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 | 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. | 0 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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.. | 0 | |||||
| 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.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| 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.") . | 68,168 | 162,184 | 295,888 | 706,829 | 865,810 | 2,098,879 |
| 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...... | 2,253 | 23,387 | 39,133 | 36,531 | 101,304 | |
| 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.. | 24,000 | 24,000 | 32,844 | 80,844 | ||
| 6 | Total. Add lines 1 through 5. | 68,168 | 188,437 | 343,275 | 778,806 | 902,341 | 2,281,027 |
| 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.) | 2,281,027 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 68,168 | 188,437 | 343,275 | 778,806 | 902,341 | 2,281,027 |
| 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.). | 2,281,027 | |||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | The Board of Directors is given the 990 to review and | |
| approve. This is typically distributed prior to an upcoming | ||
| Board meeting, revviewed adn voted on at the meeting. | ||
| Pt VI, Line 12c | Conflict of Interest Policy is monitored by the CEO and | |
| Board of Directors. The policy is published and shared | ||
| with its funders, and is also reviewed annually by the | ||
| Wyoming Department of Health and Mental Health. | ||
| Pt VI, Line 15 | The Board of Directors approves salary increases. | |
| Proposed increases are presented to the board, reveiwed | ||
| voted on and approved by the Board of Directors. Approval | ||
| is based on performance which includes level of funding | ||
| generated by the CEO/ED adn associated responsibility | ||
| for overseeing the agency and the grants/programs. | ||
| Pt VI, Line 19 | Governing documents are available upon request and are | |
| also public documents which are reviewed annually by the | ||
| Dept. of Health. Continued certification as Mental Health | ||
| provider for substance abuse services requeire completeness | ||
| and compliance with Department of health regulations. | ||
| Pt III, Line 2 | (1)The BNEA-TANF federally funded program concluded 9/30/12 as | |
| federal funding was not renewed. (2) The Solid Rock Community | ||
| Cafe BNEA-Outreach initiative was established in May 2013. | ||
| (3) Federal funding for the WyADRC program was no longer | ||
| available effective 9/30/12. (4) Received $ 50,000 Walmart Foundation grant to | ||
| establish the BNEA-Hunger & Health Program. | ||
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE 8500. DEFERRED REVENUE 20000. PAYROLL LIABILITIES 10167. | |
| Form 990, Part III, Line 4d | MENTAL HEALTH & SUBSTANCE ADBUSE SERVICES LICENSED 24181. 0. 35749. | |
| Form 990, Part IX, Line 24f | OTHER 14186. 0. 14186. 0. |
| Software ID: | 11000175 |
| Software Version: |