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.") .... | 572,223 | 466,161 | 392,144 | 372,537 | 324,697 | 2,127,762 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 15,620 | 15,224 | 12,921 | 10,410 | 8,793 | 62,968 |
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | 587,843 | 481,385 | 405,065 | 382,947 | 333,490 | 2,190,730 |
| 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. | 2,190,730 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 587,843 | 481,385 | 405,065 | 382,947 | 333,490 | 2,190,730 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 3,375 | 3,613 | 1,215 | 1,228 | 2,199 | 11,630 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | 4,610 | 8,829 | 16,659 | 14,613 | 12,177 | 56,888 |
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | 2,469 | 2,449 | 2,721 | 867 | 2,857 | 11,363 |
| 11 | Total support (Add lines 7 through 10). | 2,270,611 | |||||






| 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 |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Form 990 governing body review (Part VI, line 11) | THE TAX RETURN IS REVIEWED BY THE BOARD BEFORE IT IS ELECTRONICALLY FILED | |
| 02. Conflict of interest policy compliance (Part VI, line 12c) | THE POLICY MANUAL CONTAINS A CONFILCT OF INTEREST POLICY EACH EMPLOYEE RECEIVES A COPY WHEN THEY ARE HIRED | |
| 03. CEO, executive director, top management comp (Part VI, line 15a) | ALL COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS | |
| 04. Other officer or key employee compensation (Part VI, line 15b | ALL COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS | |
| 05. Governing documents, etc, available to public (Part VI, line 19) | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE FACILITY |
| Software ID: | |
| Software Version: |