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 monetary support | |||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2008 | (b) 2009 | (c) 2010 | (d) 2011 | (e) 2012 | (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) 2008 | (b) 2009 | (c) 2010 | (d) 2011 | (e) 2012 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.).. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






Calendar year (or fiscal year beginning in) ![]() |
(a) 2008 | (b) 2009 | (c) 2010 | (d) 2011 | (e) 2012 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 1,300 | 1,350 | 1,563 | 1,075 | 5,288 | |
| 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...... | 117,618 | 111,928 | 147,086 | 131,040 | 507,672 | |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 118,918 | 113,278 | 148,649 | 132,115 | 512,960 | |
| 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.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | 512,960 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2008 | (b) 2009 | (c) 2010 | (d) 2011 | (e) 2012 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 118,918 | 113,278 | 148,649 | 132,115 | 512,960 | |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6 | 1 | 7 | |||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 6 | 1 | 7 | |||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) .. | 434 | 3,436 | 818 | 1,501 | 6,189 | |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 119,352 | 116,714 | 149,473 | 133,617 | 519,156 | |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 12000229 |
| Software Version: | 2012v2.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990-EZ, Part II, Line 26.6 | Total Liabilities.6 | N/P RAYMOND THOMPSON - Beginning $0 N/P RAYMOND THOMPSON - Ending $4500 |
| Form 990-EZ, Part II, Line 26.5 | Total Liabilities.5 | N/P AMERICAN EXPRESS - Beginning $0 N/P AMERICAN EXPRESS - Ending $1283 |
| Form 990-EZ, Part II, Line 26.4 | Total Liabilities.4 | N/P MARGUERITE THOMPSON - Beginning $1000 N/P MARGUERITE THOMPSON - Ending $0 |
| Form 990-EZ, Part II, Line 26.3 | Total Liabilities.3 | N/P FARMERS & MERCHANTS - Beginning $1211 N/P FARMERS & MERCHANTS - Ending $0 |
| Form 990-EZ, Part II, Line 26.2 | Total Liabilities.2 | N/P CC THOMPSON PROPERTIES, LLC - Beginning $8748 N/P CC THOMPSON PROPERTIES, LLC - Ending $8402 |
| Form 990-EZ, Part II, Line 26.1 | Total Liabilities.1 | PAYROLL LIABILITIES - Beginning $915 PAYROLL LIABILITIES - Ending $984 |
| Form 990-EZ, Part II, Line 24.1011 | Other Assets.1011 | Prepaid Expenses and Deferred Charges - Beginning $345 Prepaid Expenses and Deferred Charges - Ending $0 |
| Form 990-EZ, Part II, Line 24.1009 | Other Assets.1009 | Notes and Loans Receivable - Beginning $587 Notes and Loans Receivable - Ending $692 |
| Form 990-EZ, Part II, Line 24.1005 | Other Assets.1005 | Accounts Receivable - Beginning $13706 Accounts Receivable - Ending $15796 |
| Form 990-EZ, Part II, Line 24.1002 | Other Assets.1002 | Furniture and Fixtures - Beginning $2609 Furniture and Fixtures - Ending $1835 |
| Form 990-EZ, Part II, Line 24.1001 | Other Assets.1001 | Automobiles - Beginning $4661 Automobiles - Ending $1941 |
| Form 990-EZ, Part I, Line 16.24 | Other Expenses.24 | MEALS $35 |
| Form 990-EZ, Part I, Line 16.23 | Other Expenses.23 | FINANCE CHARGES $79 |
| Form 990-EZ, Part I, Line 16.22 | Other Expenses.22 | BANK CHARGES $80 |
| Form 990-EZ, Part I, Line 16.21 | Other Expenses.21 | DUES $100 |
| Form 990-EZ, Part I, Line 16.20 | Other Expenses.20 | RESIDENT LOAN $128 |
| Form 990-EZ, Part I, Line 16.18 | Other Expenses.18 | CONTRIBUTIONS $200 |
| Form 990-EZ, Part I, Line 16.17 | Other Expenses.17 | LICENSES & PERMITS $280 |
| Form 990-EZ, Part I, Line 16.16 | Other Expenses.16 | PEST CONTROL $350 |
| Form 990-EZ, Part I, Line 16.15 | Other Expenses.15 | CONTINUING EDUCATION $358 |
| Form 990-EZ, Part I, Line 16.14 | Other Expenses.14 | RESOURCE MATERIALS $406 |
| Form 990-EZ, Part I, Line 16.13 | Other Expenses.13 | MISCELLANEOUS $526 |
| Form 990-EZ, Part I, Line 16.12 | Other Expenses.12 | SECURITY $540 |
| Form 990-EZ, Part I, Line 16.11 | Other Expenses.11 | LAWN CARE $1075 |
| Form 990-EZ, Part I, Line 16.10 | Other Expenses.10 | REPAIRS & MAINTENANCE $1161 |
| Form 990-EZ, Part I, Line 16.9 | Other Expenses.9 | SPECIAL EVENTS $1497 |
| Form 990-EZ, Part I, Line 16.8 | Other Expenses.8 | PROPERTY TAXES $1538 |
| Form 990-EZ, Part I, Line 16.7 | Other Expenses.7 | TELEPHONE $2773 |
| Form 990-EZ, Part I, Line 16.6 | Other Expenses.6 | CLINICAL SUPERVISION $3200 |
| Form 990-EZ, Part I, Line 16.5 | Other Expenses.5 | OUTSIDE SERVICES $7425 |
| Form 990-EZ, Part I, Line 16.4 | Other Expenses.4 | SUPPLIES $9151 |
| Form 990-EZ, Part I, Line 16.3 | Other Expenses.3 | UTILITIES $10315 |
| Form 990-EZ, Part I, Line 16.2 | Other Expenses.2 | AUTOMOBILE EXPENSE $14449 |
| Form 990-EZ, Part I, Line 16.1 | Other Expenses.1 | RENT $14900 |
| Form 990-EZ, Part I, Line 16.1012 | Other Expenses.1012 | Insurance $2947 |
| Form 990-EZ, Part I, Line 16.1009 | Other Expenses.1009 | Depreciation $2425 |
| Form 990-EZ, Part I, Line 16.1008 | Other Expenses.1008 | Interest $28 |
| Form 990-EZ, Part I, Line 16.1005 | Other Expenses.1005 | Travel $165 |
| Form 990-EZ, Part I, Line 16.1003 | Other Expenses.1003 | Information Technology $291 |
| Form 990-EZ, Part I, Line 16.1001 | Other Expenses.1001 | Advertising and Promotion $557 |
| Form 990-EZ, Part I, Line 8.1 | Other Revenue.1 | OTHER INCOME $1501 |
| Software ID: | 12000229 |
| Software Version: | 2012v2.0 |