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.") .... | 7,125 | 729 | 9,652 | 31,914 | 23,873 | 73,293 |
| 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.. | 7,125 | 729 | 9,652 | 31,914 | 23,873 | 73,293 |
| 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).. | 31,804 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 41,489 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 7,125 | 729 | 9,652 | 31,914 | 23,873 | 73,293 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 33 | 33 | ||||
| 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.. | 21 | 21 | ||||
| 11 | Total support (Add lines 7 through 10). | 73,347 | |||||






| 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 |
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| OTHER INCOME PART II, LINE 10; DESCRIPTION: MISCELLANEOUS; 2011: 21.; |
| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt.1,line 21 | At 12/31/11 Net Assets was allocated as follows: | |
| Unrestricted Net Assets - $ 7,325 | ||
| Temporarily Restricted Net Assets - 8,800 | ||
| Total Net Assets $16,125 | ||
| At 12/31/10 the balance of Temporarily Restricted Net | ||
| Assets ($14,840) represented the revenue recognized in | ||
| 2010 for which expenses had not been incurred. Those | ||
| expenses were incurred in 2011. The $8,800 of Temporarily | ||
| Restricted Net Assets at 12/31/11 represents the | ||
| revenue of a grant awarded in 2011 for which expenses | ||
| will be incurred in 2012. | ||
| The Unrestricted Net Assets increased from $3,608 at | ||
| 12/31/10 to $7,326 at 12/31/11. | ||
| Part I | In-kind facility and services - | |
| The organization's office space is generously | ||
| provided by Vision for Children at Risk at no cost. The | ||
| value of the space, utilities, copier use, etc. is | ||
| valued at $1,000 per month or $12,000 for the year. | ||
| The executive director worked full-time in 2011 but was | ||
| paid for about half-time. The estimated fair market | ||
| value of the balance of her time, her in-kind donation | ||
| of services, is $20,700. | ||
| Form 990EZ, Part I, Line 8 | MISCELLANEOUS 21. | |
| Form 990EZ, Part I, Line 16 | FACILITY/FOOD COSTS - CONFERENCES 6985. INFORMATION TECHNOLOGY 480. SUPPLIES 2358. TRAVEL - OUT OF TOWN & MILEAGE REIMBURSEMENT 3273. STAFF TRAINING 980. MEALS 2083. OTHER 679. PAYROLL PROCESSING FEES 517. | |
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE 194. 0. PLEDGE RECEIVABLE 15005. 6930. | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE 1314. 1164. | |
| Although these in-kind contributions greatly enhanced | ||
| the organization's effectiveness, they cannot be | ||
| included in the revenue and expenses on this 990EZ. |
| Software ID: | 11000175 |
| Software Version: |