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.. | 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.") . | ||||||
| 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...... | 796,673 | 844,921 | 902,329 | 893,797 | 858,897 | 4,296,617 |
| 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. | 796,673 | 844,921 | 902,329 | 893,797 | 858,897 | 4,296,617 |
| 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.) | 4,296,617 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 796,673 | 844,921 | 902,329 | 893,797 | 858,897 | 4,296,617 |
| 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.). | 4,296,617 | |||||




| 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 | PRESENTED TO GOVERNING BODY FOR REVIEW | |
| Pt VI, Line 12c | MONITORED AND ADDRESSED AS SUCH SITUATIONS WARRANT | |
| Pt VI, Line 15 | BOARD REVIEWS AND DETERMINES CHANGE IN SALARIES AS WARRANTED | |
| Form 990EZ, Part I, Line 16 | AUTOMOBILE EXPENSE BANK SERVICE CHARGES CONTRACT SERVICES CONTRIBUTIONS DUES AND SUBSCRIPTIONS CONSULTATION SERVICES EDUCATION LICENSES AND PERMITS INSURANCE PAGER JANITORIAL SERVICES SECURITY MOVING AND RELOCATION DRUG TESTING REFERENCE MATERIAL BUILDING REPAIRS TESTING MATERIALS TAXES UTILITIES OFFICE | |
| Form 990EZ, Part II, Line 24 | INVESTMENTS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES | |
| Form 990, Part IX, Line 24f | TAXES 7602. 0. 7602. 0. LICENSES AND PERMITS 1138. 1138. 0. 0. POSTAGE AND DELIVERY 740. 592. 148. 0. MISCELLANEOUS 1098. 1098. 0. 0. JANITORIAL SERVICES 2080. 2080. 0. 0. DRUG TEST SUPPLIES 3013. 3013. 0. 0. REFERENCE MATERIALS 1167. 1167. 0. 0. EDUCATION 11640. 11640. 0. 0. TELEPHONE 23385. 18708. 4677. 0. INSURANCE 59362. 47490. 11872. 0. REPAIRS 1895. 0. 1895. 0. DUES AND SUBSCRIPTIONS 5111. 5111. 0. 0. OTHER OPERATING SUPPLIES 1053. 0. 1053. 0. |
| Software ID: | 11000175 |
| Software Version: |