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) 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 | 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) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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) 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.") . | 7,835 | 7,835 | ||||
| 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...... | 269,763 | 269,763 | ||||
| 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. | 277,598 | 277,598 | ||||
| 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.) | 277,598 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 277,598 | 277,598 | ||||
| 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.). | 0 | 0 | 277,598 | 277,598 | ||




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Member election for additional members (Part VI, line 7a) | THE NORTH CAROLINA YOUTH SOCCER ASSOCIATION AND NORTH CAROLINA ADULT SOCCER ASSOCIATION PRESIDENTS APPOINT THE SOCCER REFEREE & SOCCER YOUTH REFEREE ADMINISTRATOR AND CHAIRMAN OF THE STATE REFEREE COMMITTEE THE ADMINISTRATOR RECOMMENDS COMMITTEE DIRECTORS AND AT LARGE MEMBERS FOR APPOINTMENT THE PRESIDENTS ADMINISTRATOR AND CHAIRMAN CONFIRM BY VOTE ALL APPOINTMENTS | |
| 02. Governing body decisions (Part VI, line 7b) | THE STATE REFEREE COMMITTEE VOTE ON ALL CHANGES TO THE BYLAWS AND ANNUAL BUDGET AND FEE INCREASES THE COMMITTEE MEETS FOUR TIMES A YEAR | |
| 03. Governing body meeting documentation (Part VI, line 8a) | THE STATE REFEREE COMMITTEE MEETINGS ARE DOCUMENTED BY MINUTES TAKEN AT EACH MEETING AND APPROVED AT THE FOLLOWING MEETING | |
| 04. Form 990 governing body review (Part VI, line 11) | FORM 990 IS REVIEWED BY THE CHAIRMAN TREASURER AND PRESIDENTS OF NORTH CAROLINA YOUTH SOCCER ASSOCIATION AND NORTH CAROLINA ADULT SOCCER ASSOCIATION PRIOR TO SUBMISSION TO THE IRS AND ELECTRONICALLY SENT TO STATE REFEREE COMMITTEE MEMBERS FOR REVIEW AFTER SUBMISSION TO THE IRS | |
| 05. Governing documents, etc, available to public (Part VI, line 19) | COPIES OF THE ORGANIZATIONS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE HOUSED IN THE STATE OFFICE AND ARE MADE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST |
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| Software Version: |