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.") .... | 319 | 1,098 | 142 | 189 | 100 | 1,848 |
| 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.. | 319 | 1,098 | 142 | 189 | 100 | 1,848 |
| 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. | 1,848 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 319 | 1,098 | 142 | 189 | 100 | 1,848 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 130 | 351 | 289 | 211 | 91 | 1,072 |
| 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). | 2,920 | |||||






| 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.") . | 187,000 | 184,341 | 214,922 | 231,732 | 285,798 | 1,103,793 |
| 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...... | 129,022 | 128,852 | 137,141 | 136,628 | 143,528 | 675,171 |
| 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. | 316,022 | 313,193 | 352,063 | 368,360 | 429,326 | 1,778,964 |
| 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.) | 1,778,964 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 316,022 | 313,193 | 352,063 | 368,360 | 429,326 | 1,778,964 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | |||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| 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. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | |||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 316,022 | 313,193 | 352,063 | 368,360 | 429,326 | 1,778,964 |




| Facts And Circumstances Test |
|---|
| 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 IX | 24e | HALL OF FAME EXPENSES - 10441.24,MEETING EXPENSE - 21700.33 |
| Form 990 Part VI | 9 | DARRIN DUISTERMARS,PRESIDENT, 353 N. 120TH AVE, HOLLAND, MI. 49422 |
| Form 990 Part VI | 9 | TROY STOWELL, PRESIDENT ELECT, 200 N. FOSTER, LANSING, MI., 48912 |
| Form 990 Part VI | 9 | ART SERAFINSKI, VICE PRESIDENT, 2025 E. CLARK RD., YPSILANTI, MI 48198 |
| Form 990 Part VI | 9 | ERIC VAN HEVEL, JUNIOR OLYMPIC COMM., 500 E. WASHINGTON ST., ADRIAN MMI. 48118 |
| Form 990 Part VI | 9 | KEITH FRANK, PAST PRESIDENT, 522 SMITH ST., EAST TAWAS, MI. 48730 |
| Form 990 Part VI | 9 | DUSTIN LENT, PLAYER REP., 135 E MAUMEE ST., ADRIAN, MI., 49221 |
| Form 990 Part VI | 9 | JOHN HARRIS, PLAYER REP.,6234 KINGSHIRE RD.,GRAND BLANC, MI. 48439 |
| Form 990 Part VI | 9 | MARY SCHEURER, PLAYER REP., 259 KENT ST., PORTLAND, MI. 48875 |
| Form 990 Part VI | 9 | GARY EVANS, STATE UIC, 325 W. WILLOW, MASON, MI. 38854 |
| Form 990 Part VI | 9 | MIKE DELEO, REGIONAL UIC, 1049 S. 10TH ST. AU GRES, MI. 48703 |
| Form 990 Part VI | 9 | ANTHONY MORENO, MEMBER AT LARGE, 310 N. FRANKS AVE., STURGIS, MI 49091 |
| Form 990 Part VI | 9 | DICK BENKERT, MEMBER AT LARGE, 11284 COBBLESTONE DRIVE, GRAND LEDGE, MI. 48837 |
| Form 990 Part IX Line 24e HALL OF FAME EXPENSES - 10441.24,MEETING EXPENSE - 21700.33 Form 990 Part VI Section A Line 9 DARRIN DUISTERMARS,PRESIDENT, 353 N. 120TH AVE, HOLLAND, MI. 49422 Form 990 Part VI Section A Line 9 TROY STOWELL, PRESIDENT ELECT, 200 N. FOSTER, LANSING, MI., 48912 Form 990 Part VI Section A Line 9 ART SERAFINSKI, VICE PRESIDENT, 2025 E. CLARK RD., YPSILANTI, MI 48198 Form 990 Part VI Section A Line 9 ERIC VAN HEVEL, JUNIOR OLYMPIC COMM., 500 E. WASHINGTON ST., ADRIAN MMI. 48118 Form 990 Part VI Section A Line 9 KEITH FRANK, PAST PRESIDENT, 522 SMITH ST., EAST TAWAS, MI. 48730 Form 990 Part VI Section A Line 9 DUSTIN LENT, PLAYER REP., 135 E MAUMEE ST., ADRIAN, MI., 49221 Form 990 Part VI Section A Line 9 JOHN HARRIS, PLAYER REP.,6234 KINGSHIRE RD.,GRAND BLANC, MI. 48439 Form 990 Part VI Section A Line 9 MARY SCHEURER, PLAYER REP., 259 KENT ST., PORTLAND, MI. 48875 Form 990 Part VI Section A Line 9 GARY EVANS, STATE UIC, 325 W. WILLOW, MASON, MI. 38854 Form 990 Part VI Section A Line 9 MIKE DELEO, REGIONAL UIC, 1049 S. 10TH ST. AU GRES, MI. 48703 Form 990 Part VI Section A Line 9 ANTHONY MORENO, MEMBER AT LARGE, 310 N. FRANKS AVE., STURGIS, MI 49091 Form 990 Part VI Section A Line 9 DICK BENKERT, MEMBER AT LARGE, 11284 COBBLESTONE DRIVE, GRAND LEDGE, MI. 48837 |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |