Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990-EZ, Part I, Line 4 - Other Investment Income | Description: Interest Income. Amount: 1. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Eye exams and glasses. Grantee Name: individuals in our community. Property Description: cash paid to eyecare providers. Amount Given: 9,874. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Food shelf donation. Grantee Name: Jackson Food Cupboard. Grantee Address: 170 N Glenwood Jackson, WY 83001. Grantee Relationship: none. Property Description: cash to buy food. Amount Given: 3,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Community Resource Center. Grantee Address: 170 N Glenwood Jackson, WY 83001. Grantee Relationship: none. Property Description: cash to pay for their programs. Amount Given: 2,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to School District . Grantee Name: Teton County School District. Grantee Address: PO Box 568 Jackson, WY 83001. Grantee Relationship: none. Property Description: support for Robotics program. Amount Given: 1,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation for Medical Expenses. Grantee Name: Bank of Jackson Hole-FBO Leslie Denny. Grantee Relationship: none. Property Description: cash paid to eyecare providers. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Lions Club International-Phillipines Relief. Grantee Address: 300 W 22nd St. Oak Brook, IL 60523. Grantee Relationship: parent organization. Property Description: cash for Phillipines Typhoon Relief. Amount Given: 2,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Benevolent&Protective Order of Elks#1713 . Grantee Address: 270 W Broadway Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for charitable causes. Amount Given: 1,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation for Medical Expenses. Grantee Name: Senior Center of Jackson Hole. Grantee Address: 830 E Hansen Ave Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for medical prescriptions. Amount Given: 1,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Rocky Mountain Lions Eye Bank. Grantee Address: PO box 6026 Aurora, CO 80045. Grantee Relationship: none. Property Description: donation to cover medical expenses. Amount Given: 1,000. Total included on Form 990-EZ, line 10: 22,874. |
| Form 990-EZ, Part I, Line 14 | Description: Depreciation. Amount: 406. |
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: Bank charges. Amount: 144. Description: State chapter dues. Amount: 340. Description: International chapter dues. Amount: 722. Description: Flag Program expenses. Amount: 721. Description: Guest Meals. Amount: 30. Description: Advertising. Amount: 460. Total to Form 990-EZ, line 16: 2,417. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: Other Depreciable Assets. Beg. of Year Amount: 0. End of Year Amount: 368. |
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