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.") .... | ||||||
| 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.") . | 18,275 | 18,500 | 28,395 | 14,300 | 15,600 | 95,070 |
| 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...... | 97,431 | 161,924 | 99,516 | 118,666 | 127,826 | 605,363 |
| 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. | 115,706 | 180,424 | 127,911 | 132,966 | 143,426 | 700,433 |
| 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.) | 700,433 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 115,706 | 180,424 | 127,911 | 132,966 | 143,426 | 700,433 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 219 | 219 | ||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 219 | 219 | ||||
| 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.). | 115,706 | 180,424 | 128,130 | 132,966 | 143,426 | 700,652 |




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Members or stockholder classes and rights (Part VI, line 6) | THERE IS ONLY ONE CLASS OF MEMBERSHIP A MAJORITY OR MORE OF THE MEMBERSHIP IS REQUIRED TO ELECT OFFICERS RATIFY MOST MAJOR DECISIONS AND TO MODIFY AMEND OR ADD TO THE RULES | |
| 02. Member election for additional members (Part VI, line 7a) | THERE IS ONE CLASS OF MEMBER GOVERNING BODY MEMBERS ARE ELECTED BY A MAJORITY OF THE GENERAL MEMBERSHIP | |
| 03. Governing body decisions (Part VI, line 7b) | SOME DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY A MAJORITY OF THE GENERAL MEMBERSHIP | |
| 04. Form 990 governing body review (Part VI, line 11) | FORM 990 IS REVIEWED BY THE PRESIDENT AND TREASURER BEFORE SIGNING AFTER SIGNING THE FORM 990 WILL BE TAKEN TO THE NEXT BOARD MEETING FOR REVIEW AND DISCUSSION | |
| 05. Conflict of interest policy compliance (Part VI, line 12c) | CONTRACTS AND PAYMENTS ARE PERIODICALLY REVIEWED | |
| 06. CEO, executive director, top management comp (Part VI, line 15a) | COMPARABILITY REVIEW IS DONE BY PAST COMMITTEE MEMBER | |
| 07. Other officer or key employee compensation (Part VI, line 15b | COMPARABILITY REVIEW DONE BY TREASURER AND PRESIDENT | |
| 08. Governing documents, etc, available to public (Part VI, line 19) | UPON WRITTEN REQUEST |
| Software ID: | |
| Software Version: |