREST INSURANCE GREENLINE IMPROVEMENTS TELEPHONE TRASH REMOVAL MISCELLANEOUS TAXES | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE N/P 1680 JACKSON N/P 1810 HUNTER N/P 2113-17 BR N/P 2218 HUNTER N/P 2375 SHASTA N/P 795 MAURY N/P 820 MAURY N/P 2136 HOWELL SECURITY DEPOSITS PAYABLE LOANS FROM INDIVIDUALS DUE TO SHELBY COUNTY OTHER | |
| Form 990, Part III, Line 4d | OTHER ACTIVITIES FOR THE RESIDENTS INCLUDE THE 5078. 0. 21053. | |
| Form 990, Part IX, Line 24f | PROGRAM EXPENSES 26038. 26038. 0. 0. |
| Software ID: | 11000175 |
| Software Version: |