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.") .... | 165,081 | 156,645 | 169,927 | 172,581 | 144,666 | 808,900 |
| 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.. | 165,081 | 156,645 | 169,927 | 172,581 | 144,666 | 808,900 |
| 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).. | 132,425 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 676,475 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 165,081 | 156,645 | 169,927 | 172,581 | 144,666 | 808,900 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,621 | 1,958 | 1,611 | 1,310 | 793 | 10,293 |
| 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). | 819,193 | |||||






| 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.) | ||||||
| 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: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | EXPENSES OFFICE SUPPLIES 1,194 TRAVEL 1,138 CONFERENCES/MEETINGS 2,684 INSURANCE 6,089 POSTAGE 935 TELEPHONE 1,897 PROMOTIONS 18,176 COMMUNITY ACTIVITIES 18,468 DUES AND SUBSCRIPTIONS 1,599 REPAIRS AND MAINTENANCE 348 NON-INVESTMENT DEPRECIATION 1,735 TOTAL 54,263 |
| OTHER ASSETS | FORM 990-EZ, PART II, LINE 24 | ACCOUNTS RECEIVABLE 42,097 17,667 PREPAID EXPENSES AND DEFERRED CHARGES 2,334 5,633 22,884 22,884 LESS ACCUMULATED DEPRECIATION 19,031 20,766 INTEREST RECEIVABLE 176 0 TOTAL 48,460 25,418 |
| OTHER LIABILITIES | FORM 990-EZ, PART II, LINE 26 | ACCOUNTS PAYABLE AND ACCRUED EXPENSES 1,586 1,484 PAYROLL LIABILITIES 7,376 7,253 CUSTODIAL FUNDS 0 12,134 |
| Software ID: | |
| Software Version: |
| Person Name | Explanation |
|---|---|
| MARTIN DISTELHORST | |
| COSMO LEONE | |
|
DARREN GRIMSHAW BURLINGTON POLICE DEPT |
|
|
DAVID CAVENDER ADDS |
|
| BETH OLDFIELD | |
| REBECCA KUSTER | |
| ROCKY ROXLAU | |
|
JIM TOWLERTON GREAT RIVER MEDICAL CENTER |
|
|
KARA ROBERTS SIAPPC |
|
|
KELLI JOHNSON FARMERS MERCHANTS BANK TRUST |
|
|
MATT MURRAY BURLINGTON CITY COUNCIL |
|
| AMY HOLTKAMP | |
|
MICHELLE RANDALL GRADE A PLUS |
|
|
PAM DETTMAN DES MOINES COUNTY ATTORNEYS OFFICE |
|
| WB TRANSFORMERS | |
|
REV SHANE MCCAMPBELL RELIGIOUS |
|
|
RUSS FRY AT LARGE |
|
|
SANDY KRELLANDRE SOUTHEASTERN COMMUNITY COLLEGE |
|
| TAMARA LEVINSON | |
| MICHAEL WARNER | |
| CARL BEHNE |