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. | ||||||
| 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.") . | 1,577,556 | 5,740 | 580,997 | 2,164,293 | ||
| 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...... | 16,030 | 16,030 | ||||
| 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. | 1,577,556 | 21,770 | 580,997 | 2,180,323 | ||
| 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.) | 2,180,323 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,577,556 | 21,770 | 580,997 | 2,180,323 | ||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 252 | 676 | 13 | 941 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 252 | 676 | 13 | 941 | ||
| 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.). | 1,577,808 | 22,446 | 581,010 | 2,181,264 | ||




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part VI | 11b | The form 990 is distributed to each of the board members either as a paper copy or electronically prior to the form 990 being filed with the Internal Revenue Service. |
| Form 990 Part VI | 12c | Board members and employees are made aware of the conflict of interest policy annually. It is also part of the organizations bylaws. If there is a potential conflict of interest, the person with the potential conflict is required to advise the organization in order for there to be a resolution of the potential conflict. If discovered by someone else, the person with the potential conflict of interest is confronted. The conflict of interest policy is reviewed with board members annually. We are developing a written conflict of interest acknowledgement form which will be signed. |
| Form 990 Part VI | 15b | A compensation committee is formed with board members and human resourses staff. Salary surveys are completed and annual cola is taken into consideration. Information is gathered regarding salaries in the area for employees in similar positions as well as the performance of the person whose compensation is under review. The compensation committee reports its findings to the board members who make the final decision regarding the appropriate compensation to be paid for the position. |
| Form 990 Part VI | 19 | Our governing documents, conflict of interest policy and financial statements are made available to the public upon request. Such request can be by mail, email, fax, or telephone. |
| Form 990 Part VI Section B Line 11b The form 990 is distributed to each of the board members either as a paper copy or electronically prior to the form 990 being filed with the Internal Revenue Service. Form 990 Part VI Section B Line 12c Board members and employees are made aware of the conflict of interest policy annually. It is also part of the organizations bylaws. If there is a potential conflict of interest, the person with the potential conflict is required to advise the organization in order for there to be a resolution of the potential conflict. If discovered by someone else, the person with the potential conflict of interest is confronted. The conflict of interest policy is reviewed with board members annually. We are developing a written conflict of interest acknowledgement form which will be signed. Form 990 Part VI Section B Line 15b A compensation committee is formed with board members and human resourses staff. Salary surveys are completed and annual cola is taken into consideration. Information is gathered regarding salaries in the area for employees in similar positions as well as the performance of the person whose compensation is under review. The compensation committee reports its findings to the board members who make the final decision regarding the appropriate compensation to be paid for the position. Form 990 Part VI Section C Line 19 Our governing documents, conflict of interest policy and financial statements are made available to the public upon request. Such request can be by mail, email, fax, or telephone. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |