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.. | ||||||
| 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.") . | 287,737 | 24,411 | 50,198 | 64,211 | 26,061 | 452,618 |
| 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...... | 18,803 | 45,920 | 24,299 | 16,792 | 17,547 | 123,361 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 32,382 | 32,382 | ||||
| 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. | 306,540 | 70,331 | 74,497 | 81,003 | 75,990 | 608,361 |
| 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.) | 608,361 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 306,540 | 70,331 | 74,497 | 81,003 | 75,990 | 608,361 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 7,489 | 16,647 | 18,610 | 14,656 | 5,237 | 62,639 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 7,489 | 16,647 | 18,610 | 14,656 | 5,237 | 62,639 |
| 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.). | 314,029 | 86,978 | 93,107 | 95,659 | 81,227 | 671,000 |




| 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 | 6 | MEMBERSHIP IS AVAILABLE TO ALL PEOPLE AGE 50 OR OLDER FOR A MEMBERSHIP FEE OF 15 PER YEAR. |
| Form 990 Part VI | 7A | A BOARD OF DIRECTORS IS ELECTED BY THE MEMBERSHIP. EACH BOARD MEMBER IS ELECTED FOR A TERM OF THREE YEARS WITH ONE THIRD OF THE SEATS UP FOR ELECTION EACH YEAR. WHILE BOARD MEMBERS MAY RUN FOR MULTIPLE TERMS, THEY MAY ONLY SERVE TWO TERMS IN DIRECT SUCCESSION. |
| Form 990 Part VI | 7B | WHILE THE BOARD OF DIRECTORS HAS THE AUTHORITY TO CARRY OUT BUSINESS ON BEHALF OF THE MEMBERSHIP, MAJOR DECISIONS ARE BROUGHT TO THE MEMBERSHIP FOR DISCUSSION AND APPROVAL PRIOR TO ACTION |
| Form 990 Part VI | 11A | COPES OF FORM 990 ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS ON PREMISES OR THROUGH INTERNET DOWNLOAD. |
| Form 990 Part VI | 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE FOR REVIEW AT THE SENIOR CENTER DURING DAYTIME BUSINESS HOURS. |
| Form 990 Part XI | 5 | CHANGE WAS DUE TO UNREALIZED GAIN ON INVESTMENT HOLDINGS |
| Form 990 Part VI Section A Line 6 MEMBERSHIP IS AVAILABLE TO ALL PEOPLE AGE 50 OR OLDER FOR A MEMBERSHIP FEE OF 15 PER YEAR. Form 990 Part VI Section A Line 7A A BOARD OF DIRECTORS IS ELECTED BY THE MEMBERSHIP. EACH BOARD MEMBER IS ELECTED FOR A TERM OF THREE YEARS WITH ONE THIRD OF THE SEATS UP FOR ELECTION EACH YEAR. WHILE BOARD MEMBERS MAY RUN FOR MULTIPLE TERMS, THEY MAY ONLY SERVE TWO TERMS IN DIRECT SUCCESSION. Form 990 Part VI Section A Line 7B WHILE THE BOARD OF DIRECTORS HAS THE AUTHORITY TO CARRY OUT BUSINESS ON BEHALF OF THE MEMBERSHIP, MAJOR DECISIONS ARE BROUGHT TO THE MEMBERSHIP FOR DISCUSSION AND APPROVAL PRIOR TO ACTION Form 990 Part VI Section B Line 11A COPES OF FORM 990 ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS ON PREMISES OR THROUGH INTERNET DOWNLOAD. Form 990 Part VI Section C Line 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE FOR REVIEW AT THE SENIOR CENTER DURING DAYTIME BUSINESS HOURS. Form 990 Part XI Line 5 CHANGE WAS DUE TO UNREALIZED GAIN ON INVESTMENT HOLDINGS |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |