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) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 98,646 | 160,067 | 137,686 | 141,288 | 316,161 | 853,848 |
| 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.. | 98,646 | 160,067 | 137,686 | 141,288 | 316,161 | 853,848 |
| 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).. | 34,120 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 819,728 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 98,646 | 160,067 | 137,686 | 141,288 | 316,161 | 853,848 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 98 | 100 | 41 | 9 | 1,880 | 2,128 |
| 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.. | 10,039 | 2,036 | 12,075 | |||
| 11 | Total support (Add lines 7 through 10). | 868,051 | |||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (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.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (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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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Amended return infomation | THE ORGANIZATIONS BOOKS FOR 2009 AND 2010 WERE REVIEWED BY A CPA FIRM AND THEY RECOMMENDED THE FOLLOWING ADJUSTMENTS 1 258500 WAS PUT IN FIXED ASSETS IN 2009 BUT SHOULD HAVE BEEN REPAIRS AND MAINTENANCE THAT ADJUSTMENT WAS MADE TO PRIOR YEAR BALANCES ON THIS RETURN 2 RECEIVED 30 CEMETARY PLOTS VALUED AT 4710000 IN 2010 THE LOTS ARE WORTH THE APPRAISAL VALUE BUT BECAUSE OF THE CLIENTS SERVED BY THE ORGANIZATION THEY WILL BE IMPOSSIBLE TO SELL TO THEM THE COST OF OPENING A GRAVE IN THIS CEMETARY EXCEEDS THE COST OF A LOT IN THE CITY CEMETARY THE BOARD HAS VOTED TO REDUCE THE BALANCE SHEET AND THE CONTRIBUTIONS FOR 2010 TO REFLECT THOSE LOTS AT ZERO IT WAS FELT THAT LEAVING THEM AT FMV ON THE BOOKS WAS MISLEADING TO THOSE WHO MIGHT LOOK AT IT RECEIVED ONE HUNDRED SHARES OF STOCK IN THE YEAR BUT THEY WERE NOT REPORTED ON THE ORIGINAL RETURN | |
| 02. Form 990 governing body review (Part VI, line 11) | THE RETURN WAS PRESENTED AT THE BOARD MEETING FOLLOWING COMPLETION AND WAS AVAILABLE FOR THE REVIEW OF THE MEMBERS SUBSEQUENT TO THE MEETING THE EF SIGNATURE WAS SENT TO THE ACCOUNTANT SO IT COULD BE FILED | |
| 03. Governing documents, etc, available to public (Part VI, line 19) | The organinization maintains copies of financial statements and Form 990 in their offices and make them available upon request |
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