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.") .... | 2,611,373 | 2,326,381 | 2,373,241 | 2,643,796 | 2,385,059 | 12,339,850 |
| 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.. | 2,611,373 | 2,326,381 | 2,373,241 | 2,643,796 | 2,385,059 | 12,339,850 |
| 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. | 12,339,850 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 2,611,373 | 2,326,381 | 2,373,241 | 2,643,796 | 2,385,059 | 12,339,850 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 56,203 | 93,954 | 104,529 | 41,334 | 84,948 | 380,968 |
| 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.. | 142,492 | 35,392 | 32,949 | 5,727 | 23,541 | 240,101 |
| 11 | Total support (Add lines 7 through 10). | 12,960,919 | |||||






| 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 VI | 11b | The Executive Director and Bookkeeper review the 990 and then provide it to the members of the board. |
| Form 990 Part VI | 12c | Officers and Key Employees are required to disclose any potential conflicts of interest at the time of hire/appointment and at any time thereafter when such a conflict may appear evident. A designated agency form will be signed and dated by agency personnel and board members. A copy will be filed with company documents. Potential conflicts of interest will be discussed by members at board meetings as necessary. Members may be asked to abstain from voting on matters for which there is a perceived or real conflict. |
| Form 990 Part VI | 15 | Key employees compensation are reviewed and approved by the Board of Directors using statewide and national salary compensation data. |
| Form 990 Part VI | 19 | The organization makes the conflict of interest policy, financial statements and organizing documents available for public inspection upon request. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 250,321, Grants and allocations 0, Revenue 249,553 Family Reunification Case managers work with children in DHHS care and with their parents to reunite the family |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 345,078, Grants and allocations 0, Revenue 268,839 Homebased Care Case managers work with children and adolescents dealing with mental illness, emotional needs,. mental retardation and developmental disorders in the childs home or community to teach behavior management, skill development and physical development activities. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 91,137, Grants and allocations 0, Revenue 84,595 McKinney Homeless Assistance Engages children and youths and assesses service needs. Provide children from birth to 20 years old with treatment for mental illness, emotional health and mental retardation. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 96,269, Grants and allocations 0, Revenue 126,526 Other Other programs to provide assistance to youth and families in Androscoggin, Cumberland, Franklin, Kennebec, Knox, Lincoln, Oxford, Somerset, Sagadahoc and Waldo |
| Form 990, Part III, Line 4d Program Service Expenses 250,321, Grants and allocations 0, Revenue 249,553 Family Reunification Case managers work with children in DHHS care and with their parents to reunite the family Form 990, Part III, Line 4d Program Service Expenses 345,078, Grants and allocations 0, Revenue 268,839 Homebased Care Case managers work with children and adolescents dealing with mental illness, emotional needs,. mental retardation and developmental disorders in the childs home or community to teach behavior management, skill development and physical development activities. Form 990, Part III, Line 4d Program Service Expenses 91,137, Grants and allocations 0, Revenue 84,595 McKinney Homeless Assistance Engages children and youths and assesses service needs. Provide children from birth to 20 years old with treatment for mental illness, emotional health and mental retardation. Form 990, Part III, Line 4d Program Service Expenses 96,269, Grants and allocations 0, Revenue 126,526 Other Other programs to provide assistance to youth and families in Androscoggin, Cumberland, Franklin, Kennebec, Knox, Lincoln, Oxford, Somerset, Sagadahoc and Waldo Form 990 Part VI Section B Line 11b The Executive Director and Bookkeeper review the 990 and then provide it to the members of the board. Form 990 Part VI Section B Line 12c Officers and Key Employees are required to disclose any potential conflicts of interest at the time of hire/appointment and at any time thereafter when such a conflict may appear evident. A designated agency form will be signed and dated by agency personnel and board members. A copy will be filed with company documents. Potential conflicts of interest will be discussed by members at board meetings as necessary. Members may be asked to abstain from voting on matters for which there is a perceived or real conflict. Form 990 Part VI Section B Line 15 Key employees compensation are reviewed and approved by the Board of Directors using statewide and national salary compensation data. Form 990 Part VI Section C Line 19 The organization makes the conflict of interest policy, financial statements and organizing documents available for public inspection upon request. |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |