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. | 0 | |||||
| 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.. | 0 | |||||
| 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.") . | 181,687 | 116,160 | 83,723 | 118,443 | 193,975 | 693,988 |
| 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...... | 434,775 | 480,553 | 484,940 | 497,852 | 642,521 | 2,540,641 |
| 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. | 616,462 | 596,713 | 568,663 | 616,295 | 836,496 | 3,234,629 |
| 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. | 105,000 | 105,000 | ||||
| c | Add lines 7a and 7b.. | 105,000 | 105,000 | ||||
| 8 | Public Support (Subtract line 7c from line 6.) | 3,129,629 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 616,462 | 596,713 | 568,663 | 616,295 | 836,496 | 3,234,629 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 3,663 | 2,873 | 1,956 | 804 | 868 | 10,164 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 3,663 | 2,873 | 1,956 | 804 | 868 | 10,164 |
| 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.) | 17,229 | 31,843 | 36,982 | 32,794 | 118,848 | |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 3,363,641 | |||||




| Facts And Circumstances Test |
|---|
| OTHER INCOME PART III, LINE 12; DESCRIPTION: SPECIAL EVENTS; 2007: 0.; 2008: 17229.; 2009: 31843.; 2010: 36982.; 2011: 32794.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | EXECUTIVE DIRECTOR AND BOARD TREASURER REVIEW FORM 990 | |
| ON BEHALF OF THE BOARD OF DIRECTORS PRIOR TO FILING. | ||
| Pt VI, Line 15 | BOARD OF DIRECTORS APPROVES EXECUTIVE DIRECTOR SALARY. | |
| EXECUTIVE DIRECTOR APPROVES ALL OTHER SALARIES. | ||
| Pt VI, Line 19 | ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON | |
| RECEIPT OF WRITTEN REQUEST. | ||
| Pt VI, Line 12c | BOARD MEMBERS ARE REQUIRED TO SIGN THE CONFLICT OF | |
| INTEREST STATEMENT WHEN THEY BEGIN THEIR BOARD TERM | ||
| AND DISCLOSE ANY CONFLICTS THAT MAY ARISE. | ||
| Form 990EZ, Part I, Line 16 | CARE CONVENTION INSURANCE MISCELLANEOUS OFFICE EXPENSES PLAY THERAPY SUPPLIES PROFESSIONAL DEVEOPMENT TELEPHONE TRAVEL UNREALIZED LOSS ON INVESTMENTS | |
| Form 990EZ, Part II, Line 24 | PREPAIDS INVESTMENTS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES BONDS, MORTGAGES & OTHER NOTES |
| Software ID: | 11000175 |
| Software Version: |