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.") . | 1,941,333 | 361,700 | 106,198 | 56,641 | 5,823 | 2,471,695 |
| 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...... | 1,000,232 | 338,457 | 257,713 | 485,322 | 2,081,724 | |
| 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. | 1,941,333 | 1,361,932 | 444,655 | 314,354 | 491,145 | 4,553,419 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 3,000 | 2,000 | 5,000 | |||
| 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.. | 3,000 | 2,000 | 5,000 | |||
| 8 | Public Support (Subtract line 7c from line 6.) | 4,548,419 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,941,333 | 1,361,932 | 444,655 | 314,354 | 491,145 | 4,553,419 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 13,036 | 2,926 | 803 | 118 | 257 | 17,140 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 13,036 | 2,926 | 803 | 118 | 257 | 17,140 |
| 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.). | 4,570,559 | |||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 19 | INFORMATION REGARDING THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS | |
| OF THE ORGANIZATION IS PROVIDED UPON REQUEST. THAT INFORMATION IS | ||
| PROVIDED IN SOFT OR HARD COPY BASED ON THE REQUEST OF THE RECIPIENT. | ||
| Pt VI, Line 11a | THE PRESIDENT & CEO REVIEWS THE 990 WITH THE TAX RETURN PREPARER PRIOR TO FILING. | |
| Form 990, Part III, Line 4d | CKF NATIONAL NETWORK- THE GOAL FOR THIS PROJECT WAS TO SUPPORT 24700. 0. 0. ROPER ST. FRANCIS CONTRACTED WITH THE SOUTHERN INSTITUTE TO DEVELOP 0. 0. 12938. PROVIDED CONSULTANT SERVICES TO IMPORVE THE APPLICATION PROCESS 5362. 0. 0. WORKSMART! IS A CONTINUOUS IMPROVEMENT EFFORT INITIATED BY THE LOUSIANA DEPT OF HEALTH & HOSPITALS 995. 0. 0. | |
| Form 990, Part VI, Line 9 | SERGIO BENDIXEN 2800 PONCE DE LEON BILD STE 1111 CORAL GABLES FL 333134 UNITA BLACKWELL 139 TWIN OAKS DRIVE MAYERSVILLE MS 39113 MICHAEL CASTLE 1233 LONGWORTH HOUSE OFFICE BLDG WASHINGTON DC 20515 JUDY LANGFORD 535 HAROLD AVE NE ATLANTA GA 30307 DAVID MATTHEWS 200 COMMONS ROAD DAYTON OH 45459 NATASHA METCALF 10 BURTON HILLS BLVD NASHVILLE TN 37215 RICHARD W. RILEY 101 CONSITITUTION AVE, NW, STE 900 WASHINGTON DC 20001 PAUL STARNES 4004 PATTON DR. CHATTANOOGA TN 37412 BEEGIE TRUESDALE 2866 BELDEN | |
| Form 990, Part IX, Line 24f | MEMBERSHIP FEES 1389. 1271. 118. 0. BANK CHARGES 695. 508. 187. 0. PRINTING 463. 461. 2. 0. |
| Software ID: | 11000175 |
| Software Version: |