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.") .... | 142,412 | 180,211 | 176,848 | 178,229 | 181,341 | 859,041 |
| 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.. | 142,412 | 180,211 | 176,848 | 178,229 | 181,341 | 859,041 |
| 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. | 859,041 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 142,412 | 180,211 | 176,848 | 178,229 | 181,341 | 859,041 |
| 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). | 859,041 | |||||






| 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 |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 12c | BOARD MEMBERS ARE ASKED TO SELF REPORT | |
| Pt VI, Line 15 | YEARLY REVIEW BY THE BOARD | |
| Pt VI, Line 7b | BOARD VOTES ON AMENDMENTS | |
| Pt VI, Line 19 | ITEMS ARE MADE AVAILABLE UPON REQUEST TO PUBLIC | |
| Pt VI, Line 11a | BOARD MEMBERS REVIEW FORM 990 PRIOR TO FILING | |
| Pt XI | ROUNDING | |
| Form 990, Part VI, Line 9 | PAUL MEDICI 12 NICKERSON ST PAWTUCKET RI 02860 SHEMIKA MOORE 734 RIVER AVE PROVIDENCE RI 02908 DAVID CLYLE MORSE 234 MATHEWSON ST PROVIDENCE RI 02903 LOUISE TILLINGHAST 144 SUMTER ST PROVIDENCE RI 02907 PATRICIA TROSCLAIR 27 AYRAULT ST PROVIDENCE RI 02908 DAVID CONTI 14 WHIPPLE ROAD SMITHFIELD RI 02917 BETTY BOYNTON 25 EAST ST #22 PROVIDENCE RI 02903 LIZ MCGRATH 67 BAYVIEW AVE PORTSMOUTH RI 02871 SAMUEL REMLEY 79 WOODHAVEN BLVD N. PROVIDENCE RI 02911 DIANA D. BURDETT PO BOX 5639 PROVIDENCE RI 02 | |
| Form 990, Part IX, Line 24f | TRASH REMOVAL/EXTERMINATOR 3386. 3386. 0. 0. OUTREACH EXPENSES 20277. 20277. 0. 0. MEAL SITE EXPENSES 2757. 2757. 0. 0. FOOD PANTRY EXPENSES 1468. 1468. 0. 0. GRANT EXPENSES 1103. 1103. 0. 0. |
| Software ID: | 11000175 |
| Software Version: |