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. | ||||||
| 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.") . | 52,845 | 23,828 | 28,250 | 56,082 | 59,140 | 220,145 |
| 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...... | 107,311 | 67,667 | 68,891 | 43,193 | 45,443 | 332,505 |
| 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. | 160,156 | 91,495 | 97,141 | 99,275 | 104,583 | 552,650 |
| 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.) | 552,650 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 160,156 | 91,495 | 97,141 | 99,275 | 104,583 | 552,650 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9,306 | 10,028 | 19,334 | |||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 9,306 | 10,028 | 19,334 | |||
| 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.) | 10,773 | 10,388 | 21,476 | 42,637 | ||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 170,929 | 101,883 | 118,617 | 108,581 | 114,611 | 614,621 |




| Facts And Circumstances Test |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
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| 11) CANYON MOON THEATRE CO., INC'S POLICY FOR THE FORM 990 TAX RETURN WILL BE TO HAVE THE TREASURER OF THE ORGANIZATION PRESENT THE 990 WITH ALL SCHEDULES TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. ADDITIONALLY, EACH MEMBER OF THE BOARD OF DIRECTORS WILL RECEIVE AN EMAIL VERSION (IN PDF FORMAT) OF THE FORM 990 AND WILL HAVE 10 DAYS TO REVIEW THE DOCUMENT. EACH BOARD MEMBER WILL BE RESPONSIBLE FOR SENDING A CONFIRMATION EMAIL TO THE TREASURER THAT THEY HAVE REVIEWED THE FORM 990 WITHIN THE 10-DAY PERIOD. 19) TO AVOID REAL AND PERCEIVED CONFLICTS OF INTEREST, ALL EMPLOYEES, OFFICERS, AND DIRECTORS ARE TO PROMPTLY DISCLOSE IN WRITING TO THE BOARD OF THE CANYON MOON THEATRE CO. INC ANY CONFLICTS OF INTEREST THAT EMERGE. THE BOARD WILL DETERMINE WHETHER A CONFLICT EXISTS, AND WHETHER THE CONFLICTED INDIVIDUAL MAY VOTE OR OTHERWISE MAKE DECISIONS ON MATTERS RELATED TO THE CONFLICT. ALL DIRECTORS AND OFFICERS MUST AT LEAST ANNUALLY DISCLOSE IN WRITING TO THE BOARD ANY POTENTIAL CONFLICTS OF INTEREST THAT MAY FORSEEABLY ARISE. AT THE ANNUAL BOARD MEETING OF THE CANYON MOON THEATRE CO. INC., THE CONFLICT OF INTEREST POLICY WILL BE ADDRESSED AND ALL BOARD MEMBERS AND EMPLOYEES WILL BE ASKED WHETHER THEY HAVE A CONFLICT OF INTEREST. |
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