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.") .... | 42,690 | 13,413 | 14,323 | 38,811 | 109,237 | |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 92,164 | 143,813 | 189,034 | 425,011 | ||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | 134,854 | 157,226 | 14,323 | 227,845 | 534,248 | |
| 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. | 534,248 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 134,854 | 157,226 | 14,323 | 227,845 | 534,248 | |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 125 | 2,018 | 2,143 | |||
| 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). | 536,391 | |||||






| 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.) | 0 | |||||
| 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 |
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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 11a | A DRAFT COPY OF FORM 990 IS PROVIDED TO THE PRESIDENT WHO REVIEWS THIS WITH THE TREASURER AND OTHER BOARD MEMBERS & APPROVES | |
| Pt VI, Line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST | |
| Pt VI, Line 6 | THE ORGANIZATION HAS 9 MEMBERS OF THE GOVERNING BODY | |
| Pt VI, Line 7a | THE ORGANIZATION HAS MEMBERS OF THE GOVERNING BODY WHO MAY ELECT MEMBERS | |
| Pt VI, Line 7b | THE BOARD MEMBERS MUST APPROVE ALL DECISIONS FOR THE ORGANIZATION | |
| Pt XI | NET CHANGE IN ASSETS DUE TO YEAR END BALANCE ADJUSTMENTS | |
| Form 990EZ, Part I, Line 16 | ADVERTISING APPARATUS IMPROVEMENTS BADGES AND BRASS BANK SERVICE CHARGES BANQUET/PICNIC CHAPTER 19 TESTING CONTRIBUTIONS DUES AND SUBSCRIPTIONS DUTY CREW FILING FEE FUEL FUNDRAISER EXPENSES INSURANCE INTEREST EXPENSE LAND PHONES LICENSES AND PERMITS MEDICAL SUPPLIES MISCELLANOUS EXPENSE NEW PORTABLE EQUIPMENT NEW UNIFORM EXPENSES OFFICE EQUIPMENT/SUPPLIES PORTABLE EQUIPMENT REALIZED LOSS ON SALE OF INVESTMENTS REIMBURSED EXPENSES REPAIRS AND MAINTENANCE FIRE TRUCKS TOOLS TRAINING ROOM/TRAINING U | |
| Form 990EZ, Part II, Line 24 | BRUSH 36-1 4169. ENGINE 36-3 45000. FURNISHINGS/DURABLE GOODS 20001. OFFICE ADDITION 12292. OFFICERS VEHICLE 11500. RESCUE 53200. SPECIAL UNIT 36 7500. UTILITY 36 0. | |
| Form 990EZ, Part II, Line 26 | ENGINE 36-3 LOAN 23409. RESCUE 36-1 LOAN 0. CREDIT CARDS PAYABLE 1888. ACCOUNTS PAYABLE 73605. STATION 2 NOTES PAYABLE 93625. | |
| Form 990, Part IX, Line 24f | DUTY CREW 138. 138. 0. 0. FILING FEE 125. 0. 125. 0. FUEL 10508. 10508. 0. 0. PHONE EXPENSE 2379. 2379. 0. 0. MEDICAL SUPPLIES 528. 528. 0. 0. PORTABLE EQUIPMENT 12308. 12308. 0. 0. REPAIRS/MAINT FIRE TRUCKS 42432. 41919. 513. 0. TOOLS 88. 88. 0. 0. TRAINING ROOM AND TRAINING EXPENSE 127. 127. 0. 0. UNIFORMS 105. 105. 0. 0. |
| Software ID: | 11000175 |
| Software Version: |