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.") . | 609,768 | 581,918 | 521,398 | 612,403 | 732,009 | 3,057,496 |
| 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...... | 472,876 | 484,259 | 462,726 | 451,562 | 488,938 | 2,360,361 |
| 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. | 1,082,644 | 1,066,177 | 984,124 | 1,063,965 | 1,220,947 | 5,417,857 |
| 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.) | 5,417,857 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,082,644 | 1,066,177 | 984,124 | 1,063,965 | 1,220,947 | 5,417,857 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 39,929 | 50,502 | 19,065 | 29,556 | 30,524 | 169,576 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 39,929 | 50,502 | 19,065 | 29,556 | 30,524 | 169,576 |
| 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.). | 5,587,433 | |||||




| 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 3 | EMS CONTRACTED OUT TO PROFESSIONAL ORGANIZATION VINTECH MANAGEMENT | |
| Pt VI, Line 6 | ORGANIZATION HAS VOLUNTEER MEMBERS | |
| Pt VI, Line 7a | VOLUNTEER MEMBERS VOTE IN GOVERNING BODY | |
| Pt VI, Line 7b | MEMBERS VOTE ON DECISIONS OF GOVERNING BODY | |
| Pt VI, Line 8a | MINUTES ARE KEPT OF GOVERNING BODY AND MEMBERSHIP MEETINGS | |
| Pt VI, Line 8b | MINUTES NOT REQUIRED FOR SPECIAL COMMITTEES | |
| Pt VI, Line 11a | FORM 990 AVAILABLE TO GOVERNING BODY BUT NOT DIRECTLY PROVIDED | |
| Pt XI | OTHER CHANGES IN NET ASSETS LINE 5 FROM SECURITIES MARKET ADJ | |
| Pt VI, Line 19 | DOCUMENTS AVAILABLE UPON REQUEST | |
| Form 990, Part IX, Line 24f | CONTRACTED EMS BILLING SERVIC 55199. 55199. EMS SUPPLIES 30620. 30620. SMALL EQUIPMENT 41995. 41995. TRAINING, CERTIFICATION 9448. 9448. TELEPHONE 7441. 744. 6697. COMMINICATION EXPENSES 1128. 113. 1015. OPEN HOUSE & KIDS DAY 4263. 4263. OFFICE/ADMINISTRATIVE EXPENSES 4482. 4482. FUND DRIVE EXPENSES 6818. 6818. DANCE COSTS 5982. 5982. FIREMANS WELFARE, RECREATION 12858. 12858. OTHER EXPENSES 115. 115. ENVIRONMENTAL 1387. 1387. CONTRACTED EMS SERVICES 478283. 478283. |
| Software ID: | 11000175 |
| Software Version: |