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.") .... | 261,817 | 193,628 | 180,527 | 231,549 | 244,400 | 1,111,921 |
| 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.. | 261,817 | 193,628 | 180,527 | 231,549 | 244,400 | 1,111,921 |
| 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).. | 520,393 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 591,528 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 261,817 | 193,628 | 180,527 | 231,549 | 244,400 | 1,111,921 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,696 | 986 | 129 | 41 | 8 | 2,860 |
| 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). | 1,114,781 | |||||






| 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.) | ||||||
| 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: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part VI | 2 | Elizabeth Peterson and Charles Strouss and Mary Schaefer Strouss are family. |
| Form 990 Part VI | 11b | Form 990 and schedules were completed. A pdf copy was sent to each board member for their review and comment. Each board member replied with their changes or that there were no changes needed. After completion and corrections, the final version was sent to the board and was filed with IRS. |
| Form 990 Part VI | 12c | At a board meeting, all members were asked to disclose any conflicts of interest with INCOR and they were asked to abstain from casting votes on any issues for which the conflicts would apply. There were no conflicts disclosed. This process will be repeated at each annual meeting in the future. |
| Form 990 Part VI | 19 | Our governing documents and annual financial reports are on file with the State of Washington. Interested parties can check online thru the Secretary of State Charities programs website to access this information. Also they are available to the public by request directly at INCOR. Our conflict of interest policy is available and may be requested from INCOR. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 156,452, Grants and allocations 156,452, Revenue 0 Health-general rehabilitative Public safety / disaster preparedness relief Religion / spiritual development Purchase receive donated relief goods ship relief goods sponsor medical outreaches support feeding centers and orphanages prison ministry international domestic. |
| Form 990, Part III, Line 4d Program Service Expenses 156,452, Grants and allocations 156,452, Revenue 0 Health-general rehabilitative Public safety / disaster preparedness relief Religion / spiritual development Purchase receive donated relief goods ship relief goods sponsor medical outreaches support feeding centers and orphanages prison ministry international domestic. Form 990 Part VI Section A Line 2 Elizabeth Peterson and Charles Strouss and Mary Schaefer Strouss are family. Form 990 Part VI Section B Line 11b Form 990 and schedules were completed. A pdf copy was sent to each board member for their review and comment. Each board member replied with their changes or that there were no changes needed. After completion and corrections, the final version was sent to the board and was filed with IRS. Form 990 Part VI Section B Line 12c At a board meeting, all members were asked to disclose any conflicts of interest with INCOR and they were asked to abstain from casting votes on any issues for which the conflicts would apply. There were no conflicts disclosed. This process will be repeated at each annual meeting in the future. Form 990 Part VI Section C Line 19 Our governing documents and annual financial reports are on file with the State of Washington. Interested parties can check online thru the Secretary of State Charities programs website to access this information. Also they are available to the public by request directly at INCOR. Our conflict of interest policy is available and may be requested from INCOR. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |