TY 2011 Form 990EZ

- TIN:

Form990-EZ

Department of the Treasury
Internal Revenue Service

Short Form
Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)

Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-1150

2011

Open to Public
Inspection

For the 2011 calendar year, or tax year beginning 01-01-2011, and ending 12-31-2011

Check if applicable:

Address change

Name change

Initial return

Terminated

Amended return

Application pending

C Name of organization
FRATERNAL ORDER OF POLICE 21 LIMA

Number and street (or P. O. box, if mail is not delivered to street address)750 W ROBB AVENUE
Room/suite

City or town, state or country, and ZIP + 4 LIMA, OH45801

D Employer identification number

23-7115916

E Telephone number

F Group Exemption
Number. . bullet

G Accounting method: CashAccrualOther (specify) bullet

H Check bullet

required to attach Schedule B
(Form 990, 990-EZ, or 990-PF).I Website: bullet

NAJ Tax-Exempt status(check only one)501(c)(3) 501(c)( 8) bullet

(insert no.) 4947(a)(1) or 527

K Check

if the organization is not a section 509(a)(3) supporting organization or a section 527 organization and its gross receipts are normally not more than $50,000. A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.

L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more,file Form 990 instead of Form 990-EZ........... bullet

$ 95,175


1	Contributions, gifts, grants, and similar amounts received...............			1	22,996
2	Program service revenue including government fees and contracts ............			2	20,093
3	Membership dues and assessments......................			3	29,143
4	Investment income...........................			4	9,550
5a	Gross amount from sale of assets other than inventory........	5a
b	Less: cost or other basis and sales expenses...........	5b
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ......			5c
6	Gaming and fundraising events
a	Gross income from gaming (attach Schedule G if greater than $15,000) .	6a
b	Gross income from fundraising events (not including $ of contributions from fundraising events reported on line 1) (attach Schedule G if the
	sum of such gross income and contributions exceeds $15,000)	6b	13,393
c	Less: direct expenses from gaming and fundraising events.......	6c	7,332
d	Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c)			6d	6,061
7a	Gross sales of inventory, less returns and allowances........	7a
b	Less: cost of goods sold.................	7b
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .........			7c
8	Other revenue (describe in Schedule O) .....................			8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8.................			9	87,843
10	Grants and similar amounts paid (list in Schedule O) .................			10	13,829
11	Benefits paid to or for members........................			11
12	Salaries, other compensation, and employee benefits................			12	1,920
13	Professional fees and other payments to independent contractors............			13	1,400
14	Occupancy, rent, utilities, and maintenance...................			14	9,500
15	Printing, publications, postage, and shipping...................			15	1,191
16	Other expenses (describe in Schedule O) ....................			16	60,447
17	Total expenses. Add lines 10 through 16 ....................			17	88,287
18	Excess or (deficit) for the year (Subtract line 17 from line 9)............			18	-444
19	Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
	end-of-year figure reported on prior year’s return)................			19	278,270
20	Other changes in net assets or fund balances (explain in Schedule O) ..........			20
21	Net assets or fund balances at end of year. Combine lines 18 through 20.........			21	277,826

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 10642I Form 990-EZ (2011)

Form 990-EZ (2011)

Page 2

Part IIBalance Sheets (see the instructions for Part II.)Check if the organization used Schedule O to respond to any question in this Part II.............

(See the instructions for Part II.)(A) Beginning of year(B) End of year

22Cash, savings, and investments................

231,476

238,095

23Land and buildings....................

24Other assets (describe in Schedule O) ..........

46,794

39,731

25Total assets......................

278,270

277,826

Total liabilities (describe in Schedule O) .............

27Net assets or fund balances (line 27 of column (B) must agree with line 21)..

278,270

277,826

Part IIIStatement of Program Service Accomplishments (see the instructions for Part III.) Check if the organization used Schedule O to respond to any question in this Part III .	Expenses (Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? ASSISTING WITH POLICE OFFICERS EDUCATION INSURANCE
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 POLICE OFFICER INSURANCE PROGRAM (Grants $ ) If this amount includes foreign grants, check here ...			28a	10,216
29 GRANTS/SCHOLARSHIPS TO LAW ENFORCEMENT EDUCATION & STUDENTS/SUPPORT ORGANIZATION (Grants $ 10,220) If this amount includes foreign grants, check here ...			29a
30 MISCELLANEOUS DONATIONS TO ORGANIZATIONS (Grants $ 3,609) If this amount includes foreign grants, check here ...			30a
31 Other program services (describe in Schedule O) .................. (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a)..............	32	10,216

Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (see the instructions for Part IV.)Check if the organization used Schedule O to respond to any question in this Part IV..........

(a) Name and title	(b) Average hours per week devoted to position	(c)Reportable compensation (Forms W-2/1099-MISC) (if not paid, enter -0-)
LEON CAMPBELL 6295 BILLYMACK ELIDA,OH45807	TRUSTEE002.00	0
MICHAEL WATKINS 5431 RIVER RIDGE ELIDA,OH45807	PRESIDENT002.00	0
MICHAEL WHITE 3001 INWOOD LIMA,OH45806	REC SECRETARY002.00	0
ALAN MEFFERD 1517 ELLISON DR LIMA,OH45805	FIN SECRETARY004.00	1,500
BERLIN CARROLL 563 HEFNER DR LIMA,OH45801	TREASURER004.00	3,180
DENNIS MORGAN 2455 SHERWOOD DR LIMA,OH45805	VICE PRESIDENT002.00	0
BRAD BATY 1618 N KENILWORTH LIMA,OH45805	2ND VICE PRESIDENT002.00	0
RANDY DEVELBISS 1227 BRICE AVENUE LIMA,OH45805	SERGEANT AT ARMS002.00	0
JOHN D PARKER 2280 REINELL LIMA,OH45805	TRUSTEE002.00	0
PATRICIA WOGERMAN 1242 LATHAM AVENUE LIMA,OH45805	TRUSTEE002.00	0

Form 990-EZ (2011)

Page 3

Part VOther Information(Note the Schedule A and personal benefit contract statement requirements in the instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V

Yes

Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................

Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions). ..........................

35a

Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............

35a

If ‘Yes’ to line 35a, has the organization filed a Form 990-T for the year? If ‘No,’ provide an explanation in Schedule O.

35b

Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III.

35c

Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N ................

37a

Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet

37a

Did the organization file Form 1120-POL for this year?...................

37b

38a

Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were

any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..

38a

If “Yes,” complete Schedule L, Part II and enter the total amount involved .

38b

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on line 9.......

39a

Gross receipts, included on line 9, for public use of club facilities.....

39b

40a

Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:

section 4911 bullet

; section 4912 bullet

; section 4955 bullet

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ......

40b

Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958... bullet

Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization.................... bullet

All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. ......................

40e

41List the states with which a copy of this return is filed. bullet

42aThe organization's books are in care of bullet

SIELSCHOTT WALSH KEIFER REGULA CPA' Telephone no. bullet

(419) 222-2001

Located at bullet

711 DEAN AVE
LIMA,OH ZIP + 4 bullet

45804

At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?

Yes

42b

If “Yes,” enter the name of the foreign country: bullet

See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

At any time during the calendar year, did the organization maintain an office outside the U.S.?

42c

If “Yes,” enter the name of the foreign country: bullet

43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041Check here ....... bullet

and enter the amount of tax-exempt interest received or accrued during the tax year.... bullet

Yes

44a

Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of

Form 990-EZ.................................

44a

Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completedinstead of Form990-EZ.............................

44b

Did the organization receive any payments for indoor tanning services during the year?.........

44c

If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanationin Schedule O................................

44d

45a

Did the organization have a controlled entity within the meaning of
section 512(b)(13)?............................

45a

45b

Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form990-EZ (see instructions).....................

45b

Form 990-EZ (2011)

Page 4

Yes

Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes,” complete Schedule C, Part I. ..............

Part VI

Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI ...........

Yes

Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ....

49a

Did the organization make any transfers to an exempt non-charitable related organization?......

49a

If "Yes," was the related organization a section 527 organization?................

49b

Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and title of each employee paid more than $100,000	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC)	(d) Health benefits, contributions to employee benefit plans, and deferred compensation	(e) Estimated amount of other compensation
NONE

Total number of other employees paid over $100,000 ................. bullet

Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and address of each independent contractor paid more than $100,000	(b) Type of service	(c) Compensation
NONE

Total number of other independent contractors each receiving over $100,000.......... bullet

Did the organization complete Schedule A? NOTE:All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ..................... Yes No

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid preparer use only

Print/type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image

Firm's address Right pointing arrowhead image

Phone no.

May the IRS discuss this return with the preparer shown above? See instructions ......... bullet

YesNo

Form 990-EZ (2011)

Additional Data

Software ID:	11000218
Software Version:	2011.0.0

Form 990-EZ, Special Condition Description:

Special Condition Description

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

FRATERNAL ORDER OF POLICE 21 LIMA

Employer identification number

23-7115916

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization FRATERNAL ORDER OF POLICE 21 LIMA
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization FRATERNAL ORDER OF POLICE 21 LIMA
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
FRATERNAL ORDER OF POLICE 21 LIMA

Employer identification number

23-7115916

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:	11000218
Software Version:	2011.0.0

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization
FRATERNAL ORDER OF POLICE 21 LIMA

Employer identification number

23-7115916

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2011

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 PANCAKE DAY (event type)	(b) Event #2 MEETING DINNER (event type)	(c) Other Events 2 (total number)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	12,521	662	210	13,393
2	Less: Charitable contributions . . .
3	Gross income (line 1 minus line 2) . . .	12,521	662	210	13,393
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .
7	Food and beverages . .	3,508	1,391		4,899
8	Entertainment . . .
9	Other direct expenses .	2,157	36	240	2,433
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				7,332
11	Net income summary. Combine lines 3 and 10 in column (d)............				6,061

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Schedule G (Form 990 or 990-EZ) 2011

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2011

Additional Data

Software ID:	11000218
Software Version:	2011.0.0

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

FRATERNAL ORDER OF POLICE 21 LIMA

Employer identification number

23-7115916

Identifier	Return Reference	Explanation
Form 990-EZ Part V	35	THE REVENUE OF 20,093 REPORTED ON FORM 990-EZ, PART 1, LINE 2 IS INCOME RELATED TO THE EXEMPT PURPOSE. THEREFORE, NO 990-T IS REQUIRED.
		Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee MATTHEW A LINK 959 N ELIZABETH ST LIMA OH 45801, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee BRYAN C WOGERMAN 1242 LATHAM AVE LIMA OH 45801, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee BROOKE A SHULTZ 3650 REDBUD LANE LIMA OH 45801, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee EMILY A GARLOCK 2306 BRITT AVE LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee KAITLIN K BLACKBURN 12172 INFIRMARY WAPAKONETA OH 45895, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee MICHELLE L KOHLI 1866 DILLER RD LIMA OH 45807, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee ALEXIS L MCDANIEL 1729 ACKERMAN RD HARROD OH 45850, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee CORY M WHITE 3001 INWOOD DR LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee ASHLEY S EVANS 3001 INWOOD DR LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee CHARI B MAULT 5036 EAST RD LIMA OH 45807, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee KAYLA M NOLAN 1546 BUNKER DR LIMA OH 45807, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee DEBORAH L MARTIN 1068 W MARKET ST LIMA OH 45801, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee ASHLEE C ELCHERT 310 MARCELLA LANE CRIDERSVILLE OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee JACOB B BREITIGAN 2643 RIVERBEND ELIDA OH 45807, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee ANDREW S CRESS 105 W PENDLETON COLUMBUS GROVE OH 45830, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee AARON L CORTES 1251 WONDERLICK RD LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee DANIELLE R RICKER 2214 LOST CREEK BLVD LIMA OH 45804, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee JENNIFER L MEARS 1529 PUTTERS LANE LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee PATRICK T MAGINNITY 722 W MURPHY AVE LIMA OH 45801, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee JOSIE M DUNHAM 1783 HOMEWARD LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee SARAH M BAKER 1150 S GRUBB RD LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee SARAH A CLARK 901 FT JENNINGS RD DELPHOS OH 45833, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee RYAN A BAILEY 824 BARBARA WAPAKONETA OH 45895, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee JESSICA M LADD 18217 ROAD 20-R FT JENNINGS OH 45844, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee ELIZABETH CRITES 1705 MCBRIDE RD DELPHOS OH 45833, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee BENJAMIN D CRITES 1705 MCBRIDE RD DELPHOS OH 45833, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee STEPHANIE D SARNO 2210 W HIGH ST LIMA OH 45801, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee BRETT M KEITH 1477 WEST SHORE LIMA OH 45805, Cash Grant 365, Relationship Blood Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee FOP FOUNDATION CIRS 222 EAST TOWN ST COLUMBUS OH 43215, Cash Grant 300, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee DARE OF ALLEN COUNTY 333 N MAIN ST LIMA OH 45801, Cash Grant 250, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee FOP21 CHARITIES 5431 RIVER RIDGE ST ELIDA OH 45807, Cash Grant 1,000, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee FOP21 CHARITIES 5431 RIBER RIDGE ST ELIDA OH 45807, Cash Grant 609, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee SPECIAL OLYMPICS 3303 WINCHESTER PIKE COLUMBUS OH 43232, Cash Grant 250, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee STATE LODGE FOP 222 EAST TOWN ST COLUMBUS OH 43215, Cash Grant 1,000, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee FOP FOUNDATION 222 EAST TOWN ST COLUMBUS OH 43215, Cash Grant 100, Relationship Form 990-EZ, Part I, Line 10, Grants Paid Activity , Grantee SAVE K9 TOMMY PO BOX 15 TIFFIN OH 44883, Cash Grant 100, Relationship Form 990-EZ, Part I, Line 16, Other Expenses Conferences, conventions, and meetings 3,013 Form 990-EZ, Part I, Line 16, Other Expenses BANK SERVICE CHARGES 1 Form 990-EZ, Part I, Line 16, Other Expenses BELEVOLENCE GIFTS 694 Form 990-EZ, Part I, Line 16, Other Expenses PER CAPITA DUES 16,161 Form 990-EZ, Part I, Line 16, Other Expenses EXPLORER POST 21 EXPENSES 21,233 Form 990-EZ, Part I, Line 16, Other Expenses LIFE INSURANCE 10,216 Form 990-EZ, Part I, Line 16, Other Expenses INTERNET 339 Form 990-EZ, Part I, Line 16, Other Expenses OFFICE SUPPLIES 242 Form 990-EZ, Part I, Line 16, Other Expenses KIDS CHRISTMAS 653 Form 990-EZ, Part I, Line 16, Other Expenses MISCELLANEOUS 2,239 Form 990-EZ, Part I, Line 16, Other Expenses SUPPLIES 5,540 Form 990-EZ, Part I, Line 16, Other Expenses FOREIGN TAX 16 Form 990-EZ, Part I, Line 16, Other Expenses COIN REGISTRATION 100 Form 990-EZ, Part II, Line 24, Other Assets DIVIDENDS RECEIVABLE Beginning of year 2,810, End of year 335 Form 990-EZ, Part II, Line 24, Other Assets LOAN RECEIVABLE Beginning of year 43,984, End of year 39,396 Form 990-EZ Part V Line 35 THE REVENUE OF 20,093 REPORTED ON FORM 990-EZ, PART 1, LINE 2 IS INCOME RELATED TO THE EXEMPT PURPOSE. THEREFORE, NO 990-T IS REQUIRED.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:	11000218
Software Version:	2011.0.0