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.") .... | ||||||
| 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.. | ||||||
| 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.") . | 6,200 | 10,155 | 8,886 | 4,169 | 199,675 | 229,085 |
| 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...... | 138,682 | 135,507 | 127,910 | 100,544 | 117,842 | 620,485 |
| 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. | 144,882 | 145,662 | 136,796 | 104,713 | 317,517 | 849,570 |
| 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. | 180,674 | 180,674 | ||||
| c | Add lines 7a and 7b.. | 180,674 | 180,674 | ||||
| 8 | Public Support (Subtract line 7c from line 6.) | 668,896 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 144,882 | 145,662 | 136,796 | 104,713 | 317,517 | 849,570 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9,490 | 9,075 | 5,354 | 4,741 | 1,886 | 30,546 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 9,490 | 9,075 | 5,354 | 4,741 | 1,886 | 30,546 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | |||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 154,372 | 154,737 | 142,150 | 109,454 | 319,403 | 880,116 |




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part VI | 11b | A copy of the 990 and applicable schedules is provided to the board of directors for review and approval prior to submission to the IRS. |
| Form 990 Part VI | 12c | Conflicts are reported to the board. |
| Form 990 Part VI | 15a | The board of directors reviews and approves the compensation for the Executive Director. The board serve as volunteers and are not compensated. |
| Form 990 Part VI | 19 | 990 and applicable schedules are available upon request during normal business hours. The organization also posts this information online through Guidestar. |
| Form 990 Part VI | 2 | Laura and Peder Berg are husband and wife and both serve on the volunteer board of directors. |
| Form 990 Part VI Section B Line 11b A copy of the 990 and applicable schedules is provided to the board of directors for review and approval prior to submission to the IRS. Form 990 Part VI Section B Line 12c Conflicts are reported to the board. Form 990 Part VI Section B Line 15a The board of directors reviews and approves the compensation for the Executive Director. The board serve as volunteers and are not compensated. Form 990 Part VI Section C Line 19 990 and applicable schedules are available upon request during normal business hours. The organization also posts this information online through Guidestar. Form 990 Part VI Section A Line 2 Laura and Peder Berg are husband and wife and both serve on the volunteer board of directors. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |