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.") . | 29,631 | 64,882 | 62,232 | 160,246 | 98,321 | 415,312 |
| 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...... | 151,141 | 190,852 | 167,207 | 205,412 | 211,713 | 926,325 |
| 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. | 180,772 | 255,734 | 229,439 | 365,658 | 310,034 | 1,341,637 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 7,356 | 10,255 | 7,475 | 18,867 | 8,500 | 52,453 |
| 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. | 143,632 | 134,613 | 129,563 | 175,385 | 192,484 | 775,677 |
| c | Add lines 7a and 7b.. | 150,988 | 144,868 | 137,038 | 194,252 | 200,984 | 828,130 |
| 8 | Public Support (Subtract line 7c from line 6.) | 513,507 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 180,772 | 255,734 | 229,439 | 365,658 | 310,034 | 1,341,637 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 98 | 30 | 61 | 103 | 172 | 464 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 98 | 30 | 61 | 103 | 172 | 464 |
| 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.). | 1,342,101 | |||||




| 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 | DIRECTOR REVEIEWS 990 PRIOR TO FILING. | |
| Pt VI, Line 12c | PERIODIC BD MEETINGS ALLOW FOR CONFLICTS OF INTEREST | |
| Pt VI, Line 12c | TO BE DISCLOSED AND DISCUSSED. | |
| Pt VI, Line 19 | 990 AND FINANCIAL STATEMENTS ARE MAINTAINED AT THE | |
| Pt VI, Line 19 | GENERAL OFFICE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| Form 990, Part IX, Line 24f | PROGRAM BENEVOLENCE 10683. 10683. MEALS AND ENT. 1459. 1459. LICENSES AND PERMITS 366. 366. 0. PROFESSIONAL FEES 1701. 1701. 0. |
| Software ID: | 11000175 |
| Software Version: |