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.") .... | 460,868 | 537,762 | 556,594 | 676,560 | 682,232 | 2,914,016 |
| 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.. | 460,868 | 537,762 | 556,594 | 676,560 | 682,232 | 2,914,016 |
| 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. | 2,914,016 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 460,868 | 537,762 | 556,594 | 676,560 | 682,232 | 2,914,016 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 62 | 16 | 78 | |||
| 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.. | 1,200 | 1,650 | 2,850 | |||
| 11 | Total support (Add lines 7 through 10). | 2,916,944 | |||||






| 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 VI | 11b | A Draft Copy of the Form 990 in pdf format is sent the Board of Directors for their review, comment and changes. Any and all changes are incorporated into the draft and it is then finalized before the actual filing of it. |
| Form 990 Part VI | 12c | The Board of Directors reviews the conflict of interest policy, matters and documents when appropriate. |
| Form 990 Part VI | 15a | The State of Connecticut has five 5 independent living centers that have very similar mission statements and operations. Therefore, the Board of Directors has the ability to compare compensation levels for the same position in very similar organizations. In addition, the organization belongs to the national organization of independent living centers that affords a national comparision as well. |
| Form 990 Part VI | 19 | The organization does make its Form 990, Conflict of Interest Policy and Financial Statements available to the public upon request. It provides copies of Form 990 as requested. In addition, a copy of the return is published on the GuideStar website for all to review. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 15,000, Grants and allocations 0, Revenue 0 Provide direct case service funds to people with disabilities in order to remove or modify barriers in the community or work place that would allow these individuals to live or work more independently in their homes or work better in their workplace. |
| Form 990, Part III, Line 4d Program Service Expenses 15,000, Grants and allocations 0, Revenue 0 Provide direct case service funds to people with disabilities in order to remove or modify barriers in the community or work place that would allow these individuals to live or work more independently in their homes or work better in their workplace. Form 990 Part VI Section B Line 11b A Draft Copy of the Form 990 in pdf format is sent the Board of Directors for their review, comment and changes. Any and all changes are incorporated into the draft and it is then finalized before the actual filing of it. Form 990 Part VI Section B Line 12c The Board of Directors reviews the conflict of interest policy, matters and documents when appropriate. Form 990 Part VI Section B Line 15a The State of Connecticut has five 5 independent living centers that have very similar mission statements and operations. Therefore, the Board of Directors has the ability to compare compensation levels for the same position in very similar organizations. In addition, the organization belongs to the national organization of independent living centers that affords a national comparision as well. Form 990 Part VI Section C Line 19 The organization does make its Form 990, Conflict of Interest Policy and Financial Statements available to the public upon request. It provides copies of Form 990 as requested. In addition, a copy of the return is published on the GuideStar website for all to review. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |