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.") .... | 7,522,337 | 9,011,456 | 8,508,623 | 7,974,835 | 5,376,845 | 38,394,096 |
| 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.. | 7,522,337 | 9,011,456 | 8,508,623 | 7,974,835 | 5,376,845 | 38,394,096 |
| 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. | 38,394,096 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 7,522,337 | 9,011,456 | 8,508,623 | 7,974,835 | 5,376,845 | 38,394,096 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6,890 | 1,886 | 1,683 | 2,043 | 216 | 12,718 |
| 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.. | 215,345 | 75,575 | 53,037 | 100,878 | 30,719 | 475,554 |
| 11 | Total support (Add lines 7 through 10). | 38,882,368 | |||||






| 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 |
|---|
| Explanation |
|---|
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990 Part IX | 24E | PROGRAM MGMT TOTAL SERVICE GENERAL EXPENSE EXPENSES EXPENSES PROFESSIONAL SERVICES FEES 125,143 49,981 75,162 COST OF GOOD SOLD 57,844 57,685 159 PRINTING PUBLICATIONS 25,924 24,434 1,490 POSTAGE 12,735 11,544 1,191 BAD DEBT EXPENSE 4,264 4,264 - MISCELLANEOUS EXPENSE 36,877 17,709 19,168 MEDICAID PROVIDER ASSESSMENT 130,999 130,999 - IN-KIND EXPENSES 153,590 153,590 - DUES MEMBERSHIPS 32,071 22,040 10,031 ALLOCATED ADMIN COSTS - 992,909 992,909 579,447 1,465,155 885,708 |
| Form 990 Part VI | 11 | A COPY OF FORM 990 WAS PROVIDED FOR REVIEW PRIOR TO SUBMISSION |
| Form 990 Part VI | 19 | ORGANIZATION DOCUMENTS, CONFLICT OF INTEREST STATEMENTS AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| Form 990 Part VI | 12C | CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND UPDATED NO LESS THAN ANNUALLY |
| Form 990 Part VI | 15B | COMPENSATION OF EXECUTIVES AND KEY EMPLOYEES IS COMPARED TO AGENCIES OF SIMILAR SIZE AND PROGRAMMING TO DETERMINE REASONABLENESS. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 1,010,070, Grants and allocations 0, Revenue 0 THE EMPLOYMENT SERVICES DIVISION EMPOWERS INDIVIDUALS WITH THE SKILLS TO BE COMFORTABLE IN THEIR COMMUNITY. 464 INDIVIDUALS BENEFITED FROM THESE SERVICES DURING THE YEAR. |
| Form 990, Part III, Line 4d Program Service Expenses 1,010,070, Grants and allocations 0, Revenue 0 THE EMPLOYMENT SERVICES DIVISION EMPOWERS INDIVIDUALS WITH THE SKILLS TO BE COMFORTABLE IN THEIR COMMUNITY. 464 INDIVIDUALS BENEFITED FROM THESE SERVICES DURING THE YEAR. Form 990 Part IX Line 24E PROGRAM MGMT TOTAL SERVICE GENERAL EXPENSE EXPENSES EXPENSES PROFESSIONAL SERVICES FEES 125,143 49,981 75,162 COST OF GOOD SOLD 57,844 57,685 159 PRINTING PUBLICATIONS 25,924 24,434 1,490 POSTAGE 12,735 11,544 1,191 BAD DEBT EXPENSE 4,264 4,264 - MISCELLANEOUS EXPENSE 36,877 17,709 19,168 MEDICAID PROVIDER ASSESSMENT 130,999 130,999 - IN-KIND EXPENSES 153,590 153,590 - DUES MEMBERSHIPS 32,071 22,040 10,031 ALLOCATED ADMIN COSTS - 992,909 992,909 579,447 1,465,155 885,708 Form 990 Part VI Section B Line 11 A COPY OF FORM 990 WAS PROVIDED FOR REVIEW PRIOR TO SUBMISSION Form 990 Part VI Section C Line 19 ORGANIZATION DOCUMENTS, CONFLICT OF INTEREST STATEMENTS AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990 Part VI Section B Line 12C CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND UPDATED NO LESS THAN ANNUALLY Form 990 Part VI Section B Line 15B COMPENSATION OF EXECUTIVES AND KEY EMPLOYEES IS COMPARED TO AGENCIES OF SIMILAR SIZE AND PROGRAMMING TO DETERMINE REASONABLENESS. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |