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.") .... | 30,100 | 31,645 | 20,150 | 1,800 | 1,150 | 84,845 |
| 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 | 30,100 | 31,645 | 20,150 | 1,800 | 1,150 | 84,845 |
| 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).. | 45,009 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 39,836 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 30,100 | 31,645 | 20,150 | 1,800 | 1,150 | 84,845 |
| 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). | 84,845 | |||||






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 |
|---|---|
| FORM 990-EZ, PART I, LINE 10 | NONE 17,090 0 0 |
| FORM 990-EZ, PART III | THE CORPORATION IS ORGANIZED TO RAISE FUNDS TO (I) SUPPORT CANCER AWARENESS AND EDUCATION ABOUT CANCER AND CANCER TREATMENT METHODS, (II) MEDICAL RESEARCH FOR CANCER TREATMENT AND PROVIDE FINANCIAL SUPPORT FOR CANCER PATIENTS AND THEIR FAMILIES WHO ARE POOR AND ARE IN NEED OF FINANCIAL ASSISTANCE TO PAY FOR CANCER MEDICAL TREATMENT AND RELATED TRANSPORTATION EXPENSES TO MEDICAL FACILITIES TO RECEIVE MEDICAL TREATMENT AND TEMPORARY LIVING EXPENSES INCURRED WHILE UNDERGOING MEDICAL TREATMENT. |
| FORM 990-EZ, PART III, LINE 28 | ASSISTANCE PROVIDED TO 37 CANCER PATIENTS AND THEIR FAMILIES SUFFERING FINANCIAL HARDSHIP. THE FOUNDATION PAID FOR LIVING EXPENSES SUCH AS INSURANCE, UTILITIES, RENT, MORTGAGE PAYMENTS, FOOD, GAS, PROPERTY TAXES, MEDICAL SUPPLIES, AND AUTO LOAN PAYMENTS. PAYMENTS WERE MADE TO THE PROVIDER OF THE GOODS AND SERVICES AND NOT DIRECTLY TO THE CANCER PATIENTS OR THEIR FAMILIES. |
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| Person Name | Explanation |
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DAN PEOPLES DAN PEOPLES |
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ALLEN W FEHNEL ALLEN W FEHNEL |
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CLAYTON CHRISTOPHER CLAYTON CHRISTOPHER |
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GARY CHRISTOPHER GARY CHRISTOPHER |
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GENE CRISMAN GENE CRISMAN |
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GERRI CHRISTOPHER GERRI CHRISTOPHER |
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LANCE FOX LANCE FOX |
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LISA PARIGI LISA PARIGI |
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MARTIN BROUSSARD MARTIN BROUSSARD |
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MICHAEL R JENKINS MICHAEL R JENKINS |
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JO BETH JENKINS JO BETH JENKINS |
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MONTY CHRISTOPHER MONTY CHRISTOPHER |
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SHELLEY TORTORICE SHELLEY TORTORICE |
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BILL SCOTT BILL SCOTT |