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.") .... | 935,523 | 1,229,912 | 1,297,943 | 1,397,557 | 1,254,850 | 6,115,785 |
| 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.. | 935,523 | 1,229,912 | 1,297,943 | 1,397,557 | 1,254,850 | 6,115,785 |
| 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. | 6,115,785 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 935,523 | 1,229,912 | 1,297,943 | 1,397,557 | 1,254,850 | 6,115,785 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9,003 | 4,475 | 616 | 688 | -429 | 14,353 |
| 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). | 6,130,138 | |||||






| 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 |
|---|
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 10b | FORM 990 PROVIDED TO BOARD PRESIDEN, TREASURER, EXEC. DIR, & BUS MGR PRIOR TO SUBMISSION | |
| Pt VI, Line 12c | WRITTEN CONFLICT OF INTEREST MONITORING IS ON GOING | |
| Pt VI, Line 15 | DISCUSSED & APPROVED BY BOARD MEMBER & BASED ON BUDGET | |
| Pt VI, Line 19 | ADVETISED IN THE LOCAL NEWSPAPER | |
| Pt III, Line 2 | N/A | |
| Pt III, Line 3 | N/A | |
| Pt V, Line 3b | N/A | |
| Pt VI, Line 2 | N/A | |
| Pt VI, Line 3 | N/A | |
| Pt VI, Line 4 | N/A | |
| Pt VI, Line 5 | N/A | |
| Pt VI, Line 6 | N/A | |
| Pt VI, Line 7a | N/A | |
| Pt VI, Line 7b | N/A | |
| Pt VI, Line 8a | BOARD MEETING MINUTES DOCUMENTED & APPROVED AT SUBSEQUENT MEETING | |
| Pt VI, Line 8b | COMMITTEE'S REPORT TO BOARD & ANY COMMITTEE ACTION IS APPROVED BY FULL BOARD | |
| Pt VI, Line 11a | REVIEWED AT FINANCE COMMITTEE MTG & COPIES PROVIDED TO ALL BOARD MEMBERS | |
| Pt XII, Line 1 | N/A | |
| Pt XII, Line 2c | N/A | |
| Pt XII, Line 3b | N/A | |
| Form 990, Part IX, Line 24f | SUPPLIES 77774. 73346. 2911. 1517. SMALL FURNISHINGS & EQUIPMENT 3920. 3920. 0. 0. EQUIPMENT RENTAL 4222. 4222. 0. 0. TELEPHONE 13564. 13564. 0. 0. POSTAGE 1520. 12. 1300. 208. RECRUITMENT/DEVELOPMENT 3405. 3255. 150. 0. LOCAL TRANSPORTATION 8815. 8446. 369. 0. GOOD SAM 12568. 12568. 0. 0. RESIDENT ACTIVITY FUND 2680. 2680. 0. 0. DIRECT CLIENT ASSISTANCE 387. 387. 0. 0. EMPLOYMENT ASSISTANCE 945. 945. 0. 0. PUBLICATIONS AND DUES 1688. 1250. 438. 0. NEWSLETTER PRINTING 13730. 0. 0. 13730. LICENSE |
| Software ID: | 11000175 |
| Software Version: |