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.") .... | 1,748,371 | 3,178,557 | 2,343,942 | 2,318,583 | 3,311,952 | 12,901,405 |
| 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.. | 1,748,371 | 3,178,557 | 2,343,942 | 2,318,583 | 3,311,952 | 12,901,405 |
| 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. | 12,901,405 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,748,371 | 3,178,557 | 2,343,942 | 2,318,583 | 3,311,952 | 12,901,405 |
| 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). | 12,901,405 | |||||






| 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 | 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...... | ||||||
| 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. | ||||||
| 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.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 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.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part IX | STATEMENT OF FUNCTIONAL EXPENSES OTHER EXPENSES OUTREACH EXPENSE, HEALTH EDUCATION SUPPLIES,RECRUITMENT, | |
| Form 990 Part IX | 990 PART IX990 PART IX PROGRAM Management 31-Jul-12 LINE 24F SERVICE and General Total Expenses outreach 1,526 100 1,626 Health education supplies 1,383 0 1,383 Recruitment 58 2,381 2,439 Dues and membership 7,606 51,023 58,629 Books and subscriptions 342 2,901 3,243 Miscellaneous 2,656 23,986 26,642 Insurance and bonding 49,824 32,705 82,529 Property Taxes 0 0 0 Equipment rental 8,103 1,515 9,618 Equipment repairs 24,883 18,435 43,318 Maintenance and Repairs 48,565 22,826 71,391 Utilities 37,672 17,876 55,548 Storage Expense 0 9,043 9,043 Fund raising 0 17,523 17,523 Janitorial fees and maintenance 29,535 12,184 41,719 Client transportation 614 0 614 Uniform 189 350 539 TOTAL 212956 212848 425804 | |
| LINE 24F | ||
| outreach | ||
| Health education supplies | ||
| Recruitment | ||
| Dues and membership | ||
| Books and subscriptions | ||
| Miscellaneous | ||
| Insurance and bonding | ||
| Property Taxes | ||
| Equipment rental | ||
| Equipment repairs | ||
| Maintenance and Repairs | ||
| Utilities | ||
| Storage Expense | ||
| Fund raising | ||
| Janitorial fees and maintenance | ||
| Client transportation | ||
| Uniform | ||
| Form 990 Part IX STATEMENT OF FUNCTIONAL EXPENSES OTHER EXPENSES OUTREACH EXPENSE, HEALTH EDUCATION SUPPLIES,RECRUITMENT, Management 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 212848 |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |