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.") .... | 125,685 | 154,022 | 231,488 | 266,256 | 249,254 | 1,026,705 |
| 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.. | 125,685 | 154,022 | 231,488 | 266,256 | 249,254 | 1,026,705 |
| 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. | 1,026,705 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 125,685 | 154,022 | 231,488 | 266,256 | 249,254 | 1,026,705 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 18 | 7 | 2,767 | 40 | 8 | 2,840 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | 1,560 | 6,000 | 6,000 | 13,560 | ||
| 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). | 1,043,105 | |||||






| 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 11a | Board reviews 990-chairman signs return | |
| Pt VI, Line 19 | Disclosure upon written request presented to the board | |
| Pt VI, Line 12c | Member makes board aware of conflict, then excuses themself from voting | |
| Pt V, Line 3b | UBIT due to rental of 12% of property; more than 85% | |
| property's use is substantially related to the exempt | ||
| purpose hence rents from real property are excluded in | ||
| computing UBIT | ||
| Pt VI, Line 15 | Board researches and sets appropriate compensation for Executive Director | |
| Form 990, Part IX, Line 24f | FACILITY - BEEBE:SUPPLIES - BEEBE 726. 617. 109. 0. FACILITY - CABOT:SUPPLIES - CABOT 5641. 4795. 846. 0. MEDICAL PROGRAM:SUPPLIES - MED 802. 802. 0. 0. GENERAL:ADOPTION 9437. 9437. 0. 0. GENERAL:CLIENT EXPENSES 4203. 4203. 0. 0. GENERAL: VOLUNTEER EXPENSES 805. 684. 121. 0. GENERAL:VOLUNTEER TRAINING 1136. 1136. 0. 0. GENERAL: DUES & SUBS 429. 322. 107. 0. GOLF FUNDRAISER 5930. 5930. 0. 0. BANQUET EXPENSE 13250. 13250. 0. 0. FAM & PARENTING AUTO EXP 1249. 1249. 0. 0. GENERAL: LONOKE EXPENSES 51 |
| Software ID: | 11000175 |
| Software Version: |