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. | 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.. | 0 | |||||
| 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.") . | 1,090,873 | 430,837 | 416,794 | 530,630 | 558,817 | 3,027,951 |
| 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...... | 1,478 | 1,478 | ||||
| 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. | 1,090,873 | 430,837 | 416,794 | 530,630 | 560,295 | 3,029,429 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 20,000 | 119,025 | 100,500 | 230,610 | 177,485 | 647,620 |
| 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.. | 20,000 | 119,025 | 100,500 | 230,610 | 177,485 | 647,620 |
| 8 | Public Support (Subtract line 7c from line 6.) | 2,381,809 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,090,873 | 430,837 | 416,794 | 530,630 | 560,295 | 3,029,429 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 35,461 | 76,372 | 1,956 | 1,397 | 826 | 116,012 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 35,461 | 76,372 | 1,956 | 1,397 | 826 | 116,012 |
| 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.). | 3,145,441 | |||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | The Treasurer presented the 990 to the Board of Directors | |
| Pt VI, Line 11a | on August 14, 2012 using the article published by | |
| Pt VI, Line 11a | PPC in their Nonprofit Update, "Board Review of 990", published April 2009. | |
| Pt VI, Line 12c | The governance committee regularly reviews transactions | |
| Pt VI, Line 12c | to determine if a conflict exists. | |
| Pt VI, Line 2 | There is a husband and wife on the Board of Directors | |
| Pt VI, Line 19 | The documents are provided upon request. The 990 is | |
| Pt VI, Line 19 | published on Guidestar. | |
| Pt VI, Line 15 | The Executive Committee's combined knowledge of other | |
| Pt VI, Line 15 | similarly situated (size, geography, population served) | |
| Pt VI, Line 15 | organizations was the basis used for comparative data. | |
| Pt XI | Rounding | |
| Form 990, Part IX, Line 24f | REPAIRS AND MAINTENANCE 14536. 14536. 0. 0. TRAINING AND EDUCATION 404. 0. 404. 0. BANK CHARGES 1617. 0. 1617. 0. MEALS AND ENTERTAINMENT 711. 711. 0. 0. MISCELLANEOUS 839. 420. 419. 0. PROPERTY TAXES 3294. 3294. 0. 0. REGISTRATION/FEES/DUES 3284. 2299. 985. 0. FUEL 1538. 1538. 0. 0. PRINTING 1091. 0. 0. 1091. VEHICLE MAINTENANCE 334. 334. 0. 0. |
| Software ID: | 11000175 |
| Software Version: |