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.") . | 90,060 | 212,712 | 284,118 | 270,274 | 857,164 | |
| 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.. | 34,504 | 6,615 | 7,633 | 9,255 | 16,941 | 74,948 |
| 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. | 34,504 | 96,675 | 220,345 | 293,373 | 287,215 | 932,112 |
| 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.) | 932,112 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 34,504 | 96,675 | 220,345 | 293,373 | 287,215 | 932,112 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,821 | 290 | 5 | 2,116 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,821 | 290 | 5 | 2,116 | ||
| 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.) | 167,925 | 277,322 | 239,720 | 58,138 | 104,626 | 847,731 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 204,250 | 374,287 | 460,070 | 351,511 | 391,841 | 1,781,959 |




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Members or stockholder classes and rights (Part VI, line 6) | ORGANIZATION HAS A SINGLE CLASS OF MEMBERS | |
| 02. Member election for additional members (Part VI, line 7a) | CURRENT BOARD MEMBERS ELECT NEW BOARD MEMBERS AFTER REVIEWING RECOMMENDATIONS MADE BY A NOMINATIONS COMMITTEE ALL COMMITTEE RECOMMENDATIONS ARE REVIEWED AND APPROVED BY A MAJORITY OF THE BOARD OF DIRECTORS | |
| 03. Governing body decisions (Part VI, line 7b) | WRITTEN MINUTES ARE KEPT FOR EVERY BOARD MEETING ANDOR COMMITTEE MEETING | |
| 04. Governing body meeting documentation (Part VI, line 8a) | BOARD OF DIRECTORS DOCUMENTS IN WRITING ALL DECISIONS TAKEN DURING ALL MEETINGS | |
| 05. Form 990 governing body review (Part VI, line 11) | BOARD OF DIRECTORS DISCUSS THE FINANCIAL REPORT EVERY MEETING AND ARE PROVIDED WITH A COPY OF FORM 990 TO REVIEW AND APPROVE BEFORE FILING | |
| 06. Conflict of interest policy compliance (Part VI, line 12c) | A CONFLICT OF INTEREST POLICY IS ON FILE | |
| 07. Governing documents, etc, available to public (Part VI, line 19) | ALL FINANCIAL REPORTS MINUTES OF MEETINGS AND TAX RETURNS ARE AVAILABLE FOR PUBLICS INSPECTION AT THE ORGANIZATIONS OFFICE DURING NORMAL BUSINESS HOURS | |
| 08. Explanation of other changes in net assets or fund balances (Part XI, line 5) | WRITE OFF OF UNCOLLECTIBLE ACCOUNTS RECEIVABLE IN THE AMOUNT OF 12079 |
| Software ID: | |
| Software Version: |