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.") .... | 331,552 | 341,645 | 343,239 | 359,894 | 271,395 | 1,647,725 |
| 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.. | 331,552 | 341,645 | 343,239 | 359,894 | 271,395 | 1,647,725 |
| 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. | 1,647,725 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 331,552 | 341,645 | 343,239 | 359,894 | 271,395 | 1,647,725 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 46,460 | 42,255 | 25,052 | 861 | 10 | 114,638 |
| 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). | 1,762,363 | |||||






| 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: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part VI | 11 | Upon receipt of the form 990 from the tax preparer the report is ciriculated to the executive board for their review all coments are forwarded to the president. The presidentif necessary calls an executive meeting to review any significant comment. The tax preparer may be call to such meeting. upon approval by the executive committee, the executive director is authorized to sign and the report or sign the 8879-EO form |
| Form 990 Part VI | 19 | The organizations governing documents conflict of interest policy and financial statements are available to the public upon request. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 500, Grants and allocations 0, Revenue 0 YOUTH PROGRAMS |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 525, Grants and allocations 0, Revenue 0 DAY CARE ASSISTANCE |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 418, Grants and allocations 0, Revenue 0 COMMUNITY RELATIONS COMMUNITY RELATIONS |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 3,760, Grants and allocations 0, Revenue 0 ECONOMIC DEVELOPMENT ECONOMIC DEVELOPMENT |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 PROPERTY REPAIRS PROPERTY REPAIRS |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 FUNERAL ASSISTANCE |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 14,870, Grants and allocations 0, Revenue 0 PROPERTY UTILITIES |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 129, Grants and allocations 0, Revenue 0 OTHER PROGRAM EXPENSES |
| Form 990, Part III, Line 4d Program Service Expenses 500, Grants and allocations 0, Revenue 0 YOUTH PROGRAMS Form 990, Part III, Line 4d Program Service Expenses 525, Grants and allocations 0, Revenue 0 DAY CARE ASSISTANCE Form 990, Part III, Line 4d Program Service Expenses 418, Grants and allocations 0, Revenue 0 COMMUNITY RELATIONS COMMUNITY RELATIONS Form 990, Part III, Line 4d Program Service Expenses 3,760, Grants and allocations 0, Revenue 0 ECONOMIC DEVELOPMENT ECONOMIC DEVELOPMENT Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 PROPERTY REPAIRS PROPERTY REPAIRS Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 FUNERAL ASSISTANCE Form 990, Part III, Line 4d Program Service Expenses 14,870, Grants and allocations 0, Revenue 0 PROPERTY UTILITIES Form 990, Part III, Line 4d Program Service Expenses 129, Grants and allocations 0, Revenue 0 OTHER PROGRAM EXPENSES Form 990 Part VI Section B Line 11 Upon receipt of the form 990 from the tax preparer the report is ciriculated to the executive board for their review all coments are forwarded to the president. The presidentif necessary calls an executive meeting to review any significant comment. The tax preparer may be call to such meeting. upon approval by the executive committee, the executive director is authorized to sign and the report or sign the 8879-EO form Form 990 Part VI Section C Line 19 The organizations governing documents conflict of interest policy and financial statements are available to the public upon request. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |