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. | ||||||
| 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.. | ||||||
| 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.") . | ||||||
| 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 |
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| Explanation |
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| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990-EZ, Part I, Line 16, Other Expenses Meals and entertainment 150 Form 990-EZ, Part I, Line 16, Other Expenses Conferences, conventions, and meetings 500 Form 990-EZ, Part I, Line 16, Other Expenses Interest 12,009 Form 990-EZ, Part I, Line 16, Other Expenses Supplies 700 Form 990-EZ, Part I, Line 16, Other Expenses Telephone 4,052 Form 990-EZ, Part I, Line 16, Other Expenses Alarm security service 722 Form 990-EZ, Part I, Line 16, Other Expenses Benevolence gifts 1,700 Form 990-EZ, Part I, Line 16, Other Expenses Bank charges 1,080 Form 990-EZ, Part I, Line 16, Other Expenses Corporate filing fee 61 Form 990-EZ, Part I, Line 16, Other Expenses Office expenses 1,176 Form 990-EZ, Part I, Line 16, Other Expenses Storage expense 1,586 Form 990-EZ, Part I, Line 16, Other Expenses Worship ministries expense 4,700 Form 990-EZ, Part I, Line 16, Other Expenses Church literature 1,086 Form 990-EZ, Part I, Line 16, Other Expenses Flowers expense 392 Form 990-EZ, Part I, Line 16, Other Expenses IT Support expense 600 Form 990-EZ, Part I, Line 16, Other Expenses Janitorial expense 1,749 Form 990-EZ, Part I, Line 16, Other Expenses Pest control services 180 Form 990-EZ, Part I, Line 16, Other Expenses Special speakers expense 1,850 Form 990-EZ, Part I, Line 16, Other Expenses Youth program expense 815 Form 990-EZ, Part I, Line 16, Other Expenses Clergy supplies 133 Form 990-EZ, Part I, Line 16, Other Expenses Missions support 2,235 Form 990-EZ, Part I, Line 16, Other Expenses Social expenses 1,206 Form 990-EZ, Part I, Line 16, Other Expenses Sunday school materials 1,131 Form 990-EZ, Part I, Line 16, Other Expenses Gifts 100 Form 990-EZ, Part I, Line 16, Other Expenses Ladies program expense 1,050 Form 990-EZ, Part I, Line 16, Other Expenses Nursery and childcare expense 1,401 Form 990-EZ, Part I, Line 16, Other Expenses Parsonage 7,810 Form 990-EZ, Part I, Line 16, Other Expenses Visitation and evangilization supplies 100 Form 990-EZ, Part I, Line 16, Other Expenses Website upkeep and maintenance 978 Form 990-EZ, Part II, Line 24, Other Assets Recoverable deposits Beginning of year 23,923, End of year 23,923 Form 990-EZ, Part II, Line 24, Other Assets Organizational cost Beginning of year 750, End of year 750 Form 990-EZ, Part II, Line 26, Liabilities Loans Payable - Long Term Beginning of year 511,139, End of year 495,366 Form 990-EZ, Part II, Line 26, Liabilities Capital Beginning of year 1,000, End of year 1,000 |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |