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. | ||||||
| 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.") . | 162,267 | 64,639 | 37,797 | 56,841 | 42,589 | 364,133 |
| 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...... | 11,289 | 10,380 | 39,445 | 8,762 | 14,828 | 84,704 |
| 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. | 173,556 | 75,019 | 77,242 | 65,603 | 57,417 | 448,837 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 40,800 | 24,725 | 2,750 | 15,936 | 14,309 | 98,520 |
| 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. | 293 | 293 | ||||
| c | Add lines 7a and 7b.. | 40,800 | 24,725 | 2,750 | 16,229 | 14,309 | 98,813 |
| 8 | Public Support (Subtract line 7c from line 6.) | 350,024 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 173,556 | 75,019 | 77,242 | 65,603 | 57,417 | 448,837 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 125 | 78 | 217 | 17 | 13 | 450 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 125 | 78 | 217 | 17 | 13 | 450 |
| 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.). | 173,681 | 75,097 | 77,459 | 65,620 | 57,430 | 449,287 |




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| PART 1, LINE 1 - GRANTS AND SIMILAR AMOUNTS PAID: WORLD VISION - $840 VIOLET RICHARDSON AWARDS - $2,000 WOMEN'S OPPORTUNITY AWARD - $3,000 RUBY AWARD - $1,053 PROJECT TRUST - $7,302 GERTRUDE WALDEN CHILD CARE CENTER - $1,500 FLORIDA ARTS & DANCE COMPANY - $1,500 SHARED HOPE INTERNATIONAL - $1,705 OTHER PROJECTS - $294 PART 1, LINE 16 - OTHER EXPENSES: DUES - $2,837 LOCAL MEMBERSHIPS - $325 INSURANCE - $225 CONFERENCES - $315 OFFICE - $1,069 FEES & LICENSES - $75 TELEPHONE - $2,460 MEMBERSHIP DEVELOPMENT - $264 PROGRAM SERVICE EXPENSES (PART III) - $13,679 PART III, LINE 31 - OTHER PROGRAM SERVICES: EDUCATIONAL LUNCHES - $9,712 DISTRICT AND REGIONAL CONFERENCES - $2,821 ANNUAL BANQUET - $1,145 |
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