Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
BUFORD COMMUNITY VOLUNTEER FIRE DEPARTMENT
Employer identification number
71-0580952
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(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
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
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.") ....
51,095
27,081
25,919
26,975
33,971
165,041
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
101,082
100,292
107,979
113,516
107,579
530,448
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
152,177
127,373
133,898
140,491
141,550
695,489
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.
695,489
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
152,177
127,373
133,898
140,491
141,550
695,489
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
1,152
1,167
485
445
380
3,629
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.)..
225
275
1,871
1,002
327
3,700
11
Total support (Add lines 7 through 10).
702,818
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
98.960 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
98.940 %
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
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.") .
51,095
27,081
17,659
16,920
25,811
138,566
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......
101,082
100,292
116,239
123,571
115,739
556,923
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.
152,177
127,373
133,898
140,491
141,550
695,489
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.)
695,489
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
152,177
127,373
133,898
140,491
141,550
695,489
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,152
1,167
485
445
380
3,629
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
1,152
1,167
485
445
380
3,629
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.)
..
225
275
1,871
1,002
327
3,700
13
Total support. (Add lines 9, 10c, 11, and 12.)..
153,554
128,815
136,254
141,938
142,257
702,818
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
98.960 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
98.940 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.520 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.520 %
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Part II Line 10 COMMUNITY BUILDING RENTAL AND CLEAN UP FEES
Explanation
Part II Line 10 COMMUNITY BUILDING RENTAL AND CLEAN UP FEES
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000057
Software Version:
12.15.422.1
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
BUFORD COMMUNITY VOLUNTEER FIRE DEPARTMENT
Employer identification number
71-0580952
Identifier
Return Reference
Explanation
Form 990 Part V
14B
ORGANIZATION DOES NOT PROVIDE INDOOR TANNING SERVICES.
Form 990 Part VI
6
THIS ORGANIZATION HAS VOTING MEMBERS
Form 990 Part VI
7B
MAJOR PURCHASES MUST BE APPROVED BY MAJORITY VOTE
Form 990 Part VI
11
THE GOVERNING BODY HAS THE RIGHT TO REVIEW ALL TAX FILING BEFORE THE RETURNS ARE FILED IF THEY SO DESIRE
Form 990 Part VI
19
ANY PERSON MAY REQUEST TO SEE ANY AND ALL RECORDS FROM THIS ORGANIZATION.
THE ORGANIZATION IS SUBJECT TO ACT 35 OF 2010 OF THE ARKANSAS LEGISLATURE, AND APPROPRIATE REGULATIONS THEREOF, WHICH ACTS AS A MONITORED CONFLICT OF INTEREST POLICY. THE ORGANIZATION IS REQUIRED TO SUBMIT AN ANNUAL REPORT TO THE STATE OF ARKANSAS DETAILING ALL RELEVANT INFORMATION SO THE STATE CAN REVIEW AND DETERMINE WHETHER THERE IS CONFLICT OF INTEREST. WE ALSO REVIEW THIS AS AN ADDITIONAL LEVEL OF MONITORING.
Form 990 Part VI
13
THE COUNTY MONITORS OUR ORGANIZATION, INCLUDING FULLFILLING REGULATORY REQUIREMENTS FOR A WHISTLEBLOWER POLICY. WE ARE REQUIRED TO SUBMIT AN ANNUAL TRANSPARENCY REPORT TO THE COUNTY WHICH IS PUBLICLY AVAILABLE. WE ALSO REVIEW THIS AS AN ADDITIONAL LEVEL OF MONITORING.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.