Form990-EZ
Click to see list of attachments
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
bullet Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
bulletThe organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
2011
Open to Public
Inspection
A
For the 2011 calendar year, or tax year beginning 01-01-2011, and ending 12-31-2011
B
Check if applicable:
C Name of organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC
Number and street (or P. O. box, if mail is not delivered to street address)PO BOX 1333
  Room/suite
City or town, state or country, and ZIP + 4 DUNDEE, FL33838
D Employer identification number

20-2367388
E Telephone number

(863) 439-4320
F Group Exemption
Number. . bullet  
G Accounting method: Other (specify) bullet   H Check bulletI Website:bulletN/AJ Tax-Exempt status(check only one)—Click to see attachment(   ) bullet(insert no.) or
K Check bullet A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more,file Form 990 instead of Form 990-EZ........... bullet $ 85,463
Part IRevenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I.)Check if the organization used Schedule O to respond to any question in this Part I...........
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received............... 1 85,463
2 Program service revenue including government fees and contracts ............ 2  
3 Membership dues and assessments...................... 3  
4 Investment income........................... 4  
5a Gross amount from sale of assets other than inventory........ 5a  
b Less: cost or other basis and sales expenses........... 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ...... 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) . 6a  
b Gross income from fundraising events (not including $   of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) 6b  
c Less: direct expenses from gaming and fundraising events....... 6c  
d Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c) 6d  
7a Gross sales of inventory, less returns and allowances........ 7a  
b Less: cost of goods sold................. 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ......... 7c  
8 Other revenue (describe in Schedule O) ..................... 8  
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8................. 9 85,463
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ................. 10 53,016
11 Benefits paid to or for members........................ 11  
12 Salaries, other compensation, and employee benefits................ 12 22,102
13 Professional fees and other payments to independent contractors............ 13 0
14 Occupancy, rent, utilities, and maintenance................... 14 2,861
15 Printing, publications, postage, and shipping................... 15 1,609
16 Other expenses (describe in Schedule O) .................... 16 18,452
17 Total expenses. Add lines 10 through 16 .................... 17 98,040
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9)............ 18 -12,577
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return)................ 19 35,695
20 Other changes in net assets or fund balances (explain in Schedule O) .......... 20 0
21 Net assets or fund balances at end of year. Combine lines 18 through 20.........Bullet 21 23,118
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2011)
Form 990-EZ (2011)
Page 2
Part IIBalance Sheets (see the instructions for Part II.)Check if the organization used Schedule O to respond to any question in this Part II.............

(See the instructions for Part II.)(A) Beginning of year(B) End of year
22Cash, savings, and investments................
34,997
22
22,744
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
875
24
630
25Total assets......................
35,872
25
23,374
26
Total liabilities (describe in Schedule O) .............
177
26
256
27Net assets or fund balances (line 27 of column (B) must agree with line 21)..
35,695
27
23,118
Part IIIStatement of Program Service Accomplishments (see the instructions for Part III.) Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? REBUILDING TOGETHER OF POLK COUNTY'S MISSION IS TO BRING VOLUNTEERS AND COMMUNITIES TOGETHER TO IMPROVE THE HOMES AND LIVES OF HOMEOWNERS IN NEED. PROGRAMS FOCUS ON SERVING THE ELDERLY, THE DISABLED, VETERANS, ACTIVE DUTY SERVICE MEMBER'S FAMILIES AND FAMILIES WITH YOUNG CHILDREN, AS WELL AS NON-PROFITS SERVING THESE COMMUNITIES. EMPHASIS IS ON LOW INCOME HOMEOWNERS.THE ORGANIZATION CONTINUES IT'S ROLE IN DISASTER RECOVERY, MAINTAINING A CLOSE WORKING RELATIONSHIP WITH LOCAL EMERGENCY MANAGEMENT, PARTICIPATING IN DISASTER RESPONSE TRAINING AND EXERCISES, AND OFFERING DISASTER PREPAREDNESS TRAINING TO THE LOCAL COMMUNITY.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 CASE MANAGEMENT - CASE MANAGEMENT IS A METHOD OF PROVIDING SERVICES WHEREBY THE CASE MANAGER ASSESSES THE NEEDS OF THE CLIENT AND DEVELOPS A PLAN WITH THE CLIENT TO ADDRESS THOSE NEEDS. CASE MANAGEMENT INVOLVES BOTH THE CLIENT AND THE RESOURCES. CASE MANAGERS WORK WITH CLIENTS UNTIL THE CASE IS RESOLVED AND NEEDS ARE MET TO THE BEST OF THE ORGANIZATION'S ABILITIES. DURING 2011, THE ORGANIZATION WORKED ON 47 CASES. OF THESE, 14 CASES WERE CLOSED DUE TO NON RETURN OF THE APPLICATION. ANOTHER 8 DID NOT QUALIFY FOR THE SERVICES.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 28a 0
29 DURING 2011, THERE WAS ONE UNDECLARED DISASTER IN POLK COUNTY. THE HOMEOWNERS AFFECTED BY THE MARCH TORNADO WERE ALL INSURED. WHILE THE ORGANIZATION CONTINUED TO WORK WITH EMERGENCY MANAGEMENT TO OFFER PREPAREDNESS TECHNIQUES TO RESIDENTS, THERE WAS NO NEED OF CASE WORK OR REPAIR ASSISTANCE IN THIS CATEGORY. THE FOCUS IN 2011 WAS WORKING WITH POLK COUNTY GOVERNMENT AND EMERGENCY MANAGEMENT TO DEVELOP THE DISASTER HOUSING TASK FORCE. POLK COUNTY GOVERNMENT REC'D FUNDING THROUGH A STATE GRANT TO COMPLETE THIS. EVERY COUNTY IN FLORIDA WAS REQUIRED TO FORM A DISASTER HOUSING TASK FORCE AND COMPLETE A DISASTER HOUSING PLAN.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 29a 0
30 THE ORGANIZATION WORKS WITH VOLUNTEERS TO REPAIR HOMES OF LOW INCOME HOMEOWNERS. DURING 2011, 15 PROJECTS WERE COMPLETED. 90% OF THE WORK WAS COMPLETED BY VOLUNTEERS. 280 VOLUNTEERS SERVED 1,585.45 HOURS FOR A VALUE OF $91,026.31. ONE OF THESE PROJECTS WAS A RENOVATION OF A FORMER BED AND BREAKFAST THAT IS NOW USED AS A HOME FOR SINGLE MOMS SPONSORED BY A NON-PROFIT IN HAINES CITY, FL. SIX ROOMS WERE REPAINTED, THE KITCHEN REC'D ALL NEW CABINETS AND FLOORING, TWO EXTERIOR DOORS WERE REPLACED, FIVE BATHROOMS REC'D NEW EXHAUST FANS, SIX SMOKE ALARMS AND ONE CARBON MONOXIDE ALARM WERE INSTALLED, FOUR WARDROBES WERE PROVIDED, ONE FORMER BATHROOM WAS RENOVATED TO A UTILITY CLOSET WITH SHELVING, THE GROUNDS WERE LANDSCAPED, THE SIDEWALK WAS WIDENED TO ACCOMMODATE A WHEELCHAIR, THE WHEELCHAIR RAMP WAS REBUILT AND A 12X14 DECK WAS ADDED COMPLETE WITH BENCH SEATING. THE ORGANIZATION FOCUSED ON ITS VETERAN SERVICES PROGRAM THIS YEAR. 8 OF THE 15 COMPLETED PROJECTS WERE FOR MILITARY VETERANS.
(Grants $ 5,000) If this amount includes foreign grants, check here ...MediumBullet		 30a 90,370
UNMET NEEDS COMMITTEE - THIS VOLUNTEER COMMITTEE IS COMPRISED OF REPRESENTATIVES FROM VARIOUS ORGANIZATIONS THAT PROVIDE RESOURCES IN THE RECOVERY PROCESS FOR DISASTER-CAUSED HUMAN NEEDS. THIS COMMITTEE INCLUDES REPRESENTATIVES FROM MEMBER ORGANIZATIONS OF NATIONAL VOLUNTARY ORGANIZATIONS ACTIVE IN DISASTER AND AREA CHURCHES. THE PURPOSE OF THE COMMITTEE IS TO PLAN AND SUPERVISE SERVICE DELIVERY TO VICTIMS INCLUDING CASE MANAGEMENT. THE COMMITTEE IS DESIGNED TO STRENGTHEN AREA-WIDE DISASTER COORDINATION BETWEEN ALL ORGANIZATIONS TO ELIMINATE DUPLICATION OF EFFORT AND RESOLVE CASES ON A JOINTLY BASIS. THE COMMITTEE MEETS IN LAKE WALES, FLORIDA. DURING 2011, THIS COMMITTEE MET 1 TIME TO DISCUSS ORGANIZATIONAL MATTERS AND WHAT EACH ORGANIZATION WAS DOING AT THE PRESENT TIME IN RELATION TO THE DISASTER RECOVERY PROCESS. THE DISASTER HOUSING TASK FORCE WHICH WORKS WITH THIS COMMITTEE MET 5 TIMES IN 2011.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 0
31 Other program services (describe in Schedule O) ..................
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a)..............bullet 32 90,370
Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (see the instructions for Part IV.)Check if the organization used Schedule O to respond to any question in this Part IV..........
(a) Name and title (b) Average
hours per week
devoted to position		 (c)Reportable compensation
(Forms W-2/1099-MISC)
(if not paid, enter -0-) 		(d) Health benefits, contributions to employee benefit plans,
and deferred compensation		 (e) Estimated amount
of other compensation
JUNE BARNETT
2309 COVENTRY COURT
LAKELAND,FL33803
 PRESIDENT0.50 0 0 0
DIANA WOODHEAD
136 BERMUDA COURT
WINTER HAVEN,FL33880
 SECRETARY0.50 0 0 0
MILDRED MCMILLON
310 HEATHERPOINT DRIVE
LAKELAND,FL33809
 DIRECTOR0.30 0 0 0
TRIPP BARNETT
2309 COVENTRY COURT
LAKELAND,FL33803
 DIRECTOR0.30 0 0 0
KIMBRA FRENCH
2624 CANAL STREET
LAKELAND,FL33801
 DIRECTOR0.30 0 0 0
JANCI HURT
1804 4TH COURT SE
WINTER HAVEN,FL33880
 DIRECTOR0.30 0 0 0
MIKE MASON
415 GLENEAGLES COURT
WINTER HAVEN,FL33884
 DIRECTOR0.30 0 0 0
JOE DIONSI
1030 CANARY CIR S
LAKELAND,FL33809
 DIRECTOR0.30 0 0 0
ALICE SPIVEY
PO BOX 267
DUNDEE,FL33838
 EXECUTIVE DIRECTOR24.00 14,809 0 0
Form 990-EZ (2011)
Form 990-EZ (2011)
Page 3
Part VOther Information(Note the Schedule A and personal benefit contract statement requirements in the instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions). ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If ‘Yes’ to line 35a, has the organization filed a Form 990-T for the year? If ‘No,’ provide an explanation in Schedule O.
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III.
35c
 
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
0
b
Did the organization file Form 1120-POL for this year?...................
37b
 
 
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes,” complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet0 ; section 4912 bullet0 ; section 4955 bullet0
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ......
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958...bullet0
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization....................bullet0
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. ......................
40e
 
No
41List the states with which a copy of this return is filed. bullet
42aThe organization's books are in care of bulletALICE SPIVEY Telephone no. bullet (863) 439-4320
Located at bullet620 DUNDEE RD SUITE A
DUNDEE,FL ZIP + 4bullet33838
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes,” enter the name of the foreign country: bullet  
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside the U.S.?
42c
 
No
If “Yes,” enter the name of the foreign country: bullet  
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of
Form 990-EZ.................................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completedinstead of Form990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year?.........
44c
 
No
d
If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanationin Schedule O................................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of
section 512(b)(13)?............................
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form990-EZ (see instructions).....................
45b
 
No
Form 990-EZ (2011)
Form 990-EZ (2011)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes,” complete Schedule C, Part I. ..............
46
 
No
Part VI
Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI ...........
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
No
48
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ....
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
No
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and title of each employee paid more than $100,000 (b) Average
hours per week
devoted to position		 (c) Reportable compensation
(Forms W-2/1099-MISC) 		(d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation
NONE
f
Total number of other employees paid over $100,000 .................bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
d
Total number of other independent contractors each receiving over $100,000..........bullet  
52
Did the organization complete Schedule A? NOTE:All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A .....................
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2011)

Additional Data


Software ID:  
Software Version:  

Form 990-EZ, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC
Employer identification number

20-2367388
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(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                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
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.") .... 378,481 534,592 51,766 106,105 85,463 1,156,407
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.. 24,000 24,000 24,000 15,816 8,256 96,072
4 Total. Add lines 1 through 3.. 402,481 558,592 75,766 121,921 93,719 1,252,479
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.           1,252,479
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4.. 402,481 558,592 75,766 121,921 93,719 1,252,479
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 556 2,249       2,805
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).           1,255,284
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
99.780 %
15
15
99.840 %
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
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.)            
Section B. Total Support
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.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC
Employer identification number

20-2367388
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC 		Employer identification number

20-2367388
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC 		Employer identification number

20-2367388
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC 		Employer identification number

20-2367388
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC
Employer identification number

20-2367388
Identifier Return Reference Explanation
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: RICHARD & BETTY CARTER. AMOUNT GIVEN: 1,134.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: JOHN & DONNA WEEMS. AMOUNT GIVEN: 8,509.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: JAMES & GLORIA COSSAIRT. AMOUNT GIVEN: 8,908.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: DOROTHY MAITS. AMOUNT GIVEN: 1,400.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: CARL PALMER. AMOUNT GIVEN: 1,100.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: MICHAEL FLYNN. AMOUNT GIVEN: 475.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: MARK NORRIS. AMOUNT GIVEN: 6,071.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: CYRUS & JOAN KLEIN. AMOUNT GIVEN: 2,534.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: NANCY STORCH. AMOUNT GIVEN: 179.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: RITA & CHARLES CHILDRESS. AMOUNT GIVEN: 1,076.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: CHERYL COLLIER. AMOUNT GIVEN: 1,068.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: VERONICA WALSH. AMOUNT GIVEN: 96.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: DAVID & MARY WOJNAR. AMOUNT GIVEN: 213.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO INDIVIDUALS. GRANTEE NAME: WILLIAM & BARBARA SKINNER. AMOUNT GIVEN: 203.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO OTHER NON-PROFIT CENTERS. GRANTEE NAME: THE SUNSHINE FOUNDATION'S DREAM VILLAGE. GRANTEE ADDRESS: 5400 COUNTY ROAD 547 NORTH DAVENPORT, FL 33837. AMOUNT GIVEN: 7,386.
GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: SPECIFIC ASSISTANCE TO OTHER NON-PROFIT CENTERS. GRANTEE NAME: THE WAY HOME. GRANTEE ADDRESS: 106 1ST STREET HAINES CITY, FL 33844. AMOUNT GIVEN: 12,664. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 53,016.
OCCUPANCY, RENT, UTILITIES AND MAINTENENCE FORM 990-EZ, PART I, LINE 14 DESCRIPTION: DEPRECIATION. AMOUNT: 45. DESCRIPTION: OTHER EXPENSES. AMOUNT: 2,816. TOTAL TO FORM 990-EZ, LINE 14: 2,861.
OTHER EXPENSES FORM 990-EZ, PART I, LINE 16 DESCRIPTION: SUPPLIES. AMOUNT: 889. DESCRIPTION: TELEPHONE. AMOUNT: 2,436. DESCRIPTION: TRAVEL. AMOUNT: 4,646. DESCRIPTION: CONFERENCES, CONVENTIONS, MTGS. AMOUNT: 190. DESCRIPTION: BASIC TOOLS. AMOUNT: 1,977. DESCRIPTION: VOLUNTEER SUPPORT. AMOUNT: 1,385. DESCRIPTION: INSURANCE. AMOUNT: 2,126. DESCRIPTION: LICENSES AND FEES. AMOUNT: 253. DESCRIPTION: MISCELLANEOUS EXPENSE. AMOUNT: 233. DESCRIPTION: MEMBERSHIP DUES. AMOUNT: 4,317. TOTAL TO FORM 990-EZ, LINE 16: 18,452.
OTHER ASSETS FORM 990-EZ, PART II, LINE 24 DESCRIPTION: DEPOSITS. BEG. OF YEAR AMOUNT: 200. END OF YEAR AMOUNT: 0. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 675. END OF YEAR AMOUNT: 630.
OTHER LIABILITIES FORM 990-EZ, PART II, LINE 26 DESCRIPTION: ACCRUED PAYROLL TAXES. BEG. OF YEAR AMOUNT: 177. END OF YEAR AMOUNT: 256.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  

TY 2011 TransferPrsnlBnftContractsDecl
Name:
REBUILDING TOGETHER OF POLK COUNTY INC
FKA REBUILD POLK AFTER DISASTER INC
EIN: 20-2367388
Declaration:
THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.