TY 2013 Form 990

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) STEVE IRVING........................................................................
President

0.00
.......................0.00

(2) RICH BALLA........................................................................
Treasurer

0.00
.......................0.00

(3) CHRIS CARPENTER........................................................................
Director

0.00
.......................0.00

(4) Jeff Waddell........................................................................
Director

0.00
.......................0.00

(5) RITA JACOBSON........................................................................
Director

0.00
.......................0.00

(6) PATRICK DELANEY........................................................................
Director

0.00
.......................0.00

(7) TERRY BISHOP........................................................................
Director

0.00
.......................0.00

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(A)
Name and business address

(B)
Description of services

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	635,238
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,020
9	Other employee benefits .......	26,651
10	Payroll taxes ...........	96,766
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	0
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	120,000
23	Insurance ..............	39,848
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Equipment lease/rental	104,924
b	Chemicals/fertilizer	64,853
c	Repair and maintenance	63,784
d	Utilities	61,088
e	All other expenses	237,022
25	Total functional expenses. Add lines 1 through 24e	1,453,194	0	0	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.

(A)
Total expenses

(B)
Program service expenses

(D)
Fundraising expenses

Grants and other assistance to governments and organizations in the United States. See Part IV, line 21

Grants and other assistance to individuals in the United States. See Part IV, line 22

Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16

Benefits paid to or for members

Compensation of current officers, directors, trustees, and key employees ....

Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....

Other salaries and wages

635,238

Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....

3,020

Other employee benefits .......

26,651

Payroll taxes ...........

96,766

Fees for services (non-employees):

Management ......

Legal .........

Accounting ...........

Lobbying ...........

Professional fundraising services. See Part IV, line 17

Investment management fees ......

Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........

Advertising and promotion ....

Office expenses .......

Information technology ......

Royalties ..

Occupancy ...........

Travel ............

Payments of travel or entertainment expenses for any federal, state, or local public officials ......

Conferences, conventions, and meetings ....

Interest ...........

Payments to affiliates .......

Depreciation, depletion, and amortization .....

120,000

Insurance ..............

39,848

Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)

Equipment lease/rental

104,924

Chemicals/fertilizer

64,853

Repair and maintenance

63,784

Utilities

61,088

All other expenses

237,022

Total functional expenses. Add lines 1 through 24e

1,453,194

Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet

if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	285,875	1	103,857
2	Savings and temporary cash investments .........	152,652	2	411,063
3	Pledges and grants receivable, net ...........		3	0
4	Accounts receivable, net .............	533,610	4	449,494
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............		7	0
8	Inventories for sale or use ..............	22,809	8	22,604
9	Prepaid expenses and deferred charges ..........		9	465
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	5,798,945
b	Less: accumulated depreciation .....	10b	3,458,522	2,359,014	10c	2,340,423
11	Investments—publicly traded securities ..........		11	0
12	Investments—other securities. See Part IV, line 11 .....		12	0
13	Investments—program-related. See Part IV, line 11 .....		13	0
14	Intangible assets ...............		14	0
15	Other assets. See Part IV, line 11 ...........		15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......	3,353,960	16	3,327,906
	17	Accounts payable and accrued expenses .........	80,539	17	91,429
18	Grants payable .................		18
19	Deferred revenue ................	506,609	19	418,009
20	Tax-exempt bond liabilities .............		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................		25
26	Total liabilities. Add lines 17 through 25.........	587,148	26	509,438
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	2,766,812	27	2,818,468
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,766,812	33	2,818,468
34	Total liabilities and net assets/fund balances ........	3,353,960	34	3,327,906

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............

(A)
Beginning of year

(B)
End of year

Cash–non-interest-bearing .............

285,875

103,857

Savings and temporary cash investments .........

152,652

411,063

Pledges and grants receivable, net ...........

Accounts receivable, net .............

533,610

449,494

Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................

Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L

Notes and loans receivable, net .............

Inventories for sale or use ..............

22,809

22,604

Prepaid expenses and deferred charges ..........

465

10a

Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D

10a

5,798,945

Less: accumulated depreciation .....

10b

3,458,522

2,359,014

10c

2,340,423

Investments—publicly traded securities ..........

Investments—other securities. See Part IV, line 11 .....

Investments—program-related. See Part IV, line 11 .....

Intangible assets ...............

Other assets. See Part IV, line 11 ...........

Total assets. Add lines 1 through 15 (must equal line 34)......

3,353,960

3,327,906

Accounts payable and accrued expenses .........

80,539

91,429

Grants payable .................

Deferred revenue ................

506,609

418,009

Tax-exempt bond liabilities .............

Escrow or custodial account liability. Complete Part IV of Schedule D..

Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified

persons. Complete Part II of Schedule L..........

Secured mortgages and notes payable to unrelated third parties ..

Unsecured notes and loans payable to unrelated third parties ....

Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................

Total liabilities. Add lines 17 through 25.........

587,148

509,438

Organizations that follow SFAS 117 (ASC 958), check here MediumBullet

and complete lines 27 through 29, and lines 33 and 34.

Unrestricted net assets ..............

2,766,812

2,818,468

Temporarily restricted net assets ...........

Permanently restricted net assets ...........

Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet

and complete lines 30 through 34.

Capital stock or trust principal, or current funds ........

Paid-in or capital surplus, or land, building or equipment fund .....

Retained earnings, endowment, accumulated income, or other funds

Total net assets or fund balances ...........

2,766,812

2,818,468

Total liabilities and net assets/fund balances ........

3,353,960

3,327,906

	(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

		Amount
c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Description of property	(a) Cost or other basis (investment)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,310,735		1,310,735
b	Buildings ................	4,488,210	3,458,522	1,029,688
c	Leasehold improvements ............
d	Equipment ................
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......	2,340,423

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......	1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................	2e
3	Subtract line 2e from line 1.....................	3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................	4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......	5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........	1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................	2e
3	Subtract line 2e from line 1.....................	3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................	4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......	5

- 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.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

KISHWAUKEE COUNTRY CLUB INC

Employer identification number

36-1327041

Return Reference	Explanation
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	The organization has adult members of several classifications. These include, equity memberships which allows full use of club facilities in addition to voting rights. Other memberships provide for limited use of club facilities with no voting rights.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	The Organization's equity members elect the board of directors annually. The board of directors elects the officers from within the board.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	Capital expenditures in excess of $25,000 and any assessments must be approved by a majority of voting equity members.
Form 990, Part VI, Line 11b: Form 990 Review Process	990 is reviewed by Organization's president and/or treasurer prior to filing.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	No documents available to the public.
Form 990, Part IX, Line 24e: Other Expenses	Adjustment to financial stmt: Column (A) - Total = $-363; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Advertising: Column (A) - Total = $1541; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Bad debts: Column (A) - Total = $1859; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Club events: Column (A) - Total = $10773; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Computer fees: Column (A) - Total = $19743; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Credit card fees: Column (A) - Total = $18995; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Gas/oil: Column (A) - Total = $24303; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Golf Course improvement/maint.: Column (A) - Total = $23555; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Handicap exp: Column (A) - Total = $12160; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Irrigation: Column (A) - Total = $4096; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Legal/professional fees: Column (A) - Total = $8226; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	License: Column (A) - Total = $5107; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Miscellaneous: Column (A) - Total = $2188; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Office postage: Column (A) - Total = $9547; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Other Supplies: Column (A) - Total = $15451; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Real estate taxes: Column (A) - Total = $44400; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Restaurant Supplies: Column (A) - Total = $31181; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Telephone: Column (A) - Total = $4260; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000170
Software Version:	2013v3.1

1	Briefly describe the organization’s mission or most significant activities: A local country club providing its members and their guests with various social and recreational activities including golf, tennis, swimming and leisure dining.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	97
6	Total number of volunteers (estimate if necessary) .............	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	61,985
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		0
9	Program service revenue (Part VIII, line 2g) .........	1,205,835	1,166,452
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	838	452
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	342,916	337,946
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	1,549,589	1,504,850
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	773,236	761,675
16a	Professional fundraising fees (Part IX, column (A), line 11e).....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	695,878	691,519
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,469,114	1,453,194
19	Revenue less expenses. Subtract line 18 from line 12.......	80,475	51,656
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,353,960	3,327,906
21	Total liabilities (Part X, line 26).............	587,148	509,438
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,766,812	2,818,468

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	Operation of golf course, tennis club, swimming pool and dining facility for the use of members and their guests.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			0
			Business Code
2a
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			1,166,452
3	Investment income (including dividends, interest, and other similar amounts).......			452		452
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a		532,550
b	Less: cost of goods sold ..b		194,604
c	Net income or (loss) from sales of inventory..			337,946	276,413	61,533
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			1,504,850	1,442,865	61,985

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

1.(a) Description of liability		(b) Book value
Federal income taxes









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................