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) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 17,144 | 103,912 | 374,402 | 495,458 | ||
| 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.. | 17,144 | 103,912 | 374,402 | 495,458 | ||
| 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).. | 276,839 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 218,619 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 17,144 | 103,912 | 374,402 | 495,458 | ||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2 | 6 | 8 | |||
| 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). | 495,466 | |||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (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) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (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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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Form 990 governing body review (Part VI, line 11) | THE EXECUTIVE DIRECTOR PROVIDES INTERNAL FINANCIAL RECORDS TO THE ACCOUNTANT AND ANSWERS ANY QUESTIONS THE ACCOUNTANT MAY HAVE THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 BEFORE IT IS FILED THEN IT IS PRESENTED TO THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING THE FORM 990 AND OTHER GOVERNING DOCUMENTS ARE STORED IN AN OFFICE FILE DRAWER AND ARE AVAILABLE TO THE PUBLIC SHOULD ANYONE REQUEST TO REVIEW THEM | |
| 02. Conflict of interest policy compliance (Part VI, line 12c) | THE EXECUTIVE DIRECTOR IS CONTINUALLY AWARE OF THE POSSIBILITY OF CONFLICTS OF INTEREST ACCORDING TO PERSONNEL POLICIES THE ED DISCUSSES ANY POTENTIAL CONFLICTS OF INTERESTS WITH THE PARTYIES INVOLVED TO ENSURE THAT THEY ARE EITHER NOT PERMITTED TO ARISE OR ADEQUATE CHECK AND BALANCES ARE IN PLACE TO PROVIDE PROPER OVERSIGHT SHOULD THERE BE AN ACTUAL CONFLICT OF INTEREST THAT IS PERMITTED IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST DIRECTLY INVOLVES THE EXECUTIVE DIRECTOR THE BOARD OF DIRECTORS APPROVES A SYSTEM OF OVERSIGHT FOR THOSE CONFLICTS THE BOARD OF DIRECTORS IS ALSO FAMILIAR WITH THE CONFLICTS OF INTEREST POLICY AND CAN INITIATE ACTION PERTAINING TO ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST OF WHICH THEY OTHERWISE BECOME AWARE | |
| 03. CEO, executive director, top management comp (Part VI, line 15a) | LOCAL NON-PROFIT SALARY ANALYSIS IS PERFORMED BY BOARD | |
| 04. Governing documents, etc, available to public (Part VI, line 19) | FORM 990 IS STORED IN AN OFFICE FILE DRAWER AND IS AVAILABLE TO THE PUBLIC SHOULD ANYONE REQUEST TO REVIEW IT A REQUEST CAN BE MADE BY A MEMBER OF THE PUBLIC VIA A WRITTEN LETTER A PHONE CALL AN EMAIL OR IN PERSON A COPY CAN THEN BE SENT ELECTRONICALLY OR VIA POSTAL MAIL OR IT CAN BE VIEWED IN PERSON AT THE BEAR OFFICE THE 990 IS ALSO POSTED INDEPENDENTLY ON THE WEBSITE GUIDESTAR AND CAN BE VIEWED BY THE PUBLIC THERE |
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