Attach to Form 990 or Form 990-EZ.
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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 0 | 0 | 14,435 | 15,919 | 40,022 | 70,376 |
| 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 | 0 | 0 | 14,435 | 15,919 | 40,022 | 70,376 |
| 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).. | 63,593 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 6,783 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 0 | 0 | 14,435 | 15,919 | 40,022 | 70,376 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 0 | 0 | 0 | 0 | 4 | 4 |
| 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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | 70,380 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 16,120 | 14,435 | 15,919 | 40,022 | 86,496 |
| 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. | 0 | 16,120 | 14,435 | 15,919 | 40,022 | 86,496 |
| 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.) | 86,496 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 16,120 | 14,435 | 15,919 | 40,022 | 86,496 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1 | 2 | 3 | 3 | 4 | 13 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1 | 2 | 3 | 3 | 4 | 13 |
| 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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 1 | 16,122 | 14,438 | 15,922 | 40,026 | 86,509 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Part II, line 10 | | S.No:, Amount:, Description:| 1, $0, n/a| |
| Part III, line 12 | | S.No:, Amount:, Description:| 1, $0, n/a| |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Part I, line 10 | |Activity:, Grantee Name:, Grantee Address:, Amount:, Relationship:| Donation to Fund Wellness Walk, Lake Health Foundation, "7590 Auburn Road Concord Twp Oh 44077", $8373.00, None| Charitable donation to fund operations, Extended Housing, "270 E. Main Street, Suite 300, Painesville, OH 44077", $1000.00, None| Donation to Help fund operations, Project Hope, "25 Freedom Rd, Painesville, OH 44077", $2500.00, None| Annual Charitable donation, Salvation Army, "69 Pearl St, Painesville, OH 44077", $250.00, None| Holiday Donation, 15500 S Waterloo Rd, Cleveland, OH, "15500 S Waterloo Rd, Cleveland, OH 44110", $250.00, None| Charitable Donation for operations, Carolines Kids, "7394 Morley Rd, Painesville, OH 44077", $100.00, None| Donation Charitable, Mission 4 Maureen, "1568 S. Green Rd. 21602 South Euclid, OH 44121", $100.00, None| Donation to assist in fundraising, Eastlake North HS Band, "34041 Stevens Boulevard eastlake oh 44095", $100.00, None| donation to fundraiser for scholarship fund., Danny Parmertar Fund, "8068 Eastway Drive Mentor Oh 44060", $100.00, None| Youth Sports Donation, Solon Rec Department, "35000 Portz Pkwy, Cleveland, OH 44139", $275.00, None| Fundraiser Donation, Lake Humane Society, "7564 E Tyler Boulevard Mentor OH 44060", $180.00, None| Fundraiser Donation to help build a new playground, Brook Park Memorial Elementary, "16900 Holland Road Brook Park, OH 44142", $100.00, None| Fundraiser donation, Rotary Club of Cleveland, "3813 Euclid Ave, Cleveland, OH 44115", $750.00, None| Fundraiser donation, Littlest Heros, "32000 Aurora Rd, Solon, OH 44139", $325.00, None| Donation to general operations, Discover Aviation Center, "44050 Russia Road Unit 6 Elyria OH 44035", $500.00, None| Fundraiser Donation, American Cancer Society, "10501 Euclid Ave Cleveland Oh 44106", $130.00, None| Fundraiser Donation, Rolling Thunder, "PO Box 216 Neshanic Station NJ 08853", $844.00, None| Fundraiser donation, Littlest Heros, "32000 Aurora Rd, Solon, OH 44139", $250.00, None| Fundraiser donation, Lake County Humane Society, "7564 E Tyler Boulevard Mentor OH 44060", $760.00, None| Fundraiser donation, Special Sports, "7643 Mary Lane Mentor OH 44060", $825.00, None| Fundraiser donation, Greater Western Reserve, "4930 Enterprise Blvd. NW. Warren OH 44481", $700.00, None| Donation to general operations, Project Love, "5244 Mayfield Rd, Lyndhurst, OH 44124", $250.00, None| Youth Sports Donation, Solon Cyclones, "6679 Som Center Rd Solon OH 44139", $785.00, None| Fundraiser donation, Kirtland Music Boosters, "9150 Chillicothe Rd, Kirtland, OH 44094", $100.00, None| Fundraiser donation directed to this organization, Salvation Army, "69 Pearl St, Painesville, OH 44077", $250.00, None| Fundraiser donation directed to this organization, Greater Cleveland Food Bank, "15500 S Waterloo Rd, Cleveland, OH 44110", $250.00, None| Fundraiser donation, Euclid Beach Park, "E 156th St, Cleveland, OH 44110", $180.00, None| Donation related to funds raised for Mikes Safe Fund, St. Gabriels Church, "9925 Johnnycake Ridge Rd, Mentor, OH 44060", $8000.00, None| Approved Grant Request to help fund local chapter to educate, American Fdn for Suicide Prevention, "120 Wall Street 29th Floor New York, NY 10005", $4400.00, None| Fundraiser Donation, Madison Joint Rec Dept, "P.O. Box 456 Madison OH 44057", $200.00, None| Fundraising Donation, EPAL, "600 E349th Street Eastlake OH 44095", $1000.00, None| Donation to support Eastlake Saftey Town, Eastlake PD, "35150 Lakeshore Blvd, Willoughby, OH 44095", $100.00, None| Grant Request Donation to support buidling of new Baseball Field, Wickliffe HS Baseball Boosters, "2255 Rockefeller Rd, Wickliffe, OH 44092", $500.00, None| Scholarship to employees, Local 160 Scholarship, "8358 Munson Road 104 Mentor OH 44060", $1000.00, None| Sponsorship of 2014 and 2015 Kidz Biz Awards, LC Chambers of Commerce, "1 Victoria Square Suite 265a Painesville OH 44077", $500.00, None| Youth Sports Donation, Mentor Girls Softball, "PO Box 446 Mentor OH 44060", $195.00, None| Youth Sports Donation, SEYSBA, "Po Box 21165 South Euclid OH 44121", $225.00, None| Youth Sports Donation, McMinn Baseball League, "PO Box 725 Mentor Oh 44060", $250.00, None| Youth Sports Donation, Mayfield Boys Baseball, "PO Box 24086 Mayfield Hts OH 44124", $300.00, None| Youth Sports Donation, Euclid Boys League, "PO Box 32614 Euclid OH 44132", $300.00, None| Youth Sports Donation, City of Highland Hts, "5827 Highland Road Highland Hts OH 44143", $250.00, None| Youth Sports Donation, Twinsburg Baseball, "10270 Ravenna Rd Twinsburg OH 44087", $1100.00, None| Youth Sports Donation, Willowick Titans, "491 E 327th St Willowick OH 44095", $150.00, None| Youth Sports Donation, Willowick Softball, "283 Woodmere Drive Eastlake OH 44095", $250.00, None| Donation to general operations, Gideons International, "PO Box 140800 Nashville, TN 37214", $100.00, None| |
| Part I, line 16 | | Other Expenses:, Amount:| Payment to R Demko Mgmt fee bonus, $2000.00| |
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