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.") .... | ||||||
| 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.") . | 48,365 | 62,186 | 37,230 | 190,971 | 100,034 | 438,786 |
| 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...... | 114,205 | 129,386 | 143,931 | 130,654 | 140,359 | 658,535 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 38,407 | 36,214 | 45,092 | 45,318 | 43,615 | 208,646 |
| 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. | 200,977 | 227,786 | 226,253 | 366,943 | 284,008 | 1,305,967 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 40,000 | 40,000 | ||||
| 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.. | 40,000 | 40,000 | ||||
| 8 | Public Support (Subtract line 7c from line 6.) | 1,265,967 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 200,977 | 227,786 | 226,253 | 366,943 | 284,008 | 1,305,967 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 5,240 | 5,280 | 5,132 | 2,709 | 2,688 | 21,049 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 5,240 | 5,280 | 5,132 | 2,709 | 2,688 | 21,049 |
| 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.) | 459 | 459 | ||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 1,327,475 | |||||




| Facts And Circumstances Test |
|---|
| OTHER INCOME PART III, LINE 12; DESCRIPTION: MISCELLANEOUS; 2007: 0.; 2008: 459.; 2009: 0.; 2010: 0.; 2011: 0.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | A COPY OF THE COMPLETED FORM 990 IS GIVEN TO EACH BOARD | |
| EITHER IN PERSON OR THROUGH THE MAIL WITH INSTRUCTIONS | ||
| TO REVIEW THE FORM. PRIOR TO MAILING THE FORM 990 THE | ||
| BOARD APPROVES THE 990 AT A REGULARLY SCHEDULED MEETING. | ||
| Pt VI, Line 12c | THE CONFLICT OF INTEREST POLICY HAS BEEN ADOPTED AND | |
| EACH BOARD MEMBER IS REQUIRED TO COMPLETE A DISCLOSURE | ||
| OF INTEREST FORM ANNUALLY. ANY CONFLICTS THAT ARISE | ||
| WOULD BE ADDRESSED BY THE EXECUTIVE COMMITTEE AND THE | ||
| FULL BOARD, WHEN APPROPRIATE. | ||
| Pt VI, Line 15 | THE PERSONNEL COMMITTEE CONDUCTS AN ANNUAL REVIEW OF | |
| THE EXECUTIVE DIRECTOR AND PROVIDES WRITTEN | ||
| DOCUMENTATION WHICH INCLUDES A RECOMMENDATION FOR | ||
| COMPENSATION WHICH IS BASED ON PERFORMANCE, BUDGET | ||
| CONSTRAINTS AND COMPARATIVE INFORMATION. | ||
| Pt VI, Line 19 | ALL FINANCIAL STATEMENTS, POLICIES AND PROCEDURES, AND | |
| OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC | ||
| UPON REQUEST. | ||
| Pt XI | LINE 5 - LOSS ON DISPOSAL OF UNDEPRECIATED ASSETS | |
| UPON DEMOLITION OF PRIOR BUILDING IMPROVEMENTS | ||
| Form 990, Part IX, Line 24f | INSURANCE DUES |
| Software ID: | 11000175 |
| Software Version: |