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 monetary support | |||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| (A)
AREA AGENCY ON AGING REGION X AREA AGENCY ON AGING REGION X |
431159115 | 7 | Yes | Yes | Yes | 1,555 | |||
| (B)
AREA COMMUNITY HEALTH EMISSARIES INC (ACHE) AREA COMMUNITY HEALTH EMISSARIES INC (ACHE) |
371468927 | 7 | Yes | Yes | Yes | 1,555 | |||
| (C)
BIG BROTHERS & BIG SISTERS OF JASPER & NEWTON COUNTIES BIG BROTHERS & BIG SISTERS OF JASPER & NEWTON COUNTIES |
431767815 | 9 | Yes | Yes | Yes | 950 | |||
| (D)
OZARK TRAILS COUNCIL BOY SCOUTS OF AMERICA OZARK TRAILS COUNCIL BOY SCOUTS OF AMERICA |
440546294 | 9 | Yes | Yes | Yes | 2,333 | |||
| (E)
CEREBRAL PALSY CEREBRAL PALSY OF TRI-COUNTY INC |
440614493 | 7 | Yes | Yes | Yes | 8,553 | |||
| (F)
CHILDREN'S MERCY HOSPITAL CHILDREN'S MERCY HOSPITAL |
440605373 | 7 | Yes | Yes | Yes | 15,939 | |||
| (G)
NEWTON COUNTY 4-H COUNCIL NEWTON COUNTY 4-H COUNCIL |
203658274 | 7 | Yes | Yes | Yes | 2,333 | |||
| (H)
GIRL SCOUTS GIRL SCOUTS |
440594943 | 9 | Yes | Yes | Yes | 2,333 | |||
| (I)
LAFAYETTE HOUSE LAFAYETTE HOUSE |
431170015 | 7 | Yes | Yes | Yes | 11,663 | |||
| (J)
NEOSHO CROSSLINES MINISTRIES CROSSLINES GUEST HOUSE |
431488438 | 7 | Yes | Yes | Yes | 4,665 | |||
| (K)
SWMO CHAPTER- AMERICAN RED CROSS AMERICAN RED CROSS SWMO CHAPTEROSS |
530296605 | 7 | Yes | Yes | Yes | 7,775 | |||
| (L)
SALVATION ARMY SALVATION ARMY |
430653584 | 7 | Yes | Yes | Yes | 6,220 | |||
| (M)
NEWTON CO CANCER FUND NEWTON CO CANCER FUND |
431304557 | 7 | Yes | Yes | Yes | 700 | |||
| (N)
SPECIAL OLYMPICS MISSOURI INC SPECIAL OLYMPICS MISSOURI INC |
237328374 | 7 | Yes | Yes | Yes | 1,866 | |||
| (O)
STUDENT ASSISTANCE STUDENT ASSISTANCE |
446003638 | 7 | Yes | Yes | Yes | 622 | |||
| (P)
FREEMAN SOUTHWEST FAMILY YMCA FREEMAN SOUTHWEST FAMILY YMCA |
431729473 | 7 | Yes | Yes | Yes | 2,333 | |||
| (Q)
CHILDREN'S HAVEN CHILDREN'S HAVEN |
043603881 | 7 | Yes | Yes | Yes | 1,944 | |||
| Total | 73,339 | ||||||||
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. | ||||||
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). | ||||||






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.) | ||||||
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.).. | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| GRANTS AND SIMILAR AMTS PAID TO ORGANIZATIONS | FORM 990-EZ, PART I, LINE 10 | CEREBRAL PALSY OF TRI-COUNTY, INC. CHARITABLE 1401 W AUSTIN WEBB CITY, MO 64870 8,553 0 0 CHILDREN'S MERCY HOSPITAL CHARITABLE 2401 GILLHAM RD KANSAS CITY, MO 64108 15,939 0 0 LAFAYETTE HOUSE CHARITABLE PO BOX 1765 JOPLIN, MO 64802-1185 11,663 0 0 AMERICAN RED CROSS SWMO CHAPTER CHARITABLE 401 S JACKSON JOPLIN, MO 64801 7,775 0 0 SALVATION ARMY CHARITABLE 116 N JEFFERSON NEOSHO, MO 64850 6,220 0 0 |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | EXPENSES OFFICE 1,582 TRAVEL 143 INSURANCE 257 MISCELLANEOUS 115 TOTAL 2,097 |
| PRIMARY EXEMPT PURPOSE | FORM 990-EZ, PART III | THE PURPOSE OF THIS CORPORATION SHALL BE TO RAISE FUNDS FROM RESIDENTS OF THE CITY OF NEOSHO AND OTHER PERSONS, FIRMS OR CORPORATIONS DESIRING TO CONTRIBUTE (TO THE (IF POSSIBLE) EXCLUSION OF ALL OTHER FUND RAISING DRIVES WITHIN THE CITY OF NEOSHO FOR THE SAME ULTIMATE PURPOSE OR PURPOSES), FOR CHARITABLE, BENEVOLENT, NON-PROFIT, HUMANITARIAN AND GENERAL HEALTH, WELFARE AND EDUCATION PURPOSES AND TO MAKE BENEVOLENT DISTRIBUTIONS OF SUCH FUNDS ON THE BASIS TO BE DETERMINED BY THE BOARD OF DIRECTORS TO THE POOR, UNDERPRIVILEGED OR STRICKEN AND TO EACH NON-PROFIT ORGANIZATION WHICH NOW IS OR MAY HEREAFTER SERVE THE RESIDENTS OF THE CITY OF NEOSHO AS THE BOARD OF DIRECTORS MAY DESIGNATE, WHOSE PURPOSE IS TO PROVIDE CHARITABLE ASSISTANCE TO THE POOR, NEEDY OR STRICKEN OR WHOSE PURPOSE IS TO PROVIDE BENEVOLENT AND CHARITABLE FINANCIAL ASSISTANCE TO OR FOR THE GENERAL HEALTH, EDUCATION OR WELFARE OF DESERVING PERSONS. |
| FIRST ACCOMPLISHMENT | FORM 990-EZ, PART III, LINE 28 | THE ORGANIZATION HAS A FUND RAISING DRIVE EACH YEAR WHICH IS PUBLICIZED THROUGH THE MEDIA. A GOAL IS ESTABLISHED AND EFFORTS ARE MADE TO MEET OR EXCEED THAT GOAL. DURING THE MOST RECENT FUND DRIVE ENDED JULY 31, 2011, FUNDS PLEDGED AND COLLECTED WERE DISBURSED TO THE AGENCIES IN THE AREA REQUESTING SUPPORT AS APPROVED. THE AGENCIES FUNDED MEET THE ORGANIZATIONS' PURPOSE OF PROVIDING CHARITABLE ASSISTANCE TO THE POOR, NEEDY OR STRICKEN. SUCH FUNDS WERE DISTRIBUTED BASED ON THE BOARD OF DIRECTORS DETERMINATION OF FINANCIAL NEED. AGENCIES FUNDED, INCLUDING AMOUNTS OF ASSISTANCE, ARE LISTED ON SCHEDULE A, PART I, QUESTION 11H. |
| Software ID: | |
| Software Version: |
| Person Name | Explanation |
|---|---|
| BILL CARLSTEN | |
| LINDA CROSBY | |
| ROB HIGGINBOTHAM | |
| SUSAN VERSLUIS | |
| DANNY SNOW | |
| DIANA MESSENS | |
| CINDY BROWN | |
| BECKY WILLIAMS | |
| MARTI MILLIKIN | |
| RENEE DENTON | |
| HEATHER SANDERS | |
| ALYSSA MARTIN | |
| EARL REYNOLDS | |
| JEFF MAXWELL | |
| ANGELA COSSOU |