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.") . | 11,268 | 18,911 | 8,106 | 5,582 | 13,239 | 57,106 |
| 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. | 11,268 | 18,911 | 8,106 | 5,582 | 13,239 | 57,106 |
| 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.) | 57,106 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 11,268 | 18,911 | 8,106 | 5,582 | 13,239 | 57,106 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,163 | 618 | 957 | 242 | 125 | 3,105 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,163 | 618 | 957 | 242 | 125 | 3,105 |
| 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.) | 1,919 | 500 | 2,419 | |||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 62,630 | |||||




| Facts And Circumstances Test |
|---|
| OTHER ADDL INFO: PART III, SECTION A - 1(E) UNUSUAL GRANTS/CONTRIBUTIONS; CONTRIBUTION OF UNDEVELOPED LAND BY THE COONECTICUT; FOREST AND PARK ASSOCIATION, INC. APPRAISED VALUE OF; $190,000. THIS WAS A NON-CASH GIFT.; OTHER INCOME PART III, LINE 12; DESCRIPTION: SPECIAL EVENT; 2007: 0.; 2008: 1919.; 2009: 0.; 2010: 0.; 2011: 0.; DESCRIPTION: SCRAP METAL SALE; 2007: 0.; 2008: 0.; 2009: 0.; 2010: 0.; 2011: 500.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 4 | New Bylaws and an Amended and Restated Certificate | |
| of Incorporation were adopted in 2011. | ||
| Pt VI, Line 6 | Current contributors of $20 or more are classified as | |
| members of the organization. | ||
| Pt VI, Line 7a | Contributors of $20 or more are classified as members | |
| and may vote in the election of board members and | ||
| and on other matters at the annual meeting. | ||
| A slate of directors is proposed by the | ||
| current board and nominations may also be made from | ||
| the floor. | ||
| Pt VI, Line 11a | Form 990 is presented to the President & Treasurer for | |
| review before filing. The Form 990 as filed is then | ||
| presented to the Board of Directors at the next | ||
| scheduled meeting. | ||
| Pt VI, Line 19 | All related documents are available upon written | |
| request. | ||
| Pt VI, Line 12c | All NHLT Board and committee members receive a copy of | |
| the Conflict of Interest policy and related procedures | ||
| at the beginning of their term, and the policy is | ||
| explained for their benefit. In addition, the policy | ||
| will be discussed during the recruitment process for | ||
| new Board members. All Insiders shall be required to | ||
| complete and sign a certification and disclosure form, | ||
| on an annual basis, regarding conflicts of interest, | ||
| affirming that he or she: | ||
| 1) has received a copy of the Conflict of Interest Policy; | ||
| 2) has read and understands the policy; | ||
| 3) has agreed to comply and is in compliance with | ||
| the policy; | ||
| 4) shall disclose to the Board or Executive Committee | ||
| the existence of any conflict of interest; and, | ||
| 5) understands that NHLT is a charitable organization | ||
| and in order to maintain its federal tax exempt | ||
| status it must engage solely in activities that | ||
| accomplish one or more of its tax-exempt | ||
| purposes, without private inurement or | ||
| impermissible private benefit. | ||
| New policies enacted 12/20/10. |
| Software ID: | 11000175 |
| Software Version: |