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: 2. |
| 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: 9,482. |
| 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: 2,000. |
| 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: 5,000. |
| 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 Teen Power Program. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation for Medical Expenses. Grantee Name: Bank of Jackson Hole-Jhoan Gaona. Grantee Relationship: none. Property Description: cash paid for medical expenses. Amount Given: 250. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Lions Club International. Grantee Address: 300 W 22nd St. Oak Brook, IL 60523. Grantee Relationship: parent organization. Property Description: cash for general support. Amount Given: 1,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Teton Youth & Family Services. Grantee Address: PO Box 2631 Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for general support. Amount Given: 1,000. |
| 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 expenses. Amount Given: 2,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation to Non-Profit. Grantee Name: Lions of Wyoming Foundation. Grantee Address: 244 Talon Ct Cheyenne, WY 82009. Grantee Relationship: affiliated foundation. Property Description: cash for general support. Amount Given: 1,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation . Grantee Name: Howdy Partners. Grantee Address: 112 Center St Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for general support. Amount Given: 2,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation . Grantee Name: Community Safety Network. Grantee Address: 650 Hall Ave Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for general support. Amount Given: 1,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation. Grantee Name: St. John's Medical Center Oncology Department. Grantee Address: 625 E Broadway Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for oncology patients' expenses. Amount Given: 3,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation. Grantee Name: T.C. Fair Administration. Grantee Address: 305 W Snow King Ave Jackson, WY 83001. Grantee Relationship: none. Property Description: cash for general support. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Donation. Grantee Name: Mark Morzov. Grantee Relationship: none. Property Description: cash for medical expenses. Amount Given: 500. Total included on Form 990-EZ, line 10: 31,232. |
| Form 990-EZ, Part I, Line 14 | Description: Depreciation. Amount: 147. |
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: Bank charges. Amount: 13. Description: State chapter dues. Amount: 204. Description: International chapter dues. Amount: 709. Description: Flag Program expenses. Amount: 798. Description: Guest Meals. Amount: 60. Description: Travel-conventions. Amount: 134. Description: WY Secretary of State. Amount: 25. Description: Insurance/Registration. Amount: 724. Total to Form 990-EZ, line 16: 2,667. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: Other Depreciable Assets. Beg. of Year Amount: 368. End of Year Amount: 221. |
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