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 | ||||
| (A)
DC Services of San Antonio |
746106876 | 9 | No | Yes | Yes | 3,000 | |||
| (B)
Daug Charity Serv Dumas AR |
621712703 | 9 | No | Yes | Yes | 1,500 | |||
| (C)
St Gabriel Mercy Ctr Mound Bayou |
640926061 | 9 | No | Yes | Yes | 5,000 | |||
| (D)
St Agatha Ctr St L |
431579791 | 9 | No | Yes | Yes | 4,000 | |||
| (E)
Northside Community Cnter Inc St L |
431028098 | 9 | No | Yes | Yes | 3,000 | |||
| (F)
Mercy Endeavors Sr Ctr NO |
260502228 | 9 | No | Yes | Yes | 4,200 | |||
| (G)
Catholic Charities of Effingham |
370061499 | 9 | No | Yes | Yes | 4,000 | |||
| (H)
St Augustine Wellston Center |
431633395 | 9 | No | Yes | Yes | 5,000 | |||
| (I)
Mercy Medical and Mercy Life Development |
636002215 | 9 | No | Yes | Yes | 2,000 | |||
| (J)
El Paso Villa Maria |
770621343 | 9 | No | Yes | Yes | 3,000 | |||
| (K)
Project Juan Diego |
810606967 | 9 | No | Yes | Yes | 3,000 | |||
| (L)
Catholic Charities BF |
431045346 | 9 | No | Yes | Yes | 5,000 | |||
| Total | 42,700 | ||||||||
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.") . | ||||||
| 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) 2008 | (b) 2009 | (c) 2010 | (d) 2011 | (e) 2012 | (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.. | 15,817 | 15,531 | 15,251 | 13,083 | 17,181 | 76,863 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 15,817 | 15,531 | 15,251 | 13,083 | 17,181 | 76,863 |
| 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.).. | 15,817 | 15,531 | 15,251 | 13,083 | 17,181 | 76,863 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 12000057 |
| Software Version: | 12.13.328.3 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part VI | b 11a | A draft of the 990 is reviewed and approved by the Treasurer and Executive Committee before the form is filed with the IRS. |
| Form 990 Part VI | b 12c | The moral principles of the organizations ministry clearly confrom to the civil law requirements contemplated in the Whistle Blower, Record Retention and Conflict of interest Policies. |
| Form 990 Part VI | B 15 | There are no paid employees or directors. All Directors are members of Roman Catholic religious orders and they are not compensated due to their personal vows of poverty. |
| Form 990 Part VII | 1 | There are no employees. All Directors are members of Roman Catholic religious orders and they are not compensated due to their personal vows of poverty. |
| Software ID: | 12000057 |
| Software Version: | 12.13.328.3 |