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? |
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|---|---|---|---|---|---|---|---|---|---|
| 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.") .... | 283,629 | 252,296 | 140,990 | 206,552 | 159,196 | 1,042,663 |
| 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.. | 283,629 | 252,296 | 140,990 | 206,552 | 159,196 | 1,042,663 |
| 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. | 1,042,663 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 283,629 | 252,296 | 140,990 | 206,552 | 159,196 | 1,042,663 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,796 | 3,235 | 1,531 | 399 | 261 | 7,222 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | 80,967 | 11,321 | 50 | 92,338 | ||
| 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). | 1,142,223 | |||||






| 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 | 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) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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 |
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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 6 | Section A: The Board of Directors shall manage the affairs | |
| of the organization and shall be the final authority on | ||
| matters of policy directing the activities of the | ||
| organization. The board shall consist of a board chair, | ||
| and the remainder of board membership will be no more | ||
| than 52 members as follows: preferably two from each | ||
| judicial circuit (20); 6 members who shall be people who | ||
| have directly experienced a mental illness and/or | ||
| substance use disorder and/or families members of a | ||
| person who has directly experienced a mental illness | ||
| and/or substance use disorder; and 6 members from | ||
| professional associations who represents individuals, | ||
| families, providers and criminal justice. In voting | ||
| matters before the board, each board member will have one | ||
| vote per member. Officers of the organization shall | ||
| be elected by the board. | ||
| Pt VI, Line 12c | Section B: In making decisions subject to their policy, | |
| the Board of Directors shall, to the best of its ability, | ||
| obtain and rely upon appropriate data as to | ||
| comparability, such as information about compensation | ||
| paid by similarly situated organizations for similar | ||
| goods or services, current compensation surveys compiled | ||
| by independent firms, or actual written offers from | ||
| similarly situated organizations. These items are | ||
| monitored to ensure conflicts do not arise. No board | ||
| member may vote upon a matter in which he or she has a | ||
| Form 990, Part IX, Line 24f | BANK CHARGES 696. 0. 696. 0. FUNDRAISING EXPENSE 2806. 0. 0. 2806. GIFT 1085. 0. 1085. 0. JEP EXPENSE 22225. 15375. 6850. 0. POSTAGE 437. 0. 437. TELEPHONE 3365. 0. 2667. 698. | |
| direct financial interest, or in which he or she has a | ||
| busines or family relationship with anyone who has a | ||
| direct financial interest. Each board member is required | ||
| to sign on an annual basis Florida Partners in Crisis | ||
| Conflict of Interest policy statement. | ||
| Pt VI, Line 19 | They are available upon request. | |
| Pt VI, Line 11a | A copy of the return is given to Board members to review | |
| at the board meeting before it is filed. | ||
| Pt XI | Difference in tax and book depreciation | |
| Pt VI, Line 15 | Compensation is set by the Executive Committee of the Board | |
| and then approved by the Board of Directors. |
| Software ID: | 11000175 |
| Software Version: |