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.") .... | 7,100 | 18,091 | 69,515 | 78,153 | 95,223 | 268,082 |
| 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.. | 7,100 | 18,091 | 69,515 | 78,153 | 95,223 | 268,082 |
| 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).. | 40,000 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 228,082 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 7,100 | 18,091 | 69,515 | 78,153 | 95,223 | 268,082 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 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). | 268,082 | |||||






| 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.") . | 7,100 | 18,091 | 69,515 | 78,153 | 95,223 | 268,082 |
| 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. | 7,100 | 18,091 | 69,515 | 78,153 | 95,223 | 268,082 |
| 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.. | 40,000 | |||||
| 8 | Public Support (Subtract line 7c from line 6.) | 228,082 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 7,100 | 18,091 | 69,515 | 78,153 | 95,223 | 268,082 |
| 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.). | 268,082 | |||||




| 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 |
|---|---|---|
| PART I, LN 10: GRANTS & SIMILAR AMOUNTS PAID: BOYS & GIRLS CLUB....................................................$100 UNITED WAY OF CHAVES COUNTY..........................................120 COMMUNITY JUNETEENTH CELEBRATION.......................................25 DIOCESE OF RIO GRANDE CAMP STONEY FOR GRACE CAMP PROGRAM FOR CHILDREN OF INCARCERATED PARENTS .................................................350 PART I, LN 16: OTHER EXPENSES: PROGRAM EXP: SUPPLIES & REFRESH...................................$11,383 PROGRAM EXP: PROF & OTHER SVCS.....................................33,265 PROGRAM EXP: CHILD CARE ..............................................225 TRAINING, TRAVEL & MEALS............................................1,384 OVERHEAD & ADMIN: INSUR & LICENSES .................................1,160 OVERHEAD & ADMIN: OFFICE & TELEPHONE ...............................4,204 VOLUNTEER RELATIONS.................................................1,483 TOTAL TO LINE 16: ................................................$53,103 PART II, LN 24: OTHER ASSETS: COMPUTERS..........................................................$1,182 A/D - COMPUTERS .....................................................-395 FURNITURE & OFFICE EQUIP............................................5,232 A/D-FURNITURE & OFFICE EQUIP.........................................-841 TOTAL TO LINE 24...................................................$5,179 PART II, LN 26: TOTAL LIABILITIES: ADVANCE GRANTS RECEIVED...........................................$82,520 CREDIT CARDS PAYABLE..................................................618 PAYROLL TAXES PAYABLE...............................................2,070 TOTAL TO LINE 26..................................................$85,208 |
| Software ID: | |
| Software Version: |
| Person Name | Explanation |
|---|---|
| ROCHELLE SHELLY CURRIER | MS. CURRIER RECEIVES A SMALL SALARY FOR HER SERVICES AS EXECUTIVE DIRECTOR COORDINATING ALL THE ORGANIZATION'S PROGRAMS. |
| CHARMAINE L MARTIN | MS. MARTIN IS A PARTNER IN THE ACCOUNTING FIRM WHICH PREPARES THE ORGANIZATION'S PAYROLL TAX REPORTS AND FORM 990. THE FIRM IS COMPENSATED FOR THESE SERVICES. |
| CYNTHIA LUCERO | MS. LUCERO WAS COMPENSATED FOR HER SERVICES WITH THE BUILDING ASSETS PROGRAM. |
| BOBBY HEARD | IN ADDITION TO HIS DUTIES AS VICE PRESIDENT AND BOARD MEMBER, MR HEARD IS A LICENSED SOCIAL WORKER & PROVIDED SERVICES AS AN INDEPENDENT CONTRACTOR. HE RESIGNED HIS POSITION IN 2011. |
| Person Name | Explanation |
|---|---|
| ROCHELLE SHELLY CURRIER | MS. CURRIER RECEIVES A SMALL SALARY FOR HER SERVICES AS EXECUTIVE DIRECTOR COORDINATING ALL THE ORGANIZATION'S PROGRAMS. |
| CHARMAINE L MARTIN | MS. MARTIN IS A PARTNER IN THE ACCOUNTING FIRM WHICH PREPARES THE ORGANIZATION'S PAYROLL TAX REPORTS AND FORM 990. THE FIRM IS COMPENSATED FOR THESE SERVICES. |
| CYNTHIA LUCERO | MS. LUCERO WAS COMPENSATED FOR HER SERVICES WITH THE BUILDING ASSETS PROGRAM. |
| BOBBY HEARD | IN ADDITION TO HIS DUTIES AS VICE PRESIDENT AND BOARD MEMBER, MR HEARD IS A LICENSED SOCIAL WORKER & PROVIDED SERVICES AS AN INDEPENDENT CONTRACTOR. HE RESIGNED HIS POSITION IN 2011. |
| Person Name | Explanation |
|---|---|
| ROCHELLE SHELLY CURRIER | MS. CURRIER RECEIVES A SMALL SALARY FOR HER SERVICES AS EXECUTIVE DIRECTOR COORDINATING ALL THE ORGANIZATION'S PROGRAMS. |
| CHARMAINE L MARTIN | MS. MARTIN IS A PARTNER IN THE ACCOUNTING FIRM WHICH PREPARES THE ORGANIZATION'S PAYROLL TAX REPORTS AND FORM 990. THE FIRM IS COMPENSATED FOR THESE SERVICES. |
| CYNTHIA LUCERO | MS. LUCERO WAS COMPENSATED FOR HER SERVICES WITH THE BUILDING ASSETS PROGRAM. |
| BOBBY HEARD | IN ADDITION TO HIS DUTIES AS VICE PRESIDENT AND BOARD MEMBER, MR HEARD IS A LICENSED SOCIAL WORKER & PROVIDED SERVICES AS AN INDEPENDENT CONTRACTOR. HE RESIGNED HIS POSITION IN 2011. |
| Person Name | Explanation |
|---|---|
| ROCHELLE SHELLY CURRIER | MS. CURRIER RECEIVES A SMALL SALARY FOR HER SERVICES AS EXECUTIVE DIRECTOR COORDINATING ALL THE ORGANIZATION'S PROGRAMS. |
| CHARMAINE L MARTIN | MS. MARTIN IS A PARTNER IN THE ACCOUNTING FIRM WHICH PREPARES THE ORGANIZATION'S PAYROLL TAX REPORTS AND FORM 990. THE FIRM IS COMPENSATED FOR THESE SERVICES. |
| CYNTHIA LUCERO | MS. LUCERO WAS COMPENSATED FOR HER SERVICES WITH THE BUILDING ASSETS PROGRAM. |
| BOBBY HEARD | IN ADDITION TO HIS DUTIES AS VICE PRESIDENT AND BOARD MEMBER, MR HEARD IS A LICENSED SOCIAL WORKER & PROVIDED SERVICES AS AN INDEPENDENT CONTRACTOR. HE RESIGNED HIS POSITION IN 2011. |