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 01-01-2010, and ending 12-31-2010
B
Check if applicable:
C Name of organization
INTERNATIONAL ASSOCIATION OF LIONS CLUBS West Peoria
 
Number and street (or P. O. box, if mail is not delivered to street address)2112 W Edna Ct
  Room/suite
City or town, state or country, and ZIP + 4 West Peoria, IL616046023
D Employer identification number

37-1124789
E Telephone number

(309) 674-2451
F Group Exemption
Number. . bullet  
G Accounting method: Other (specify) bullet   H Check bulletI Website:bullet   J 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 $ 15,188
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 2,398
2 Program service revenue including government fees and contracts . . . . . . . 2 0
3 Membership dues and assessments . . . . . . . . . . . . . . 3 1,126
4 Investment income . . . . . . . . . . . . . . . . . . 4 0
5a Gross amount from sale of assets other than inventory . . . . 5a 0
b Less: cost or other basis and sales expenses . . 5b 0
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . . 5c 0
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) 6a 0
b Gross income from fundraising events (not including $ 10,576 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 6,199
d Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c) 6d 4,377
7a Gross sales of inventory, less returns and allowances . . . . 7a 0
b Less: cost of goods sold . . . . . . . . . . 7b 0
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . 7c 0
8 Other revenue (describe in Schedule O) . . . . . . . . . 8 1,088
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . . 9 8,989
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) . . . . . . . . 10 8,044
11 Benefits paid to or for members . . . . . . . . . . . . . . . 11 0
12 Salaries, other compensation, and employee benefits . . . . . . . . . . . 12 0
13 Professional fees and other payments to independent contractors . . . . . . . . 13 0
14 Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . . 14 280
15 Printing, publications, postage, and shipping . . . . . . . . . . . . 15 63
16 Other expenses (describe in Schedule O) . . . . . . . . . . 16 1,109
17 Total expenses. Add lines 10 through 16 . . . . . . . . . . . . 17 9,496
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . 18 -507
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 12,736
20 Other changes in net assets or fund balances (explain in Schedule O) . . . . . . . 20 0
21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . Bullet 21 12,229
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 . . . . . . . . . .
12,736
22
12,229
23Land and buildings . . . . . . . . . . . . .
0
23
0
24Other assets (describe in Schedule O) . . . . . .
0
24
0
25Total assets . . . . . . . . . . . . . .
12,736
25
12,229
26
Total liabilities (describe in Schedule O) . . . . .
0
26
0
27Net assets or fund balances (line 27 of column (B) must agree with line 21) .
12,736
27
12,229
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? Provide equipment and services to the public who are sight and hearing impaired.
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 Paid for 5 eye exams and 5 pairs of glasses for 5 people. Paid for the hearing exams and fittins of 2 hearing aids for 2 people. Paid for the cost of 2 impaired campers at the, Camp Lions for the Sight and Hearing Impaired, summer camp. Provided treats, fruit and melon, and 7 club members served 53 campers and 15 councilers after dinner on 1 night of the 2 week camp. The club raised funds for the, Greater Peoria Blind Peorples Center and provided support for over 50 members. We helped with the transportation, meals, and other functions for the members and helped with the facility maintanance and repairs. The club sponsered the Lions of Illinois Foundation hearing bus and provided volunteers for 1 day to provide hearing test for the residents of West Peoria, over 4,000, and the general public.
(Grants $ 3,164) If this amount includes foreign grants, check here ...MediumBullet		 28a 5,484
29 The club provided support to the residents of West Peoria by sponsering the 4th of July Parade and Flag Raising at at West Peoria veterans memorial. We support the West Peoria Boy Scouts Troop 11 and Cub Scouts Pack 11 and help with the West Peoria Jamboree. We help with the Night Out Against Crime and Bicycle Rodeo. We help with the West Peoria Cleanup Day and and pick up trash on 2 miles of Route 8 three time a year. We provided and delivered 14 Christmas Baskets and helped with the West Peoria Residents Association Christmas party. We help support the West Peoria Volunteer Fire Deptment.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 29a 1,062
30 The Club raised funds for the American Diabetes Association. The American Diabetes Association provided all of the pamplets and handouts. There were no expenses by the Club and all money collected, 725.00 dollars, were sent to the American Diabetes Association.
(Grants $ 725) If this amount includes foreign grants, check here ...MediumBullet		 30a 725
The Club raised funds for the International Association of Lions, Disaster Relief fund. There were no expenses to the Club. The total amount collected, 306 dollors, were sent to the International Association of Lions, Disaster Relief fund.
(Grants $ 306) If this amount includes foreign grants, check here ...MediumBullet		 306
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 7,577
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
Carolyn McCarter
2117 W Edna CT
West Peoria,IL61604
 President2 0 0 0
Jim McCarter
2117 W Edna Ct
West Peoria,IL61604
 Secretary3 0 0 0
Terry Masters
2112 W Edna Ct
West Peoria,IL616046023
 Treasurer1 0 0 0
Ann Masters
215 W Sam J Stone Ave Apt 406
Peoria,IL61605
 Director1 0 0 0
Emil Henrich
6926 Stalworth Dr Apt 327
Peoria,IL61615
 Director1 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
 
No
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 bulletTerry Masters Telephone no. bullet (309) 674-2451
Located at bullet2112 W Edna Ct
West Peoria,IL ZIP + 4bullet616046023
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: 10000077
Software Version: v1.00

Form 990-EZ, Special Condition Description:
Special Condition Description
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
INTERNATIONAL ASSOCIATION OF LIONS CLUBS West Peoria
 
Employer identification number

37-1124789
Identifier Return Reference Explanation
F99Z_P01_S00_L08 Form 990-EZ, Part I, Line 8 Funds donated by the members of the West Peoria Lions Club to cover club expenses. The expenses include the total costs of meals during the meetings, cost of pins, name tags,banners, money from members at fund raising events, and the collecting and selling of aluminum cans, tabs, and other recyclable items.
F99Z_P01_S00_L16 Form 990-EZ, Part I, Line 16 General club expenses such as meeting meals, club awards, pins, badges, other club supplies from the International Associations of Lions, club fees, banners, signs, shirts, and office supllies.
F99Z_P03_S00_L28 Form 990-EZ, Part III, Line (28-31) Line 31, Raised money for the International Association of Lions, Disaster Relief Fund. The total amount collected was sent to the Disaster Relief Fund. $306.
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

Additional Data


Software ID: 10000077
Software Version: v1.00

TY 2010 ReasonableCauseExplanation
Name:
INTERNATIONAL ASSOCIATION OF LIONS CLUBS West Peoria
EIN: 37-1124789
Software ID:10000077
Software Version:v1.00
Explanation:
I thought that I had sent a 2010 990-N e post card for the tax year 2010 for the West Peoria Lions Club. I must of made a mistake when I sent the 2010 990-N E postcard but I did not rememmber to watch for the Email verification that my 990-N epost card had been accepted by the IRS. I received a letter from the IRS this month, that they had not received my 2010 990-N Epost card but that they had recieved and aaccepted my 2011 990-N E post Card. I will send a copy of this form 990-EZ 2010 in with the response form included with the the letter from the IRS informing me of the problem with the clubs 2010 990-N E post card.