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.") .... | 177,475 | 167,220 | 145,169 | 136,647 | 214,820 | 841,331 |
| 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.. | 177,475 | 167,220 | 145,169 | 136,647 | 214,820 | 841,331 |
| 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).. | 533,777 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 307,554 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 177,475 | 167,220 | 145,169 | 136,647 | 214,820 | 841,331 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 611 | 431 | 314 | 481 | 692 | 2,529 |
| 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.. | 1,925 | 1,437 | 736 | 2,076 | 3,686 | 9,860 |
| 11 | Total support (Add lines 7 through 10). | 853,720 | |||||






| 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 |
|---|
| OTHER INCOME PART II, LINE 10; DESCRIPTION: SPECIAL EVENT INCOME, GROSS; 2007: 1925.; 2008: 1337.; 2009: 355.; 2010: 0.; 2011: 1766.; DESCRIPTION: MISCELLANEOUS; 2007: 0.; 2008: 100.; 2009: 381.; 2010: 2076.; 2011: 1920.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | The 990 is prepared by independent accountants & reviewed by management | |
| Pt VI, Line 11a | prior to filing. In the future, the Board will review the return prior to filing. | |
| Pt VI, Line 12c | The conflict of interest policy is enforced as necessary. Any Board | |
| Pt VI, Line 12c | member with a conflict of interest on any specific issue informs the | |
| Pt VI, Line 12c | Board and abstains from voting on the issue. | |
| Pt VI, Line 15 | In the annual budgeting process, the Board approves a budget line for aggregate | |
| Pt VI, Line 15 | salary expense. Thereafter, individual salaries and salary increases for | |
| Pt VI, Line 15 | employees are determined by the Executive Director. The Board of Directors | |
| Pt VI, Line 15 | sets the Executive Director salary after a performance review and | |
| Pt VI, Line 15 | a check of comparable salary information for nonprofit organizations | |
| Pt VI, Line 15 | with similar budgets. | |
| Pt VI, Line 18 | Forms 1023 and 990 are available upon request. | |
| Pt VI, Line 19 | Governing documents, conflict of interest policy and | |
| Pt VI, Line 19 | financial statements are available upon request. | |
| Pt IV, Line 13 | The organization did not have a whistleblower policy in place as of | |
| Pt IV, Line 13 | year-end, but is working on implementing one in the future. | |
| Pt IV, Line 14 | The organization did not have a document retention & destruction in | |
| Pt IV, Line 14 | place as of year-end, but is working on implementing one in the future. | |
| Form 990EZ, Part I, Line 8 | MISCELLANEOUS | |
| Form 990EZ, Part I, Line 16 | PROGRAM-EDUCATIONAL RESOURCE MATERIALS PROGRAM-COMMUNITY NETWORK COMMUNICATIONS PROGRAM-CONFERENCE FEES/MEMBERSHIPS PROGRAM-ADVERTISING PROGRAM-EVENTS PROGRAM-SUPPLIES PROGRAM-EQUIPMENT PROGRAM-TRAVEL DUES AND SUBSCRIPTIONS TRAINING & DEVELOPMENT-BOARD INSURANCE MISCELLANEOUS ADMINISTRATIVE TRAVEL FUNDRAISING LICENSE & FEES OFFICE SUPPLIES & MATERIALS TELEPHONE & COMMUNICATIONS | |
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE - NET GRANTS RECEIVABLE - NET PREPAID EXPENSES OFFICE EQUIPMENT - NET | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE PAYROLL TAXES PAYABLE |
| Software ID: | 11000175 |
| Software Version: |