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.") .... | 21,102 | 26,972 | 17,825 | 21,016 | 14,898 | 101,813 |
| 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.. | 21,102 | 26,972 | 17,825 | 21,016 | 14,898 | 101,813 |
| 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).. | 48,822 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 52,991 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 21,102 | 26,972 | 17,825 | 21,016 | 14,898 | 101,813 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 16,084 | 13,472 | 10,714 | 13,258 | 16,634 | 70,162 |
| 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). | 171,975 | |||||






| 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.) | ||||||
| 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 |
|---|
| DONATIONS ARE SOUGHT FROM MEMBERS OF ST MATTHEW LUTHERAN CHURCH IN VARIOUS WAYS. THE FOUNDATION IS PERIODICALLY PROMOTED IN THE WEEKLY CHURCH BULLETIN, PROMOTING ITS CAUSES AND MAKING REQUESTS FOR DONATIONS. MEMORIALS OF DECEASED CHURCH MEMBERS OFTEN OFFER THE OPPORTINITY TO MAKE DONATIONS TO THE FOUNDATION IN MEMORY OF THE DECEASED INDIVIDUAL. A FOUNDATION COMMITTEE IS DEVELOPING A MARKETING BROCHURE TO PROMOTE THE VARIOUS METHODS AVAILABLE TO MAKE DONATIONS TO THE FOUNDATION. IN ADDITION TO THE FOUNDATIONS MAJOR DONORS, THERE ARE APPROXIMATELY 100-140 DONORS A YEAR THAT MAKE CONTRIBUTIONS RANGING FROM 20 TO 200. THERE IS AN ELECTED 7 MEMBER BOARD OF DIRECTORS, WHO ARE ALL VOLUNTEERS. MAJOR DONORS ARE NOT REPRESENTED ON THE BOARD. A MAJOR ANNUAL PROGRAM OF THE FOUNDATION IS PROVIDING A FOOD CLOSET FOR FAMILIES IN NEED., THE FOOD CLOSET IS OPEN TO, BUT NOT GEOGRAPHICALLY LIMITED TO, THE GENERAL PUBLIC OF TEH BEAVERTON, OREGON AREA. |
| Explanation |
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| Software ID: | |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | FEDERAL FORM 990 PREPARED BY CERTIFIED PUBLIC ACCOUNTING FIRM REVIEWED BY TREASURER PRIOR TO SUBMISSION. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST. |
| Software ID: | |
| Software Version: |