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.") .... | ||||||
| 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. | 0 | |||||
| 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.. | 0 | |||||
| 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.") . | 25,957 | 7,527 | 19,139 | 10,493 | 7,158 | 70,274 |
| 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...... | 55,849 | 61,493 | 54,905 | 77,972 | 63,609 | 313,828 |
| 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. | 81,806 | 69,020 | 74,044 | 88,465 | 70,767 | 384,102 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 400 | 350 | 2,415 | 7,280 | 7,840 | 18,285 |
| 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.. | 400 | 350 | 2,415 | 7,280 | 7,840 | 18,285 |
| 8 | Public Support (Subtract line 7c from line 6.) | 365,817 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 81,806 | 69,020 | 74,044 | 88,465 | 70,767 | 384,102 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9,530 | 7,611 | 7,519 | 7,328 | 7,338 | 39,326 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 9,530 | 7,611 | 7,519 | 7,328 | 7,338 | 39,326 |
| 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.) | 2,728 | 2,211 | 1,495 | 863 | 1,267 | 8,564 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 431,992 | |||||




| Facts And Circumstances Test |
|---|
| OTHER INCOME PART III, LINE 12; DESCRIPTION: MISC.; 2007: 2728.; 2008: 0.; 2009: 1495.; 2010: 863.; 2011: 1267.; DESCRIPTION: ESCROW DEP. REFUND; 2008: 2211.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt XII, Line 2c | The board, with only seven members, acts as a board | |
| as well as the executive/finance committee and as | ||
| such reviews the financial information, the | ||
| 990, and selects the accountant. | ||
| Pt VI, Line 15 | Since there are no employees, the answer to these | |
| two questions were N/A but that wasn't an option. | ||
| Pt VI, Line 11a | The 990 draft was emailed to the board for review | |
| during a comment period. Each member was requested | ||
| to respond during that period with either an approval | ||
| or with additions/corrections. Responses were then | ||
| summarized and any changes were forwarded to the | ||
| tax preparer for inclusion in the final return. | ||
| Pt VI, Line 19 | The organization's documents are available by | |
| request. The 990's are on the Guidestar website. | ||
| Pt XII, Line 1 | Since the organization has a significant value in | |
| its building, furniture, equipment, and investments | ||
| and wanted those costs reported as assets, the | ||
| the accounting method could not be the pure "cash" | ||
| method but is considered the "modified cash" method. | ||
| Pt VI, Line 7a | Members in good standing, by written ballot, elect the | |
| board of directors for one-year terms. | ||
| Pt VI, Line 6 | Members elect the board of directors. Board decisions | |
| cannot conflict with any action taken by the members. | ||
| Members do not share in net revenue of the organization | ||
| nor are they eligible to receive any of the net assets | ||
| if the organization was to dissolve. | ||
| Form 990, Part IX, Line 24f | BAR AND GRILL COSTS 18844. 18844. 0. 0. | |
| Pt VI B,Line 13 | Since there are no employees, there is no need for a | |
| whistleblower policy. | ||
| Pt VI B,Line 12a | The board is currently reviewing conflict of interest | |
| policies and will adopt one at the August 2012 | ||
| board meeting. | ||
| Pt VI B,Line 14 | The board is currently reviewing document destruction | |
| policies and will adopt one at the August 2012 | ||
| board meeting. |
| Software ID: | 11000175 |
| Software Version: |