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.") .... | 129,548 | 223,777 | 182,725 | 206,308 | 187,388 | 929,746 |
| 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.. | 129,548 | 223,777 | 182,725 | 206,308 | 187,388 | 929,746 |
| 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. | 929,746 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 129,548 | 223,777 | 182,725 | 206,308 | 187,388 | 929,746 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 84 | 12 | 96 | |||
| 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). | 929,842 | |||||






| 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 Part VI | 12c | The monitoring and enforcement of the Institutes conflict of interest policy is reviewed for adequacy, improvement and enforcement on an annual basis as a reminder to board members, officers and employees, and as new board members are appointed. |
| Form 990 Part VI | 14 | The Institute will be addressing the development of its record retention and document destruction policy during the upcoming year. |
| Form 990 Part VI | 15a | The Institutes board initially determines the compensation level of its only executive officer. The determination is based on a formula involving the value contributed as compared to the time spent in executing the required responsibilities of the position. These salary recommendations are further subject to negotiation in contracts with individual and independent grant providers who subject them to comparable standards. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 29,000, Grants and allocations 0, Revenue 29,000 Community Participation Initiative Statewide - The Institute developed a plan for pilot sites to replicate the Community Participation Inititative in other parts of Michigan and continued seeking funding for this purpose. The purpose of the Statewide Community Participation project is to provide training materials, resources and consultation, hoping other communities can replicate the Kalamazoo project. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 11,392, Grants and allocations 0, Revenue 0 Various other program services related to the accomplishment of the Institutes goals and objectives. |
| Form 990, Part III, Line 4d Program Service Expenses 29,000, Grants and allocations 0, Revenue 29,000 Community Participation Initiative Statewide - The Institute developed a plan for pilot sites to replicate the Community Participation Inititative in other parts of Michigan and continued seeking funding for this purpose. The purpose of the Statewide Community Participation project is to provide training materials, resources and consultation, hoping other communities can replicate the Kalamazoo project. Form 990, Part III, Line 4d Program Service Expenses 11,392, Grants and allocations 0, Revenue 0 Various other program services related to the accomplishment of the Institutes goals and objectives. Form 990 Part VI Section B Line 12c The monitoring and enforcement of the Institutes conflict of interest policy is reviewed for adequacy, improvement and enforcement on an annual basis as a reminder to board members, officers and employees, and as new board members are appointed. Form 990 Part VI Section B Line 14 The Institute will be addressing the development of its record retention and document destruction policy during the upcoming year. Form 990 Part VI Section B Line 15a The Institutes board initially determines the compensation level of its only executive officer. The determination is based on a formula involving the value contributed as compared to the time spent in executing the required responsibilities of the position. These salary recommendations are further subject to negotiation in contracts with individual and independent grant providers who subject them to comparable standards. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |