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.") .... | 1,653,003 | 1,695,275 | 1,718,990 | 956,772 | 978,000 | 7,002,040 |
| 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.. | 1,653,003 | 1,695,275 | 1,718,990 | 956,772 | 978,000 | 7,002,040 |
| 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. | 7,002,040 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,653,003 | 1,695,275 | 1,718,990 | 956,772 | 978,000 | 7,002,040 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 38,373 | 20,309 | 18,692 | 26,012 | 22,416 | 125,802 |
| 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.. | 17,312 | 17,903 | 36,664 | 69,078 | 79,869 | 220,826 |
| 11 | Total support (Add lines 7 through 10). | 7,348,668 | |||||






| 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 |
|---|
| OTHER INCOME PART II, LINE 10; DESCRIPTION: MANAGEMENT FEES; 2007: 17040.; 2008: 17125.; 2009: 18138.; 2010: 19603.; 2011: 22963.; DESCRIPTION: MISCELLANEOUS; 2007: 272.; 2008: 778.; 2009: 18526.; 2010: 20105.; 2011: 44912.; DESCRIPTION: GAIN ON SALE OF SECURITIES; 2010: 29370.; 2011: 11994.; |
| Explanation |
|---|
| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | THE GOVERNING BODY IS NOT GIVEN A COPY OF THE 990 TO REVIEW. | |
| THE EXECUTIVE DIRECTOR AND ASSOCIATE DIRECTOR REVIEW | ||
| FORM 990 BEFORE FILING. | ||
| Pt VI, Line 12c | THE POLICY IS REVIEWED AT THE ANNUAL BOARD OF DIRECTORS | |
| MEETING AND BOARD MEMBERS SIGN AN ACKNOWLEDGEMENT | ||
| THAT THEY HAVE REVIEWED THE POLICY. | ||
| Pt VI, Line 15 | THE EXECUTVE DIRECTOR'S SALARY IS REVIEWED BY THE BOARD | |
| OF DIRECTORS ANNUALLY. THE BOARD OF DIRECTORS REVIEW | ||
| THE LIBERY CENTRE SERVICES, INC. SALARY SCHEDULE | ||
| ANNUALLY AND APPROVE ANY CHANGES. THE EXECUTIVE DIRECTOR | ||
| SIGNS ALL PAYROLL AUTHORIZATIONS FOR ALL EMPLOYEE | ||
| SALARY OR WAGE CHANGES. | ||
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT | |
| OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE | ||
| TO THE PUBLIC UPON REQUEST. | ||
| Pt XI | OTHER CHANGES IN NET ASSETS DUE TO NET UNREALIZED | |
| GAINS(LOSSES)ON INVESTMENTS CARRIED AT MARKET VALUE. | ||
| Form 990EZ, Part I, Line 8 | MANAGEMENT FEES MISCELLANEOUS MIDSTATE CONFERENCE | |
| Form 990EZ, Part I, Line 16 | GROCERIES-POP ADVERTISING AUTO EXPENSE DUES & SUBSCRIPTION INSURANCE MISCELLANEOUS OLD CLUBHOUSE EXPENSE REPAIR & MAINTENANCE TRAINING UNEMPLOYMENT COMMITMENT | |
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE - NET PREPAIDS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES BONDS, MORTGAGES & OTHER NOTES | |
| Form 990, Part III, Line 4d | REGISTERED NURSES PROVIDE SERVICES TO HELP MEMBERS HAVE GOOD 193040. 0. 0. MEMBERS ARE GIVEN TRANSITIONAL EMPLOYMENT AND 152605. 0. 0. | |
| Form 990, Part IX, Line 24f | WELLNESS COMMUNITY 800. 792. 8. 0. BAD DEBTS 184. 184. 0. 0. FLEX FUNDS 12234. 12234. 0. 0. MISCELLANEOUS 22168. 20083. 2085. 0. MEMBER FUNDS 809. 809. 0. 0. TRAINING 5852. 4860. 992. 0. MEMBER EDUCATION 28. 28. 0. 0. ACCREDITATION 8914. 8904. 10. 0. |
| Software ID: | 11000175 |
| Software Version: |