Attach to Form 990 or Form 990-EZ.
See separate instructions.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 | ||||
| Total | |||||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 84,571 | 207,788 | 95,680 | 6,597 | 95,131 | 489,767 |
| 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 | 84,571 | 207,788 | 95,680 | 6,597 | 95,131 | 489,767 |
| 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. | 489,767 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 84,571 | 207,788 | 95,680 | 6,597 | 95,131 | 489,767 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 4,125 | 4,639 | 4,044 | 4,673 | 16,155 | 33,636 |
| 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). | 523,403 | |||||






Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
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| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO RESPOND TO AND FIGHT FIRES IN THE TOWNS OF SALEM AND JACKSON IN WASHINGTON COUNTY, NY. THE COMPANY ALSO RESPONDS TO MEDICAL EMERGENCIES. |
| FORM 990, PAGE 6, PART VI, LINE 2 | JENNIFER SMALL MICHAEL YEZZI MEMBER MEMBER SPOUSES WILLIAM CASSIDY WILLIAM CASSIDY BOARD BOARD UNCLE/NEPHEW HENRY BATES MICHAEL & SHAWN BATES BOARD MEMBERS FATHER/SONS ROBERT ENDEE JR ROBERT ENDEE III OFFICER CONTRACTOR FATHER/SON DANA PERIARD SAMANTHA PERIARD BOARD OFFICER SPOUSES |
| FORM 990, PAGE 6, PART VI, LINE 6 | ANY PERSON OVER THE AGE OF 16 AND A RESIDENT OF THE FIRE DISTRICTS IN WHICH THE ORGANIZATION OPERATES IS ELIGIBLE FOR MEMBERSHIP. NEW MEMBERS ARE APPROVED BY A 2/3 VOTE OF MEMBERS AT THE NEXT REGULAR MEMBERSHIP MEETING TAKING PLACE AFTER AN APPLICATION IS SUBMITTED AND THE 3 DUES PAID. ALL NEW MEMBERS ARE PROBATIONARY FOR ONE YEAR AND MUST PASS AN EXAM ON THE OPERATIONS OF ALL FIRE EQUIPMENT AT THE END OF THE YEAR TO BE CONSIDERED ACTIVE MEMBERS. ALL FIRE FIGHTING MEMBERS MUST COMPLETE CERTAIN NYS COURSES AND AN ANNUAL FITNESS TEST. THERE ARE OTHER CATEGORIES OF MEMBERSHIP INCLUDING SOCIAL MEMBER AND INACTIVE MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 7A | SEE ANSWER TO PRIOR QUESTION. |
| FORM 990, PAGE 6, PART VI, LINE 7B | DECISIONS OF THE BOARD ARE APPROVED BY THE GENERAL MEMBERSHIP AT THE NEXT REGULAR MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 11B | DRAFT COPIES GIVEN TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANY POTENTIAL OR ACTUAL CONFLICTS MUST BE DISCLOSED TO AN OFFICER BY ANY MEMBER WHEN THE SITUATION GIVING RISE TO THE CONFLICT OCCURS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE AVAILABLE FOR REVIEW UPON REQUEST TO A BOARD MEMBER. |
| FORM 990, PART IX, LINE 24E | BUILDING MAINTENANCE 2,755 0 0 ANNUAL MEMBER FUNCTION 0 2,175 0 EQUIP M/R 850 0 0 DUES/MEMBERSHIPS 0 489 0 MISC 0 484 0 OFFICE SUPPLIES/EXP 0 280 0 |
| FORM 990, PART XI, LINE 9 | UNREALIZED LOSS ON INVESTMENTS 64,696 |
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