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.") .... | ||||||
| 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. | ||||||
| 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.. | ||||||
| 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.") . | 51,466 | 60,081 | 57,477 | 154,145 | 24,805 | 347,974 |
| 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. | 51,466 | 60,081 | 57,477 | 154,145 | 24,805 | 347,974 |
| 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.) | 347,974 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 51,466 | 60,081 | 57,477 | 154,145 | 24,805 | 347,974 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6 | 27 | 4 | 37 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 6 | 27 | 4 | 37 | ||
| 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.). | 51,466 | 60,087 | 57,504 | 154,149 | 24,805 | 348,011 |




| Facts And Circumstances Test |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
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| 01. Officer, directors, etc. family relationship (Part VI, line 2) | OFFICER DENNIS WRIGHTS COMPANY SIMPLY IT INC WAS CONTRACTED TO PERFORM ADMINISTRATIVE SERVICES UNDER THE HEALTH GRANT FOR THE ORGANIZATION THE COMPANY WAS HIRED AS A CONTRACTOR AND PAID 7000 DURING THE 2011 TAX YEAR | |
| 02. Members or stockholder classes and rights (Part VI, line 6) | SECTION 2 CLASSES OF MEMBERSHIP THERE SHALL BE FOUR CLASSES OF MEMBERSHIP IN THE ORGANIZATION REGULAR ASSOCIATE SUPPORTING AND HONORARY ANY MAN TWENTY-ONE 21 YEARS OF AGE OR OLDER OF GOOD CHARACTER DEDICATED TO THE PURPOSES OF THIS ORGANIZATION SHALL BE ELIGIBLE FOR MEMBERSHIP UPON ACCEPTANCE OF HIS APPLICATION BY THE BOARD OF DIRECTORS PROVIDED HE MEETS THE REQUIREMENTS FOR ONE OF THE CLASSES OF MEMBERSHIP AS ESTABLISHED BY THE BOARD OF DIRECTORS IN THE MEMBERSHIP POLICY AND MAKES PAYMENT OF SUCH DUES AND INITIATION FEES AS MAY FROM TIME TO TIME BE FIXED BY THE BOARD OF DIRECTORS A REGULAR INDIVIDUALS WITH A REGULAR MEMBERSHIP DESIGNATION ARE ALLOWED TO ATTEND ALL MEMBERSHIP MEETINGS PROVIDE INPUT ON ALL DECISIONS NOT OTHERWISE RESERVED TO THE BOARD OF DIRECTORS | |
| 03. Local chapters, branches, affiliates (Part VI, line 10a) | THE ORGANIZATION IS GOVERNED BY THE BOARD OF DIRECTORS ONLY THE 100 BLACK MEN OF AMERICAS ROLE IS TO ONLY PROVIDE GUIDANCE BUT NOT GOVERNANCE | |
| 04. Form 990 governing body review (Part VI, line 11) | THE BOARD REVIEWS THE FORM 990 FOLLOWING COMPLETION PRIOR TO SUBMISSION TO THE IRS | |
| 05. Governing documents, etc, available to public (Part VI, line 19) | PROVIDED UPON REQUEST BY THE BOARD OF DIRECTORS | |
| 06. Significant program services not listed on prior year return (Part III, line 2) | MENTORING ACROSS LIFETIME PROGRAM IS A FAMILY FOCUS INITIATIVE TO MENTORING THE ENTIRE FAMILY TO HAVE A SUSTAINABLE IMPACT WITHIN OUR COMMUNITY WE NEED TO UNDERSTAND THE DYNAMICS OF THE FAMILY AND MENTOR FROM THAT CAPACITY THE MCE MINORITY CANCER EDUCATION IS A CANCER AWARENESS AND EDUCATION INITIATIVE FUNDED BY THE AMERICAN CANCER SOCIETY THIS INITIATIVE PROMOTES CANCER AWARENESS AND EDUCATION GEARED TOWARDS BLACK MEN WE PROVIDE ADVOCACY AND INFORMATION TO THE COMMUNITY THROUGH VARIES MEDIA OUTLETS TO INCLUDE RADIO COMMERCIALS NEWSPAPER ADS WEBSITE NEWSLETTERS RELAY FOR LIFE AND HEALTH FAIRS |
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