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.") . | 111,046 | 76,027 | 163,557 | 74,647 | 82,250 | 507,527 |
| 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. | 111,046 | 76,027 | 163,557 | 74,647 | 82,250 | 507,527 |
| 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.) | 507,527 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 111,046 | 76,027 | 163,557 | 74,647 | 82,250 | 507,527 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6,349 | 6,314 | 1,970 | 6,386 | 7,407 | 28,426 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 6,349 | 6,314 | 1,970 | 6,386 | 7,407 | 28,426 |
| 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.). | 117,395 | 82,341 | 165,527 | 81,033 | 89,657 | 535,953 |




| 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 | 6 | ACHS IS A MEMBER ORGANIZATION THAT IS GOVERNED BY ELECTED OFFICERS AND A BOARD OF MANAGERS THAT ARE ALSO PERMITTED TO VOTE. |
| Form 990 Part VI | 7A | ACHS CONDUCTS A NOMINATING PROCESS AND HOLDS AN OPEN ELECTION FOR OFFICERS ON AN ANNUAL BASIS BY MEMBERS PRESENT VOICE VOTE AFFIRMATION IN ACCORDANCE WITH ACHS BY-LAWS. |
| Form 990 Part VI | 11B | ACHS PREPARES A DRAFT COPY OF ITS FORM 990 WITH SCHEDULES AND CIRCULATES TO EACH BOARD MEMBER FOR THEIR COMMENTS AND APPROVAL BEFORE SIGNING AND MAILING TO THE IRS. |
| Form 990 Part VI | 19 | ACHS RESPONDS TO WRITTEN INQUIRES FROM THE PUBLIC AFTER APPROVAL BY THE BOARD OF DIRECTORS RELEASING NON-CONFIDENTIAL DATA AND ITEMS REQUIRED TO BE IN THE PUBLIC DOMAIN. |
| Form 990 Part XI | 5 | ACHS INVESTMENTS ARE STATED AT FAIR MARKET VALUE WHICH FOR 2011 RESULTED IN AN UNREALIZED LOSS OF 1,802. |
| Form 990 Part VI Section A Line 6 ACHS IS A MEMBER ORGANIZATION THAT IS GOVERNED BY ELECTED OFFICERS AND A BOARD OF MANAGERS THAT ARE ALSO PERMITTED TO VOTE. Form 990 Part VI Section A Line 7A ACHS CONDUCTS A NOMINATING PROCESS AND HOLDS AN OPEN ELECTION FOR OFFICERS ON AN ANNUAL BASIS BY MEMBERS PRESENT VOICE VOTE AFFIRMATION IN ACCORDANCE WITH ACHS BY-LAWS. Form 990 Part VI Section B Line 11B ACHS PREPARES A DRAFT COPY OF ITS FORM 990 WITH SCHEDULES AND CIRCULATES TO EACH BOARD MEMBER FOR THEIR COMMENTS AND APPROVAL BEFORE SIGNING AND MAILING TO THE IRS. Form 990 Part VI Section C Line 19 ACHS RESPONDS TO WRITTEN INQUIRES FROM THE PUBLIC AFTER APPROVAL BY THE BOARD OF DIRECTORS RELEASING NON-CONFIDENTIAL DATA AND ITEMS REQUIRED TO BE IN THE PUBLIC DOMAIN. Form 990 Part XI Line 5 ACHS INVESTMENTS ARE STATED AT FAIR MARKET VALUE WHICH FOR 2011 RESULTED IN AN UNREALIZED LOSS OF 1,802. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |