Form990-EZ
Click to see list of attachments
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
bullet Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
bulletThe organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
2010
Open to Public
Inspection
A
For the 2010 calendar year, or tax year beginning 07-01-2010, and ending 06-30-2011
B
Check if applicable:
C Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
 
Number and street (or P. O. box, if mail is not delivered to street address)PO BOX 0671
  Room/suite
City or town, state or country, and ZIP + 4 DUBLIN, OH430170617
D Employer identification number

31-1301839
E Telephone number

(614) 413-4000
F Group Exemption
Number. . bullet  
G Accounting method: Other (specify) bullet   H Check bulletI Website:bulletWWW.DUBLINAMROTARY.ORGJ Tax-Exempt status(check only one)—( 4) bullet(insert no.) or
K Check bullet A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ.. . bullet $ 106,402
Part IRevenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I.) Check if the organization used Schedule O to respond to any question in this Part I . . . . . . . .
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . 1 33,305
2 Program service revenue including government fees and contracts . . . . . . . 2 34,755
3 Membership dues and assessments . . . . . . . . . . . . . . 3 26,352
4 Investment income . . . . . . . . . . . . . . . . . . 4 218
5a Gross amount from sale of assets other than inventory . . . . 5a  
b Less: cost or other basis and sales expenses . . 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . . 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) 6a  
b Gross income from fundraising events (not including $ 3,885 of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceed $15,000) . . . . . . .
c Less: direct expenses from gaming and fundraising events . . . 6c 946
d Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c) 6d 2,939
7a Gross sales of inventory, less returns and allowances . . . . 7a  
b Less: cost of goods sold . . . . . . . . . . 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . 7c  
8 Other revenue (describe in Schedule O) . . . . . . . . . 8 7,887
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . . 9 105,456
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) . . . . . . . . 10 34,232
11 Benefits paid to or for members . . . . . . . . . . . . . . . 11  
12 Salaries, other compensation, and employee benefits . . . . . . . . . . . 12  
13 Professional fees and other payments to independent contractors . . . . . . . . 13 7,140
14 Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . . 14  
15 Printing, publications, postage, and shipping . . . . . . . . . . . . 15 220
16 Other expenses (describe in Schedule O) . . . . . . . . . . 16 58,554
17 Total expenses. Add lines 10 through 16 . . . . . . . . . . . . 17 100,146
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . 18 5,310
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return) . . . . . . . . . . . 19 37,634
20 Other changes in net assets or fund balances (explain in Schedule O) . . . . . . . 20 -9,686
21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . Bullet 21 33,258
Part IIBalance Sheets Check if the organization used Schedule O to respond to any question in this Part II. . . . . . . . .

(See the instructions for Part II.)(A) Beginning of year(B) End of year
22Cash, savings, and investments . . . . . . . . . .
32,914
22
35,112
23Land and buildings . . . . . . . . . . . . .
 
23
 
24Other assets (describe in Schedule O) . . . . . .
5,926
24
0
25Total assets . . . . . . . . . . . . . .
38,840
25
35,112
26
Total liabilities (describe in Schedule O) . . . . .
1,206
26
1,854
27Net assets or fund balances (line 27 of column (B) must agree with line 21) .
37,634
27
33,258
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2010)
Form 990-EZ (2010)
Page 2
Part IIIStatement of Program Service Accomplishments Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? THE MISSION OF THE ORGANIZATION IS TO PROVIDE SERVICE TO OTHERS, PROMOTE INTEGRITY, AND ADVANCE WORLD UNDERSTANDING, GOODWILL, AND PEACE THROUGH ITS FELLOWSHIP OF BUSINESS, PROFESSIONAL AND COMMUNITY LEADERS. ROTARY VOLUNTEER PROGRAMS FOSTER AND FACILITATE ACTIVE VOLUNTEER INVOLVEMENT IN COMMUNITY AND INTERNATIONAL SERVICE PROJECTS.
Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 ROTARY INTERNATIONAL PROVIDES SUPPORT FOR INTERNATIONAL SERVICE PROJECTS AND CULTIVATES INTERNATIONAL UNDERSTANDING AND GOODWILL THROUGH HUMANITARIAN SERVICE.
(Grants $ 16,982) If this amount includes foreign grants, check here ...MediumBullet		 28a 29,273
29 FELLOWSHIP ACTIVITIES SUPPORT ENCOURAGES MEMBERS TO INTERACT WITH EACH OTHER THROUGH COMMUNITY SERVICE AND MEET NEW FRIENDS AND MAKE LASTING RELATIONSHIPS.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 29a 30,376
30 COMMUNITY SERVICES PROJECTS HELP TO SUPPORT SERVICE PROJECTS IN THE LOCAL COMMUNITY AND INCREASE AWARENESS OF VOLUNTEER OPPORTUNITIES.
(Grants $ 3,000) If this amount includes foreign grants, check here ...MediumBullet		 30a 9,205
VOCATIONAL SERVICE EFFORTS PLAY A VITAL ROLE IN IMPROVING THE LIVES OF COMMUNITY MEMBERS WHO NEED DIRECTION AND EXPERTISE. ROTARIANS USE THEIR PROFESSIONAL SKILLS AND EXPERIENCE WHEREVER HELP IS NEEDED.
(Grants $ 6,000) If this amount includes foreign grants, check here ...MediumBullet		 6,100
NEW GENERATIONS IS DESIGNED TO HELP SUPPORT HIGH SCHOOL COMMUNITY SERVICE CLUBS, SUPPORT ROTARY CLUB FOR 21-30 YEAR OLD YOUNG PROFESSIONALS, AND FACILITATE EXCHANGE INCOMING AND OUTGOING STUDENT PROGRAMS.
(Grants $ 8,250) If this amount includes foreign grants, check here ...MediumBullet		 8,850
31 Other program services (describe in Schedule O) . . . . . . . . . . . .
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a) . . . . . . . . . bullet 32 83,804
Part IVList of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (See the instructions for Part IV.) Check if the organization used Schedule O to respond to any question in this Part IV . . . . . . . .
(a) Name and address (b) Title and average
hours per week
devoted to position		 (c) Compensation
(If not paid,
enter -0-.) 		(d) Contributions to
employee benefit plans &
deferred compensation		 (e) Expense
account and
other allowances
DAVID CONNELLY
PO BOX O671
DUBLIN,OH43017
 PRESIDENT4.00 0 0 0
CLAUDIA TRUSTY
PO BOX O671
DUBLIN,OH43017
 PRESIDENT-ELECT4.00 0 0 0
JAMES BURNESS
PO BOX O671
DUBLIN,OH43017
 PAST PRESIDENT4.00 0 0 0
DAVID HOLLIDAY
PO BOX O671
DUBLIN,OH43017
 VICE PRESIDENT4.00 0 0 0
RICHARD WEBER
PO BOX O671
DUBLIN,OH43017
 SECRETARTY-TREASURER4.00 0 0 0
DAVID WILLIAMSON
PO BOX O671
DUBLIN,OH43017
 SERGEANT AT ARMS4.00 0 0 0
SUSAN BURNESS
PO BOX O671
DUBLIN,OH43017
 DIRECTOR4.00 0 0 0
JOHN SUSIE
PO BOX O671
DUBLIN,OH43017
 DIRECTOR4.00 0 0 0
SCOTT WILLIAMSON
PO BOX O671
DUBLIN,OH43017
 DIRECTOR4.00 0 0 0
SHARON KENDALL
PO BOX O671
DUBLIN,OH43017
 DIRECTOR4.00 0 0 0
WOLF LANT
PO BOX O671
DUBLIN,OH43017
 DIRECTOR4.00 0 0 0
BONNIE COLEY-MALIR
PO BOX O671
DUBLIN,OH43017
 DIRECTOR4.00 0 0 0
Form 990-EZ (2010)
Form 990-EZ (2010)
Page 3
Part VOther Information(Note the statement requirements in the instructions for Part V.)YesNo Check if the organization used Schedule O to respond to any question in this Part V . . . .
33
Did the organization engage in any activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ..............
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the change on Schedule O (see instructions). ...................
34
 
No
35
If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not reported on Form 990-T, explain in Schedule O why the organization did not report the income on Form 990-T. ........................
a
Did the organization have unrelated business gross income of $1,000 or more or was it a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements?
35a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year? (see instructions) ........
35b
 
 
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N .............
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
0
b
Did the organization file Form 1120-POL for this year? ...............
37b
 
 
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?
38a
 
No
b
If “Yes,” complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9 ......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities ....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ....
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ..bullet0
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization ...................bullet0
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. .................
40e
 
No
41List the states with which a copy of this return is filed. bullet
42aThe organization's books are in care of bulletAMY BARNHART Telephone no. bullet (614) 866-6724
Located at bullet1142 BERGENIA DRIVE
REYNOLDSBURG,OH ZIP + 4bullet43068
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes,” enter the name of the foreign country: bullet  
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside of the U.S.?
42c
 
No
If “Yes,” enter the name of the foreign country: bullet  
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year . . . bullet43
 
44a
Did the organization maintain any donor advised funds? If "Yes", Form 990 must be completed instead of
Yes
No
Form 990-EZ.. . . . . . . . . . . . . . . . . . . .
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completed instead of Form990-EZ. . . . . . . . .
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year? . . . . . . .
44c
 
No
d
If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanation in Schedule O. . . . . . . . .
44d
 
 
45
Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. . . . . . . . .
45
 
No
45a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. .
45a
 
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I. . . . . . . . . .
46
 
No
Form 990-EZ (2010)
Form 990-EZ (2010)
Page 4
Part VI
Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI . . . . . . . .
Yes
No
47
Did the organization engage in lobbying activities? If "Yes," complete Schedule C, Part II . . . .
47
 
 
48
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E . . .
48
 
 
49a
Did the organization make any transfers to an exempt non-charitable related organization? . . . .
49a
 
 
b
If "Yes," was the related organization a section 527 organization? . . . . . . . . .
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each employee paid more than $100,000 (b) Title and average
hours per week
devoted to position		 (c) Compensation
 (d) Contributions to
employee benefit plans &
deferred compensation		 (e) Expense
account and
other allowances
 
50(f)
Total number of other employees paid over $100,000 . . . . . . . . . . . . . bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
 
51(d)
Total number of other independent contractors each receiving over $100,000 . . . . . . . bullet  
52
Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ....................
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(See instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2010)

Additional Data


Software ID:  
Software Version:  

Form 990-EZ, Special Condition Description:
Special Condition Description
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
 
Employer identification number

31-1301839
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
  		Employer identification number

31-1301839
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
  		Employer identification number

31-1301839
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
  		Employer identification number

31-1301839
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
 
Employer identification number

31-1301839
Identifier Return Reference Explanation
OTHER INVESTMENT INCOME FORM 990-EZ, PART I, LINE 4 INTEREST INCOME 218..
OTHER REVENUE FORM 990-EZ, PART I, LINE 8 DESCRIPTION: MISCELLANEOUS. AMOUNT: 7,887.
PAYMENTS TO AFFILIATES FORM 990-EZ, PART I, LINE 10 AFFILIATE NAME: ROTARY INTERNATIONAL. AFFILIATE ADDRESS: 14255 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693. PURPOSE OF PAYMENT: POLIO PLUS - END POLIO NOW. AMOUNT OF PAYMENT: 2,000.
PAYMENTS TO AFFILIATES FORM 990-EZ, PART I, LINE 10 AFFILIATE NAME: DUBLIN ROTARY FOUNDATION. AFFILIATE ADDRESS: P.O. BOX 0671 DUBLIN, OH 43017. PURPOSE OF PAYMENT: 4X4 CLUB MATCHING. AMOUNT OF PAYMENT: 2,000.
PAYMENTS TO AFFILIATES FORM 990-EZ, PART I, LINE 10 AFFILIATE NAME: ROTARY INTERNATIONAL. AFFILIATE ADDRESS: 14255 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693. PURPOSE OF PAYMENT: PHILLIPPINES WATER PROJECT. AMOUNT OF PAYMENT: 2,000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 6,000.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: VETERAN'S MEMORIAL PROJECT. GRANTEE NAME: CITY OF DUBLIN. GRANTEE ADDRESS: 5200 EMERALD PARKWAY DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/31/11. AMOUNT GIVEN: 3,000.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: INTERVENTION RADIOLOGY. GRANTEE NAME: NATIONWIDE CHILDREN'S HOSPITAL FOUNDATION. GRANTEE ADDRESS: 700 CHILDREN'S DRIVE COLUMBUS, OH 43205. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/02/10. AMOUNT GIVEN: 7,000.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: MONTANA DE LUZ. GRANTEE NAME: MONTANA DE LUZ. GRANTEE ADDRESS: P.O. BOX 1805 COLUMBUS, OH 43216. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/20/11. AMOUNT GIVEN: 1,000.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: LEADERSHIP DUBLIN. GRANTEE NAME: LEADERSHIP DUBLIN. GRANTEE ADDRESS: 129 S. HIGH STREET DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 08/03/10. AMOUNT GIVEN: 1,500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: SONYA AGHILI & BUTLER UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ANUJANAA BASKARANATHAN & OHIO STATE UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ROBERT BEACH & COLUMBUS STATE. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: KRUTI GANDHI & UNIVERSITY OF CINCINNATI. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: AERON ROACH & WITTENBERG UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: TYLER SPERRY & UNIVERSITY OF CINCINNATI. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: SCOTT WEBER & BRIGHAM YOUNG UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ELLEN TAN & OHIO STATE UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: WHITNEY HOLDRIETH & OHIO STATE UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: 2010-11 INTERACT STIPEND. GRANTEE NAME: KAREN BROTHERS. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 1,086.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: 2010-11 INTERACT STIPEND. GRANTEE NAME: ASHLEY FINNERAN. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 549.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: 2010-11 INTERACT STIPEND. GRANTEE NAME: SHELLY JEFFRIES. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 1,575.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: 2010-11 INTERACT STIPEND. GRANTEE NAME: CLAUDIA M. TRUSTY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/03/11. AMOUNT GIVEN: 160.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: 2010-11 INTERACT STIPEND. GRANTEE NAME: JILL HARRIS. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/26/11. AMOUNT GIVEN: 500.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: TEAMBUILDING. GRANTEE NAME: CAMP MARY ORTON. GRANTEE ADDRESS: 7925 N. HIGH STREET COLUMBUS, OH 43235. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/23/11. AMOUNT GIVEN: 480.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: INERACT MISSION TRIP. GRANTEE NAME: MONTANA DE LUZ. GRANTEE ADDRESS: PO BOX 410 WORTHINGTON, OH 43085. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/31/10. AMOUNT GIVEN: 3,300.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: RYLA - ROTARY YOUTH LEADERSHIP. GRANTEE NAME: ROTARY DISTRICT 6690. GRANTEE ADDRESS: PO BOX 181 WORTHINGTON, OH 43085'. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/17/10. AMOUNT GIVEN: 600.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES - OTHER. GRANTEE NAME: BUCKEYE MILITARY MOMS - CHAPTER 9. GRANTEE ADDRESS: PO BOX 20068 COLUMBUS, OH 43220. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/18/10. AMOUNT GIVEN: 250.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: LN-4. GRANTEE NAME: EMILY SHARICK. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/31/11. AMOUNT GIVEN: 1,016.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: LN-4. GRANTEE NAME: KYLE RITTERBECK. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/31/11. AMOUNT GIVEN: 1,016.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: LN-4. GRANTEE NAME: MISSION EMANUEL. GRANTEE ADDRESS: 1220 E. CONCORD STREET ORLANDO, FL 32803. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/07/11. AMOUNT GIVEN: 700. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 28,232.
OTHER EXPENSES FORM 990-EZ, PART I, LINE 16 DESCRIPTION: OFFICE SUPPLIES. AMOUNT: 178. DESCRIPTION: OFFICERS/DIRECTORS INSURANCE. AMOUNT: 283. DESCRIPTION: LITERACY. AMOUNT: 2,443. DESCRIPTION: DISTRICT ROTARY DUES. AMOUNT: 2,772. DESCRIPTION: ROTARY INTERNATIONAL CONVENTION. AMOUNT: 3,708. DESCRIPTION: ROTARY INTERNATIONAL DUES. AMOUNT: 8,583. DESCRIPTION: MEMBER UNIFORMS. AMOUNT: 2,390. DESCRIPTION: MEETINGS. AMOUNT: 440. DESCRIPTION: CLUB ADMINISTRATION EXPENSES. AMOUNT: 1,334. DESCRIPTION: SALVATION ARMY CHRISTMAS EXPENSES. AMOUNT: 1,955. DESCRIPTION: MEALS AND FELLOWSHIP ACTIVITIES. AMOUNT: 30,407. DESCRIPTION: NEW GENERATIONS INBOUND EXPENSES. AMOUNT: 500. DESCRIPTION: KIDS VOTE. AMOUNT: 100. DESCRIPTION: ROTARY HONOR FLIGHT. AMOUNT: 1,147. DESCRIPTION: FOOD PANTRY. AMOUNT: 660. DESCRIPTION: MISCELLANEOUS EXPENSES. AMOUNT: 234. DESCRIPTION: ADVERTISING. AMOUNT: 290. DESCRIPTION: REVEILLE. AMOUNT: 719. DESCRIPTION: ETHICS CONFERENCE/4 WAY TEST. AMOUNT: 100. DESCRIPTION: GOV. VISIT. AMOUNT: 110. DESCRIPTION: PRESIDENTS FUND. AMOUNT: 201. TOTAL TO FORM 990-EZ, LINE 16: 58,554.
OTHER CHANGES IN NET ASSETS FORM 990-EZ, PART I, LINE 20 DESCRIPTION: PRIOR PERIOD ADJUSTMENT. AMOUNT: -9,686.
OTHER ASSETS FORM 990-EZ, PART II, LINE 24 DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 5,926. END OF YEAR AMOUNT: 0.
OTHER LIABILITIES FORM 990-EZ, PART II, LINE 26 DESCRIPTION: DUE TO ANGEL FUND. BEG. OF YEAR AMOUNT: 1,206. END OF YEAR AMOUNT: 1,516. DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 338.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

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TY 2010 TransferPrsnlBnftContractsDecl
Name:
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
EIN: 31-1301839
Declaration:
THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.