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.") .... | ||||||
| 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.. | ||||||
| 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. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 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). | ||||||






| 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.") . | 17,696 | 16,526 | 15,032 | 14,382 | 9,701 | 73,337 |
| 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...... | 100,253 | 95,030 | 111,729 | 109,844 | 94,016 | 510,872 |
| 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. | 117,949 | 111,556 | 126,761 | 124,226 | 103,717 | 584,209 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public Support (Subtract line 7c from line 6.) | 584,209 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 117,949 | 111,556 | 126,761 | 124,226 | 103,717 | 584,209 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 71 | 74 | 56 | 44 | 52 | 297 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 71 | 74 | 56 | 44 | 52 | 297 |
| 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.). | 118,020 | 111,630 | 126,817 | 124,270 | 103,769 | 584,506 |




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS REVIEW THE ENTIRE RETURN IN DRAFT FORM PROVIDED BY THE CERTIFIED PUBLIC ACCOUNTANT. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD REVIEWS EACH MEMBER ANNUALLY TO DETERMINE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. | |
| FORM 990, ITEM B, AMENDED RETURN EXPLANATION: | PAGE 1, PART I SUMMARY: LN # ORIGINAL NET CORRECT EXPLANATION AMOUNT CHANGE AMOUNT 7A 11,325 <11,325> -0- BANQUET PROGRAM NOT UBI 7B 11,325 <11,325> -0- 8 10,575 <874> 9,701 BOOKKEEPING ERROR 9 93,936 <80> 94,016 BOOKKEEPING ERROR 10 51 1 52 ROUNDING ERROE 12 104,562 <793> 103,769 17 120,407 <9,453> 110,954 RECLASSIFY TO FUNCTIONAL EXP'S 18 120,407 <9,453> 110,954 19 <15,845> 8,660 <7,185> 20 19,113 3,530 21,643 BOOKEEPING ERROR 21 <6,091> 6,091 -0- BOOKKEEPING ERROR 22 13,022 9,621 22,643 | |
| FORM 990, ITEM B, AMENDED RETURN EXPLANATION: | PAGE 10, PART IX STATEMENT OF FUNCTIONAL EXPENSES: LN # ORIGINAL NET CORRECT EXPLANATION AMOUNT CHANGE AMOUNT 12 419 <419> -0- RECLASSIFY 13 2,774 <2,674> 100 RECLASSIFY 24A 31,898 3,336 35,234 RECLASSIFY 24B 9,733 <9,733> -0- RECLASSIFY 24B -0- 24,557 24,557 RECLASSIFY 24C 5,893 <5,893> -0- RECLASSIFY 24C -0- 49,459 49,459 RECLASSIFY 24D 612 <78> 534 RECLASSIFY 24F 68,008 <68,008> -0- RECLASSIFY 25 120,407 <9,453> 110,954 RECLASSIFY |
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