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.. | 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.") . | 379,981 | 227,471 | 344,522 | 322,418 | 86,035 | 1,360,427 |
| 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. | 379,981 | 227,471 | 344,522 | 322,418 | 86,035 | 1,360,427 |
| 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.) | 1,360,427 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 379,981 | 227,471 | 344,522 | 322,418 | 86,035 | 1,360,427 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,099 | 2,841 | 729 | 110 | 1 | 7,780 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 4,099 | 2,841 | 729 | 110 | 1 | 7,780 |
| 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.). | 1,368,207 | |||||




| 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 | THE FINAL FORM 990 IS MADE AVAILABLE TO THE BOARD OF DIRECTORS | |
| AFTER REVIEW AND APPROVAL BY THE CHAIR AND TREASURER. | ||
| Pt VI, Line 2 | THREE OF THE BOARD MEMBERS ARE SPOUSES OF OTHER BOARD MEMBERS. | |
| Pt XI | ALL ASSETS, NET OF LIABILITIES, WERE TRANSFERRED TO THE | |
| NEVADA CHILDHOOD CANCER FOUNDATION (NCCF). THE CARING | ||
| PLACE BECAME A PROGRAM OF NCCF AND ALL FUTURE ACTIVITIES | ||
| WILL BE REPORTED UNDER NCCF'S FORM 990 DETAIL, EIN 88-0302673. | ||
| Form 990EZ, Part I, Line 16 | FUNDRAISER EXPENSE BANK FEES LICENCES & PERMITS MEALS & ENTAINMENT MERCHANT ACCOUNT FEES BOOKS & SUBSCRIPTIONS SOFTWARE SUPPLIES TELEPHONE LIABILITY INSURANCE SECURITY EXPENSE STORAGE EXPENSE VOLUNTEER EXPENSE DUES & SUBSCRIPTIONS | |
| Form 990, Part IX, Line 24f | POSTAGE & MAILING 168. 168. 0. 0. STORAGE EXPENSE 330. 0. 330. 0. REPAIRS & MAINTENANCE 581. 0. 581. 0. SECURITY EXPENSE 131. 0. 131. 0. VOLUNTEER EXPENSE 628. 628. 0. 0. SUPPLIES 151. 151. 0. 0. CONTRIBUTIONS 100. 100. 0. 0. DONATED PROFESSIONAL SERVICES 200. 0. 200. 0. COMPUTER EXPENSE 629. 0. 629. 0. DIRECT PROGRAM COSTS 331. 331. 0. 0. TELEPHONE 225. 0. 225. 0. MEDICAL 45. 0. 45. 0. LEASE 1552. 0. 1552. 0. FACILITIES/EQUIP-OTHER 245. 0. 245. 0. MOTORCYCLE TAX 3000. 0. 0. 3000. IRS PENALTIES |
| Software ID: | 11000175 |
| Software Version: |