TY 2011 Form 990EZ

- TIN:

Form990-EZ
Click to see attachment

Department of the Treasury
Internal Revenue Service

Short Form
Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)

Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-1150

2011

Open to Public
Inspection

For the 2011 calendar year, or tax year beginning 07-01-2011, and ending 06-30-2012

Check if applicable:

Address change

Name change

Initial return

Terminated

Amended return

Application pending

C Name of organization
LEAP INC

Number and street (or P. O. box, if mail is not delivered to street address)49725 COUNTY ROAD 83 ATT TIM RICE
Room/suite

City or town, state or country, and ZIP + 4 STAPLES, MN56479

D Employer identification number

31-1740634

E Telephone number

(218) 894-8610

F Group Exemption
Number. . bullet

G Accounting method: CashAccrualOther (specify) bullet

H Check bullet

required to attach Schedule B
(Form 990, 990-EZ, or 990-PF).I Website: bullet

N/AJ Tax-Exempt status(check only one)501(c)(3) Click to see attachment

501(c)( ) bullet

(insert no.) 4947(a)(1) or 527

K Check

if the organization is not a section 509(a)(3) supporting organization or a section 527 organization and its gross receipts are normally not more than $50,000. A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.

L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more,file Form 990 instead of Form 990-EZ........... bullet

$ 119,407


1	Contributions, gifts, grants, and similar amounts received...............			1	41,991
2	Program service revenue including government fees and contracts ............			2	75,349
3	Membership dues and assessments......................			3
4	Investment income...........................			4	105
5a	Gross amount from sale of assets other than inventory........	5a
b	Less: cost or other basis and sales expenses...........	5b
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ......			5c
6	Gaming and fundraising events
a	Gross income from gaming (attach Schedule G if greater than $15,000) .	6a
b	Gross income from fundraising events (not including $ of contributions from fundraising events reported on line 1) (attach Schedule G if the
	sum of such gross income and contributions exceeds $15,000)	6b	1,962
c	Less: direct expenses from gaming and fundraising events.......	6c	568
d	Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c)			6d	1,394
7a	Gross sales of inventory, less returns and allowances........	7a
b	Less: cost of goods sold.................	7b
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .........			7c
8	Other revenue (describe in Schedule O) .....................			8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8.................			9	118,839
10	Grants and similar amounts paid (list in Schedule O) .................			10	10,200
11	Benefits paid to or for members........................			11
12	Salaries, other compensation, and employee benefits................			12	28,979
13	Professional fees and other payments to independent contractors............			13	1,118
14	Occupancy, rent, utilities, and maintenance...................			14	6,621
15	Printing, publications, postage, and shipping...................			15
16	Other expenses (describe in Schedule O) ....................			16	96,063
17	Total expenses. Add lines 10 through 16 ....................			17	142,981
18	Excess or (deficit) for the year (Subtract line 17 from line 9)............			18	-24,142
19	Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
	end-of-year figure reported on prior year’s return)................			19	59,763
20	Other changes in net assets or fund balances (explain in Schedule O) ..........			20
21	Net assets or fund balances at end of year. Combine lines 18 through 20.........			21	35,621

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 10642I Form 990-EZ (2011)

Form 990-EZ (2011)

Page 2

Part IIBalance Sheets (see the instructions for Part II.)Check if the organization used Schedule O to respond to any question in this Part II.............

(See the instructions for Part II.)(A) Beginning of year(B) End of year

22Cash, savings, and investments................

49,432

27,151

23Land and buildings....................

24Other assets (describe in Schedule O) ..........

14,305

11,595

25Total assets......................

63,737

38,746

Total liabilities (describe in Schedule O) .............

3,974

3,125

27Net assets or fund balances (line 27 of column (B) must agree with line 21)..

59,763

35,621

Part IIIStatement of Program Service Accomplishments (see the instructions for Part III.) Check if the organization used Schedule O to respond to any question in this Part III .	Expenses (Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? OBJECTIVES ARE TO: 1. WORK AS A LIAISON BETWEEN THE COMMUNITY AND SCHOOL DISTRICT, 2. SUPPORT VOLUNTEERISM IN THE SCHOOL AND COMMUNITY, 3. IDENTIFY VIABLE WAYS FOR THE SCHOOL TO ADAPT TO CURRENT ECONOMICS AND DEMOGRAPHIC CIRCUMSTANCES, 4. DETERMINE THE STRENGTHS AND WEAKNESSES OF THE DISTRICT THROUGH FOCUS GROUP MEETINGS AND DECIDE WHICH OPTIONS PROVIDE THE MOST BENEFITS FOR THE COMMUNITY AND THE SCHOOL DISTRICT, 5. BUILDING A STRONGER STAPLES COMMUNITY THAT WILL ENRICH THE QUALITY OF LIFE NOW AND FOR FUTURE GENERATIONS, 6. DETERMINE THE STRENGTHS AND WEAKNESSES OF THE COMMUNITY THROUGH FOCUS GROUP MEETINGS AND DECIDE WHICH OPTIONS PROVIDE THE MOST BENEFITS FOR THE COMMUNITY AND BUSINESSES, 7. FACILITATE THE CITIZENS, CITY GOVERNMENT, AND BUSINESSES IN STAPLES TO IMPROVE COMMUNICATION AND PLANNING AND WORK TOGETHER ON PROJECTS.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 THE COFFEE SHOP PROVIDED A BUSINESS SETTING WHERE YOUTH WERE EDUCATED TO PARTICIPATE IN RUNNING A BUSINESS. THEY ALSO HELD EDUCATIONAL PROGRAMS ON VARIOUS TOPICS FROM LEARNING ABOUT THE CULTURE OF VISITING FOREIGN EXCHANGE STUDENTS TO FIXING A BIKE. YOUTH WERE ALSO PROVIDED OPPORTUNITIES ON A REGULAR BASIS FOR ARTISTIC EXPRESSION SUCH AS OPEN MIC NIGHT, COMEDY IMPROV NIGHT, VISUAL ARTS DISPLAYS AND MUSICAL PERFORMANCES). THE SHOP ALSO PROVIDES A SAFE ATMOSPHERE FOR STUDENTS TO MINGLE,PARTICIPATE IN STUDY GROUPS, SURF THE INTERNET OR PLAY GAMES. ANOTHER PROGRAM RUN AT THE COFFEE SHOP WAS A SATURDAY MORNING STORY HOUR FOR YOUNGSTERS. (Grants $ ) If this amount includes foreign grants, check here ...			28a	81,047
29 ASSISTED THE STAPLES BROADBAND COLLABORATIVE IN HIRING A CONTRACTOR TO CONDUCT A FEASIBILITY STUDY TO DETERMINE IF A BROADBAND FIBER NETWORK WILL BE POSSIBLE IN STAPLES. BROADBAND FIBER WOULD BRING HIGH SPEED INTERNET COMMUNICATION TO HOMES AND BUSINESSES IN THE CITY. THE FEASIBILITY STUDY INCLUDED MARKET ANALYSIS, ENGINEERING AND ESTIMATE COSTS OF LAYING THE FIBER CABLES THROUGHOUT THE TOWN. IT IS EXPECTED THAT BROADBAND FIBER WOULD AID IN COMMUNITY AND ECONOMIC DEVELOPMENT. (Grants $ ) If this amount includes foreign grants, check here ...			29a	25,000
30 ASSISTED THE LIONS CLUB OF STAPLES IN SENDING VETERANS TO WASHINGTON DC TO VISIT THEIR RESPECTIVE MEMORIALS AND TO VISIT ARLINGTON NATIONAL CEMETERY. (Grants $ 10,200) If this amount includes foreign grants, check here ...			30a	10,200
DOWNTOWN REVITALIZATION -IN CONJUNCTION WITH THE STAPLES/MOTLEY CHAMBER OF COMMERCE, HIRED A CONTRACTOR TO PROMOTE REVITALIZATION OF THE STAPLES AREA, INCLUDING CREATING A COMMERCIAL DIRECTORY MAP AND ARTICLES TO PUBLICIZE DOWNTOWN ROAD CONSTRUCTION PROGRESS. FRIENDS OF THE LIBRARY -CONTINUED TO PURCHASE ITEMS SUCH AS ARTWORK, CANOPY TENT AND OTHER SPECIALIZED NEEDS IN THE NEW PUBLIC LIBRARY WHICH OPENED IN MARCH 2010. ASSISTED A LOCAL GROUP OF VOLUNTEERS IN HOSTING A "HOOKED ON FISHING, NOT ON DRUGS" EVENT FOR LOCAL 4TH GRADERS. HELPED THE LOCAL GROUP "FRIENDS OF THE TRAIL" RUN AN EVENT TO BRING ATTENTION TO THE WANTS AND NEEDS OF A TRAIL SYSTEM IN THE AREA. ASSISTED STAPLES MOTLEY EARLY CHILDHOOD COALITION IN PROMOTING PROGRAMS FOR YOUNG CHILDREN (0-5) AND THEIR PARENTS. THE MISSION IS TO ENSURE THAT ALL CHILDREN HAVE A HEALTHY START AND ARE WELL-PREPARED TO START THEIR SCHOOL JOURNEY. CURRENT FOCUSES ARE: REDUCING BARRIERS TO ECFE AND SCHOOL READINESS, REDUCING BARRIERS TO HEALTHCARE (MENTAL, DENTAL, AND HEALTH), AND INCREASING OPPORTUNITIES AND AWARENESS FOR FAMILIES WITH CHILDREN 0-5 YEARS. ASSISTED A NEW CHARTER SCHOOL, CONNECTIONS HIGH SCHOOL, TO FILE FOR 501C(3) STATUS. HOSTED A LOCAL CHICK-FIL-A LEADERCAST EVENT FOR LOCAL LEADERS. (Grants $ ) If this amount includes foreign grants, check here ...		26,193
31 Other program services (describe in Schedule O) .................. (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a)..............	32	142,440

Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (see the instructions for Part IV.)Check if the organization used Schedule O to respond to any question in this Part IV..........

(a) Name and title	(b) Average hours per week devoted to position	(c)Reportable compensation (Forms W-2/1099-MISC) (if not paid, enter -0-)	(d) Health benefits, contributions to employee benefit plans, and deferred compensation	(e) Estimated amount of other compensation
TIM RICE C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	CHAIR1.00	0
CHRIS ETZLER C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	SEC., TREAS.1.00	0
JEREL NELSEN C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	VICE CHAIR1.00	0
KEVIN JENKINS C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
MARK SCHMITZ C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
TOM KAJER C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
DICK DONAT C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
SALLY GORTON C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
BARB SCHMITT C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
JEF CICHOS C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
JIM HOFER C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
LANI ROBERTS C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
MARY KOBLISKA C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
NATHAN MATHEWS C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
SUE NANIK C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
WENDY SCHLUENDER C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
BRENDA HALVORSON C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
MARK PAGNAC C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
AMY HUNTER C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
JAKE HUEBSCH C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
JEFF WIG C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
KATIE WILLIAMS C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0
LEE JENKINS C/O LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES,MN56479	DIRECTOR1.00	0

Form 990-EZ (2011)

Page 3

Part VOther Information(Note the Schedule A and personal benefit contract statement requirements in the instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V

Yes

Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................

Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions). ..........................

35a

Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............

35a

If ‘Yes’ to line 35a, has the organization filed a Form 990-T for the year? If ‘No,’ provide an explanation in Schedule O.

35b

Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III.

35c

Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N ................

37a

Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet

37a

Did the organization file Form 1120-POL for this year?...................

37b

38a

Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were

any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..

38a

If “Yes,” complete Schedule L, Part II and enter the total amount involved .

38b

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on line 9.......

39a

Gross receipts, included on line 9, for public use of club facilities.....

39b

40a

Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:

section 4911 bullet

; section 4912 bullet

; section 4955 bullet

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ......

40b

Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958... bullet

Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization.................... bullet

All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. ......................

40e

41List the states with which a copy of this return is filed. bullet

42aThe organization's books are in care of bullet

MIKE GEDDE Telephone no. bullet

(218) 894-8207

Located at bullet

PO BOX 244
STAPLES,MN ZIP + 4 bullet

56479

At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?

Yes

42b

If “Yes,” enter the name of the foreign country: bullet

See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

At any time during the calendar year, did the organization maintain an office outside the U.S.?

42c

If “Yes,” enter the name of the foreign country: bullet

43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041Check here ....... bullet

and enter the amount of tax-exempt interest received or accrued during the tax year.... bullet

Yes

44a

Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of

Form 990-EZ.................................

44a

Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completedinstead of Form990-EZ.............................

44b

Did the organization receive any payments for indoor tanning services during the year?.........

44c

If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanationin Schedule O................................

44d

45a

Did the organization have a controlled entity within the meaning of
section 512(b)(13)?............................

45a

45b

Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form990-EZ (see instructions).....................

45b

Form 990-EZ (2011)

Page 4

Yes

Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes,” complete Schedule C, Part I. ..............

Part VI

Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI ...........

Yes

Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ....

49a

Did the organization make any transfers to an exempt non-charitable related organization?......

49a

If "Yes," was the related organization a section 527 organization?................

49b

Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and title of each employee paid more than $100,000	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC)	(d) Health benefits, contributions to employee benefit plans, and deferred compensation	(e) Estimated amount of other compensation
NONE

Total number of other employees paid over $100,000 ................. bullet

Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and address of each independent contractor paid more than $100,000	(b) Type of service	(c) Compensation
NONE

Total number of other independent contractors each receiving over $100,000.......... bullet

Did the organization complete Schedule A? NOTE:All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ..................... Yes No

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid preparer use only

Print/type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image

Firm's address Right pointing arrowhead image

Phone no.

May the IRS discuss this return with the preparer shown above? See instructions ......... bullet

YesNo

Form 990-EZ (2011)

Additional Data

Software ID:
Software Version:

Form 990-EZ, Special Condition Description:

Special Condition Description

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

LEAP INC

Employer identification number

31-1740634

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

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.") ....	41,092	30,012	59,049	76,628	41,991	248,772
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..	41,092	30,012	59,049	76,628	41,991	248,772
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)..						6,969
6	Public Support. Subtract line 5 from line 4.						241,803

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
7	Amounts from line 4..	41,092	30,012	59,049	76,628	41,991	248,772
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	300	491	190	152	105	1,238
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..	4,002	938	1,504	1,003	1,394	8,841
11	Total support (Add lines 7 through 10).						258,851

Gross receipts from related activities, etc. (See instructions.) ..................

77,311

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

93.410 %

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

92.710 %

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

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.)

Section B. Total Support

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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

LEAP INC

Employer identification number

31-1740634

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization LEAP INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization LEAP INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
LEAP INC

Employer identification number

31-1740634

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

LEAP INC

Employer identification number

31-1740634

Identifier	Return Reference	Explanation
GRANTS AND SIMILAR AMTS PAID TO ORGANIZATIONS	FORM 990-EZ, PART I, LINE 10	LIONS CLUB OF STAPLES 01/06/2012 PO BOX 143 STAPLES, MN 56479 10,200 0 0
OTHER EXPENSES	FORM 990-EZ, PART I, LINE 16	EXPENSES INSURANCE 391 SUPPLIES 319 TELEPHONE 845 POSTAGE 124 POSTAGE 18 REPAIRS & MAINTENANCE 1,302 PRINTING AND PUBLICATION 1,009 BANK CHARGES 98 COST OF SALES - COFFEE SH 34,113 DOWNTOWN REVIT. PROGRAM E 8,868 EDUCATION 7 LICENSES AND FEES 350 LICENSES AND FEES 25 MISCELLANEOUS 261 MISCELLANEOUS 48 UTILITIES 4,239 LIBRARY EXPENSES 3,265 FIBER BROAD BAND EXPENSES 25,000 HOOKED ON FISHING PROJECT 949 FRIENDS OF TRAIL PROJECT 417 CONNECTIONS HIGH SCHOOL 850 LEADERCAST PROGRAM 9,575 S/M EARLY CHILDHOOD COALI 2,269 NON-INVESTMENT DEPRECIATION 1,721 TOTAL 96,063
OTHER ASSETS	FORM 990-EZ, PART II, LINE 24	INVENTORIES FOR SALE OR USE 3,453 2,476 EQUIPMENT & LHI 23,422 23,401 LESS ACCUMULATED DEPRECIATION 12,570 14,282 TOTAL 14,305 11,595
OTHER LIABILITIES	FORM 990-EZ, PART II, LINE 26	PAYROLL LIABILITIES 529 393 SALES TAX PAYABLE 1,169 1,186 GIFT CERTIFICATES PAYABLE 2,276 1,546
PRIMARY EXEMPT PURPOSE	FORM 990-EZ, PART III	OBJECTIVES ARE TO: 1. WORK AS A LIAISON BETWEEN THE COMMUNITY AND SCHOOL DISTRICT, 2. SUPPORT VOLUNTEERISM IN THE SCHOOL AND COMMUNITY, 3. IDENTIFY VIABLE WAYS FOR THE SCHOOL TO ADAPT TO CURRENT ECONOMICS AND DEMOGRAPHIC CIRCUMSTANCES, 4. DETERMINE THE STRENGTHS AND WEAKNESSES OF THE DISTRICT THROUGH FOCUS GROUP MEETINGS AND DECIDE WHICH OPTIONS PROVIDE THE MOST BENEFITS FOR THE COMMUNITY AND THE SCHOOL DISTRICT, 5. BUILDING A STRONGER STAPLES COMMUNITY THAT WILL ENRICH THE QUALITY OF LIFE NOW AND FOR FUTURE GENERATIONS, 6. DETERMINE THE STRENGTHS AND WEAKNESSES OF THE COMMUNITY THROUGH FOCUS GROUP MEETINGS AND DECIDE WHICH OPTIONS PROVIDE THE MOST BENEFITS FOR THE COMMUNITY AND BUSINESSES, 7. FACILITATE THE CITIZENS, CITY GOVERNMENT, AND BUSINESSES IN STAPLES TO IMPROVE COMMUNICATION AND PLANNING AND WORK TOGETHER ON PROJECTS.
FIRST ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 28	THE COFFEE SHOP PROVIDED A BUSINESS SETTING WHERE YOUTH WERE EDUCATED TO PARTICIPATE IN RUNNING A BUSINESS. THEY ALSO HELD EDUCATIONAL PROGRAMS ON VARIOUS TOPICS FROM LEARNING ABOUT THE CULTURE OF VISITING FOREIGN EXCHANGE STUDENTS TO FIXING A BIKE. YOUTH WERE ALSO PROVIDED OPPORTUNITIES ON A REGULAR BASIS FOR ARTISTIC EXPRESSION SUCH AS OPEN MIC NIGHT, COMEDY IMPROV NIGHT, VISUAL ARTS DISPLAYS AND MUSICAL PERFORMANCES). THE SHOP ALSO PROVIDES A SAFE ATMOSPHERE FOR STUDENTS TO MINGLE,PARTICIPATE IN STUDY GROUPS, SURF THE INTERNET OR PLAY GAMES. ANOTHER PROGRAM RUN AT THE COFFEE SHOP WAS A SATURDAY MORNING STORY HOUR FOR YOUNGSTERS.
SECOND ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 29	ASSISTED THE STAPLES BROADBAND COLLABORATIVE IN HIRING A CONTRACTOR TO CONDUCT A FEASIBILITY STUDY TO DETERMINE IF A BROADBAND FIBER NETWORK WILL BE POSSIBLE IN STAPLES. BROADBAND FIBER WOULD BRING HIGH SPEED INTERNET COMMUNICATION TO HOMES AND BUSINESSES IN THE CITY. THE FEASIBILITY STUDY INCLUDED MARKET ANALYSIS, ENGINEERING AND ESTIMATE COSTS OF LAYING THE FIBER CABLES THROUGHOUT THE TOWN. IT IS EXPECTED THAT BROADBAND FIBER WOULD AID IN COMMUNITY AND ECONOMIC DEVELOPMENT.
ALL OTHER ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 31	DOWNTOWN REVITALIZATION -IN CONJUNCTION WITH THE STAPLES/MOTLEY CHAMBER OF COMMERCE, HIRED A CONTRACTOR TO PROMOTE REVITALIZATION OF THE STAPLES AREA, INCLUDING CREATING A COMMERCIAL DIRECTORY MAP AND ARTICLES TO PUBLICIZE DOWNTOWN ROAD CONSTRUCTION PROGRESS. FRIENDS OF THE LIBRARY -CONTINUED TO PURCHASE ITEMS SUCH AS ARTWORK, CANOPY TENT AND OTHER SPECIALIZED NEEDS IN THE NEW PUBLIC LIBRARY WHICH OPENED IN MARCH 2010. ASSISTED A LOCAL GROUP OF VOLUNTEERS IN HOSTING A "HOOKED ON FISHING, NOT ON DRUGS" EVENT FOR LOCAL 4TH GRADERS. HELPED THE LOCAL GROUP "FRIENDS OF THE TRAIL" RUN AN EVENT TO BRING ATTENTION TO THE WANTS AND NEEDS OF A TRAIL SYSTEM IN THE AREA. ASSISTED STAPLES MOTLEY EARLY CHILDHOOD COALITION IN PROMOTING PROGRAMS FOR YOUNG CHILDREN (0-5) AND THEIR PARENTS. THE MISSION IS TO ENSURE THAT ALL CHILDREN HAVE A HEALTHY START AND ARE WELL-PREPARED TO START THEIR SCHOOL JOURNEY. CURRENT FOCUSES ARE: REDUCING BARRIERS TO ECFE AND SCHOOL READINESS, REDUCING BARRIERS TO HEALTHCARE (MENTAL, DENTAL, AND HEALTH), AND INCREASING OPPORTUNITIES AND AWARENESS FOR FAMILIES WITH CHILDREN 0-5 YEARS. ASSISTED A NEW CHARTER SCHOOL, CONNECTIONS HIGH SCHOOL, TO FILE FOR 501C(3) STATUS. HOSTED A LOCAL CHICK-FIL-A LEADERCAST EVENT FOR LOCAL LEADERS.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

TY 2011 CompensationExplanation

Name:

LEAP INC

EIN: 31-1740634

Person Name	Explanation
TIM RICE
CHRIS ETZLER
JEREL NELSEN
KEVIN JENKINS
MARK SCHMITZ
TOM KAJER
DICK DONAT
SALLY GORTON
BARB SCHMITT
JEF CICHOS
JIM HOFER
LANI ROBERTS
MARY KOBLISKA
NATHAN MATHEWS
SUE NANIK
WENDY SCHLUENDER
BRENDA HALVORSON
MARK PAGNAC
AMY HUNTER
JAKE HUEBSCH
JEFF WIG
KATIE WILLIAMS
LEE JENKINS