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.") .... | 526,691 | 622,441 | 484,726 | 677,219 | 586,247 | 2,897,324 |
| 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.. | 526,691 | 622,441 | 484,726 | 677,219 | 586,247 | 2,897,324 |
| 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. | 2,897,324 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 526,691 | 622,441 | 484,726 | 677,219 | 586,247 | 2,897,324 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 14,399 | 14,399 | ||||
| 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). | 2,911,723 | |||||






| 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...... | ||||||
| 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. | ||||||
| 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.) | 0 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 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.). | ||||||




| 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 6 | In January of each year, each member County Board of | |
| Pt VI, Line 7a | Supervisors shall appoint or reappoint three local elected | |
| officials or persons responsible to local elected officials | ||
| to serve at least one year as their County COG representative. | ||
| One of the three shall be designated Chairperson of that | ||
| group and shall be designated an officer candidate and member | ||
| of the COG Executive Board. The Executive Board shall appoint | ||
| a forth member from each county to serve on the policy council. | ||
| Pt VI, Line 11a | The Executive Board approves the Audit Report for the year | |
| ended in June at their December meeting. The Form 990 is | ||
| usually prepared from the audited financial statements and | ||
| presented at the December board meeting. The Executive Director | ||
| is authorized to review and sign the return. | ||
| Pt VI, Line 12c | The Executive Board and officers review the organization's | |
| disbursements each month and may inquire about conflict of | ||
| interest compliance. | ||
| Pt VI, Line 15 | The Executive Board approves the compensation of the Executive | |
| Director and compares compensation ranges of key | ||
| employees with other similar organizations. The | ||
| Executive Board reviews the compensation of the | ||
| Executive Director during the annual review and the | ||
| Executive Director performs reviews of the other | ||
| key employees. | ||
| Pt VI, Line 19 | The governing documents can be found on the Iowa Secretary | |
| of State's website. The Audited Financial Statements can be | ||
| found on the Federal Audit Clearinghouse website or the Iowa | ||
| Form 990, Part IX, Line 24f | TELEPHONE 473. 473. 0. 0. MATCHING FUNDS 3000. 3000. 0. 0. | |
| State Auditor's Office website. All these and other | ||
| documents are available upon request. | ||
| Pt XII, Line 2c | The Executive Board serves as the audit committee for the | |
| selection and approval of the annual audit. The auditor | ||
| is selected by a "Request for Proposal" every three years | ||
| by the Executive Board. | ||
| Pt XI | Statement of Change in Net Assets: | |
| Decrease in Reserve of Loans $ 290,112 |
| Software ID: | 11000175 |
| Software Version: |