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. | ||||||
| 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.") . | 7,592 | 25,688 | 33,280 | |||
| 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...... | 26,836 | 28,013 | 22,980 | 73,518 | -27,563 | 123,784 |
| 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. | 26,836 | 28,013 | 22,980 | 81,110 | -1,875 | 157,064 |
| 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.) | 157,064 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 26,836 | 28,013 | 22,980 | 81,110 | -1,875 | 157,064 |
| 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.). | 26,836 | 28,013 | 22,980 | 81,110 | -1,875 | 157,064 |




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | SEE ATTACHED STATEMENT ARTICLE 11. THE PURPOSE OR PURPOSES FOR WHICH THE CORPORATION IS FORMED ARE AS FOLLOWS: TO RECEIVE AND ADMINISTER FUNDS FOR SCIENTIFIC, EDUCATIONAL, AND CHARITABLE PURPOSES, ALL FOR PUBLIC WELFARE, AND FOR NO OTHER PURPOSES, AND TO THAT END TO TAKE AND HOLD, BY BEQUEST, DEVISE, GIFT, PURCHASE OR LEASE, EITHER ABSOLUTELY OR IN TRUST FOR SUCH OBJECTS AND PURPOSES OR ANY OF THEM, ANY PROPERTY, REAL, PERSONAL OR MIXED, WITHOUT LIMITATION AS TO AMOUNT OF VALUE, EXCEPT SUCH LIMITATIONS, IF ANY, AS MAY BE IMPOSED BY LAW; TO SELL, CONVEY, AND DISPOSE OF ANY SUCH PROPERTY AND TO INVEST AND REINVEST THE PRINCIPAL THEREOF, AND TO DEAL WITH AND EXPEND THE INCOME THEREFROM FOR ANY OF THE BEFOREMENTIONED PURPOSES, WITHOUT LIMITATION, EXCEPT SUCH LIMITATIONS, IF ANY, AS MAY BE CONTAINED IN THE INSTRUMENT UNDER WHICH SUCH PROPERTY IS RECEIVED; TO RECEIVE ANY PROPERTY, REAL, PERSONAL, OR MIXED, IN TRUST, UNDER THE TERMS OF ANY WILL, DEED OF TRUST, OR OTHER TRUST INSTRUMENT FOR THE FOREGOING PURPOSES OR ANY OF THEM (BUT FOR NO OTHER PURPOSES), AND IN ADMINISTERING THE SAME TO CARRY OUT THE DIRECTIONS AND EXERCISE THE POWERS CONTAINED IN THE TRUST INSTRUMENT UNDER WHICH THE PROPERTY IS RECEIVED, INCLUDING THE EXPENDITURE OF THE PRINCIPAL, AS WELL AS THE INCOME, FOR ONE OR MORE OF SUCH PURPOSES, IF AUTHORIZED OR DIRECTED IN THE TRUST INSTRUMENT UNDER WHICH IT IS RECEIVED; TO RECEIVE, TAKE TITLE TO, HOLD, AND USE THE PROCEEDS INCOME OF STOCKS, BONDS, OBLIGATIONS, OR OTHER SECURITIES OF ANY CORPORATION OR CORPORATION DOMESTIC OR FOREIGN, BUT ONLY FOR THE FOREGOING PURPOSES, OR SOME OF THEM; AND, IN GENERAL TO EXERCISE ANY, ALL, AND EVERY POWER FOR WHICH A NON-PROFIT CORPORATION KNOWN AS A FOUNDATION, ORGANIZED UNDER THE PROVISIONS OF THE MICHIGAN GENERAL CORPORATION ACT OR SCIENTIFIC EDUCATION, AND CHARITABLE PURPOSES, ALL FOR THE PUBLIC WELFARE, CAN BE AUTHORIZED TO EXERCISE, BUT NOT ANY OTHER POWER. THE NET INCOME OF THIS CORPORATION SHALL NOT INURE, IN WHOLE OR IN PART, TO THE BENEFIT OF PRIVATE SHAREHOLDERS OR INDIVIDUALS AND NO PART OF THE ACTIVITIES OF THIS CORPORATION SHALL ATTEMPT TO INFLUENCE LEGISLATION BY PROPAGANDA OR OTHERWISE. |
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | COMMUNITY SERVICE, VOCATIONAL SERVICE, INTERNATIONAL SERVICE, AND CLUB SERVICE GRANTS AND AWARDS |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| Software ID: | |
| Software Version: |