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. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
AMERICAN ORDNANCE LLC
Employer identification number
42-6062997
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
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).
f
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
..................................................
g
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
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(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 monetary support
Yes
No
Yes
No
Yes
No
(A)
National Child Safety Council
386035290
9
No
Yes
400
(B)
Hope Haven Development Corp
421000580
9
No
Yes
1,325
(C)
PAWS
000000000
9
No
Yes
156
(D)
Boy Scout Troop 3
420680479
9
No
Yes
312
(E)
Boy Scout Troop 51
000000000
9
No
Yes
26
(F)
Boy Scout Troop 71
205223910
9
No
Yes
211
(G)
Biggsville Ambulance
000000000
9
No
Yes
358
(H)
AMVETS Post 29
030387027
501(c)(19)
No
Yes
442
(I)
Biggsville Fire Dept
000000000
9
No
Yes
65
(J)
St Vincent Depaul Society
721557396
9
No
Yes
206
(K)
Danville Fire and Rescue
562316550
9
No
Yes
577
(L)
Great River Hospice
000000000
9
No
Yes
501
(M)
West Point Fire
421087241
9
No
Yes
485
(N)
Winfield Fire
000000000
9
No
Yes
117
(O)
Chicago Shriners Hospital
362193608
9
No
Yes
199
(P)
Mediapolis Fire and Ambulance
421192545
9
No
Yes
240
(Q)
Nauvoo Grade School Basketball
000000000
9
No
Yes
176
(R)
Honor flight of the quad cities
000000000
9
No
Yes
150
(S)
West Burlington Fire
260832805
9
No
Yes
156
(T)
Wapello Fire Dept
202146936
9
No
Yes
143
(U)
Raritan Fire Dept
000000000
9
No
Yes
221
(V)
Oqauwka Fire Dept
000000000
9
No
Yes
141
(W)
Oquawka Ambulance
364089806
9
No
Yes
25
(X)
Niota Fire Dept
000000000
9
No
Yes
33
(Y)
New London fire Dept
426005035
9
No
Yes
314
(Z)
New London Band booster
000000000
9
No
Yes
52
(AA)
American Family Radio KAYP
640607275
9
No
Yes
276
(AB)
HOPE House Center
421279943
9
No
Yes
52
(AC)
Henry County Hospice
000000000
9
No
Yes
520
(AD)
GSA Troop 9249
000000000
9
No
Yes
156
(AE)
Ft madison Athletic Boosters
000000000
9
No
Yes
260
(AF)
Burlington Homeless Shelter
421498646
9
No
Yes
189
(AG)
Farmington EMS
000000000
9
No
Yes
58
(AH)
American Lung society
204392201
9
No
Yes
52
(AI)
Iowa Special Olympics
000000000
9
No
Yes
200
(AJ)
Amanda the Panda
421166117
9
No
Yes
200
(AK)
Ronald McDonald House
421189783
9
No
Yes
150
(AL)
MDA Camp Courageous
237210932
9
No
Yes
200
(AM)
Burlington Area United Way
420680362
9
Yes
Yes
16,478
(AN)
American Cancer Society
420724036
9
Yes
Yes
3,029
(AO)
Gladstone Fire
000000000
9
No
Yes
65
(AP)
Lomax Fire
370908213
9
No
Yes
150
(AQ)
Easter Seals
420707100
9
No
Yes
150
(AR)
National Multiple Scleroris
420255544
9
No
Yes
26
(AS)
Bonaparte Fire
426004286
9
No
Yes
251
Total
29,493
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
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........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
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
.......................
b
33 1/3% support test—2011.
If the organization did not check a 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
.....................
17a
10%-facts-and-circumstances test—2012.
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
.....................................................
b
10%-facts-and-circumstances test—2011.
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
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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.)..
14
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.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
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
........
b
33 1/3% support tests—2011.
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
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Specific Org not listed in by-laws but 50% must go to area United Ways, 15% ea. to Cancer Fund and Heart Fund (through the Burlington United Way) and the balance to employee designated charity or 501-c-3 as decided by the trustees
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000197
Software Version:
v1.00
-
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
AMERICAN ORDNANCE LLC
Employer identification number
42-6062997
Identifier
Return Reference
Explanation
F99Z_P01_S00_L10
Form 990-EZ, Part I, Line 10
Form 990-EZ Part 1 Line 10 - 9 area United Ways Funds $9,750, charities designated by employees $10,015, American Heart Fund $2,926.63 and American Cancer Society $2,962.63 and distribution by the trutees of $3,900
F99Z_P03_S00_L28
Form 990-EZ, Part III, Line (28-31)
Form 990-EZ Part III Line (28-31) - The total on this line is the amount distributed by the trustees as required by the by-laws of the plan
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.