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) 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.") .... | 185,022 | 159,352 | 101,020 | 99,064 | 197,141 | 741,599 |
| 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.. | 185,022 | 159,352 | 101,020 | 99,064 | 197,141 | 741,599 |
| 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. | 741,599 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 185,022 | 159,352 | 101,020 | 99,064 | 197,141 | 741,599 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9 | 9 | 4 | 22 | ||
| 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.. | 3,274 | 11,188 | 12,701 | 7,019 | 34,182 | |
| 11 | Total support (Add lines 7 through 10). | 775,803 | |||||






| 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.) | 0 | |||||
| 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 |
|---|
| OTHER INCOME PART II, LINE 10; DESCRIPTION: REIMBURSED EXPENSES; DESCRIPTION: SODA MACHINE/EQUIP RENTAL; 2007: 3274.; 2008: 11188.; 2009: 12701.; 2010: 7019.; |
| Explanation |
|---|
| Software ID: | 10000104 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI-B, Line 11a | Each Board member is sent a PDF copy of the 990 draft | |
| Pt VI-B, Line 11a | before the return is finalized and given an opportunity | |
| Pt VI-B, Line 11a | to make any changes. | |
| Pt VI-B, Line 12c | Each Board member signs a conflict of interest statement annually | |
| Pt VI-B, Line 15 | The organization has committee in charge of Executive | |
| Director's salary. They compare to other salary for | ||
| similar positions nationwide and statewide. | ||
| Pt VI-C, Line 19 | The organization makes its governing documents available | |
| to the public upon request. | ||
| Form 990EZ, Part I, Line 8 | MISCELLANEOUS INCOME 7019. | |
| Form 990EZ, Part I, Line 16 | EXCISE TAX 115. OFFICE SUPPLIES 3674. PROGRAM EXPENSE 15297. TELEPHONE 2963. REPAIRS/MAINTENANCE 3589. INSURANCE 5080. TRAVEL 11827. MISCELLANEOUS 4612. EQUIPMENT EXPENSE 1758. | |
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE 4819. 32795. | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE 2420. 6523. PAYROLL TAXES PAYABLE 4144. 2665. DEFERRED REVENUE 21688. |
| Software ID: | 10000104 |
| Software Version: |