Form990-EZ
Click to see list of attachments
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
bullet Do not enter social security numbers on this form as it may be made public.
bullet Information about Form 990-EZ and its instructions is at www.irs.gov/form990.
OMB No. 1545-1150
2015
Open to Public
Inspection
A
For the 2015 calendar year, or tax year beginning 01-01-2015, and ending 12-31-2015
B
Check if applicable:
C Name of organization
PASSAIC COUNTY 200 CLUB
C/O MOUNTAIN DEVELOPMENT CORP
Number and street (or P. O. box, if mail is not delivered to street address)3 GARRET MOUNTAIN PLAZA NO 204
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code WOODLAND PARK, NJ07424
D Employer identification number

22-3342763
E Telephone number

(973) 225-0696
F Group Exemption
Numberbullet  
G Accounting Method: Other (specify) bullet   H Check bulletI Website:bulletWWW.PC200CLUB.ORGJ Tax-exempt status(check only one) - Click to see attachment(   ) bullet(insert no.) or
K Form of organization:  
L Add lines 5b, 6c, and 7b to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ ...........................bullet $ 117,981
Part I
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Check if the organization used Schedule O to respond to any question in this Part I.....................
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received .................... 1 1,805
2 Program service revenue including government fees and contracts ............... 2  
3 Membership dues and assessments ........................... 3 28,100
4 Investment income ........................... 4 24,171
5a Gross amount from sale of assets other than inventory ..... 5a 37,474
b Less: cost or other basis and sales expenses ....... 5b 35,184
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ...... 5c 2,290
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) 6a  
b Gross income from fundraising events (not including $ 1,805 of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceeds $15,000) ..Click to see attachment6b 25,870
c Less: direct expenses from gaming and fundraising events ... 6c 26,714
d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) 6d -844
7a Gross sales of inventory, less returns and allowances ...... 7a 70
b Less: cost of goods sold ............. 7b 42
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ......... 7c 28
8 Other revenue (describe in Schedule O) .......... 8 491
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 .............. Bullet 9 56,041
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ............ 10 14,500
11 Benefits paid to or for members ................ 11  
12 Salaries, other compensation, and employee benefits ................ 12 18,000
13 Professional fees and other payments to independent contractors ............ 13  
14 Occupancy, rent, utilities, and maintenance ................... 14 1,376
15 Printing, publications, postage, and shipping .............. 15 375
16 Other expenses (describe in Schedule O) .............. 16 13,423
17 Total expenses. Add lines 10 through 16 .............. Bullet 17 47,674
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9) ............ 18 8,367
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return) ............ 19 380,626
20 Other changes in net assets or fund balances (explain in Schedule O) .......... 20 -17,645
21 Net assets or fund balances at end of year. Combine lines 18 through 20 ....... 21 371,348
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2015)
Form 990-EZ (2015)
Page 2
Part IIBalance Sheets (see the instructions for Part II)Check if the organization used Schedule O to respond to any question in this Part II.................

(A) Beginning of year(B) End of year
22Cash, savings, and investments................
375,618
22
370,912
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
5,267
24
666
25Total assets......................
380,885
25
371,578
26
Total liabilities (describe in Schedule O) .............
259
26
230
27Net assets or fund balances (line 27 of column (B) must agree with line 21)
380,626
27
371,348
Part IIIStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations; optional for others.)
What is the organization's primary exempt purpose? TO RECIEVE FUNDS AND PROPERTY TO INVEST AND REINVEST THE SAME AND TO DISBURSE THE SAME AS VOLUNTARY, GRATUITOUS AND CHARITABLE GIFTS AND CONTRIBUTIONS WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE FOR THE BENEFIT OF DEPENDENT WIDOW/WIDOWERS, DEPENDENT CHILDREN OR THE NAMED BENEFICIARY OR BENEFICIARIES OF ANY LIFE INSURANCE POLICY PROVIDED BY THE MUNICIPALITY, COUNTY OR STATE OF SALARIED, VOLUNTEER OR SPECIAL LAW ENFORCEMENT OFFICERS INCLUDING STATE POLICE, FBI, DEA, AFT INS, USSS, USCS, USAP, SHEFIFF'S DEPARTMENT, PROSECUTOR'S OFFICE, CORRECTION OFFICERS, PRISON GUARDS, FIREFIGHTERS, EMERGENCY MEDICAL TECHNICIANS AND OTHER PUBLIC SAFETY PERSONNEL WHO, ALTHOUGH NOT SPECIFICALLY LISTED, PERFORM DUTIES OR FUNCTIONS SIMILAR OR RELATED TO THOSE SET FORTH IN THIS SECTION, LIVING OR SERVING IN PASSAIC COUNTY OR ITS MUNICIPALITIES WHO HAVE LOST THEIR LIVES IN THE LINE OF DUTY.TO RECOGNIZE VALOR OR MERITORIUS SERVICE BY ANYONE SET FORTH AS STATED ABOVE.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 CHARITABLE GIFTS FOR THE BENEFIT OF DEPENDENT WIDOWS AND WIDOWERS, CHILDREN AND BENEFICIARIES OF LAW ENFORCEMENT OFFICERS DESCRIBED IN SECTION #1 OF THE BY-LAWS
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 28a 0
29 SCHOLARSHIPS AWARDED TO CHILDREN OF LAW ENFORCEMENT AS DESCRIBED IN SECTION #1 OF THE BY-LAWS
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 29a 0
30 VARIOIUS AND SUNDRY DONATIONS TO WORTHY CHARITIES
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 30a 0
31 Other program services (describe in Schedule O) ................
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a).......... bullet 32 0
Part IV
List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated — see the instructions for Part IV)Check if the organization used Schedule O to respond to any question in this Part IV............
(a) Name and title (b) Average
hours per week
devoted to position		 (c)Reportable compensation
(Forms W-2/1099-MISC) (if not paid, enter -0-) 		(d) Health benefits, contributions to employee benefit plans,
and deferred compensation		 (e) Estimated amount
of other compensation
CHRISTINE E SCHULTZ  
 
PRESIDENT 		0.00 0 0 0
FRANK J LOGIOCO  
 
VICE PRESIDENT 		0.00 0 0 0
HEIDI SCRIPTURE  
 
VICE PRESIDENT 		0.00 0 0 0
JAMES R SUESSMANN  
 
TREASURER 		0.00 0 0 0
RICKY E BAGOLIE  
 
TRUSTEE 		0.00 0 0 0
RICHARD BERDNIK  
 
TRUSTEE 		0.00 0 0 0
JOSEPH BORELL  
 
TRUSTEE 		0.00 0 0 0
BARBARA J SCHROEDER  
 
TRUSTEE 		0.00 0 0 0
DANIEL BRANDMAN  
 
TRUSTEE 		0.00 0 0 0
JEFFREY BUONFORTE  
 
TRUSTEE 		0.00 0 0 0
JOSEPH CANNATELLA  
 
TRUSTEE 		0.00 0 0 0
THEODORE DEMARIA  
 
TRUSTEE 		0.00 0 0 0
Form 990-EZ (2015)
Form 990-EZ (2015)
Page 3
Part V
Other Information
(Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V.......
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions) ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III
35c
 
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes," complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
0
b
Did the organization file Form 1120-POL for this year?...................
37b
 
 
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes," complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet0 ; section 4912 bullet0 ; section 4955 bullet0
b
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes," complete Schedule L, Part I
40b
 
No
c
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958bullet0
d
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax on line 40c reimbursed by the organizationbullet0
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T ................
40e
 
No
41List the states with which a copy of this return is filed. bulletNJ
42aThe organization's books are in care of bulletPASSAIC COUNTY 200 CLUB
 Telephone no. bullet (973) 225-0696
Located at bullet3 GARRET MOUNTAIN PLAZAWOODLAND PARK,NJ ZIP + 4bullet07424
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes," enter the name of the foreign country: bullet
See the instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR)
c
At any time during the calendar year, did the organization maintain an office outside the U.S.? . . .
42c
 
No
If “Yes," enter the name of the foreign country: bullet
43......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed insteadof Form 990-EZ.............................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completedinstead of Form 990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year?.........
44c
 
No
d
If "Yes," to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an
explanation in Schedule O ............................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?.........
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions)......................
45b
 
 
Form 990-EZ (2015)
Form 990-EZ (2015)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes," complete Schedule C, Part I. ...........
46
 
No
Part VI
Section 501(c)(3) organizations only All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51 Check if the organization used Schedule O to respond to any question in this Part VI ..................
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
No
48
Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
No
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and title of each employee (b) Average
hours per week
devoted to position		 (c) Reportable compensation
(Forms W-2/1099-MISC) 		(d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation
NONE
f
Total number of other employees paid over $100,000 ...bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and business address of each independent contractor (b) Type of service (c) Compensation
NONE
d
Total number of other independent contractors each receiving over $100,000..........bullet  
52
Did the organization complete Schedule A? NOTE. All Section 501(c)(3) organizations must attach a
completed Schedule A ........................................bullet
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name bullet

Firm's EIN bullet
Firm's address bullet



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2015)

Additional Data


Software ID:  
Software Version:  

Form 990-EZ, Special Condition Description:
Special Condition Description

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
PASSAIC COUNTY 200 CLUB
C/O MOUNTAIN DEVELOPMENT CORP
Employer identification number

22-3342763
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (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      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....            
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            
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)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
7 Amounts from line 4..            
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 VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 3,730 2,420 370 11,065 1,805 19,390
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...... 73,478 23,910 23,471 19,295 25,940 166,094
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. 77,208 26,330 23,841 30,360 27,745 185,484
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
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.           0
c Add lines 7a and 7b..           0
8 Public support. (Subtract line 7c from line 6.) 185,484
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
9 Amounts from line 6... 77,208 26,330 23,841 30,360 27,745 185,484
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 10,289 10,451 12,513 14,237 24,171 71,661
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 10,289 10,451 12,513 14,237 24,171 71,661
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.).. 87,497 36,781 36,354 44,597 51,916 257,145
14
Section C. Computation of Public Support Percentage
15
15
72.130 %
16
16
82.690 %
Section D. Computation of Investment Income Percentage
17
17
27.870 %
18
18
17.310 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
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
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2015 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-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  
SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
PASSAIC COUNTY 200 CLUB
C/O MOUNTAIN DEVELOPMENT CORP
Employer identification number

22-3342763
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

BEEFSTEAK
(event type) 		(b) Event #2

VALOR AWARDS
(event type) 		(c) Other events

1
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
16,360
11,315
 
27,675

2
Less: Contributions . . . .
1,650
155
 
1,805
3 Gross income (line 1 minus
line 2) . . . . . .
14,710
11,160
 
25,870



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . .        
6 Rent/facility costs . . . .        
7 Food and beverages . . . 10,995 10,976   21,971
8 Entertainment . . . .        
9 Other direct expenses . . . 1,478 3,265   4,743
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 26,714
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -844
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1
Gross revenue . . . . .
 
 
 
 
VerticalDirectExpenses

2
Cash prizes . . . . .
 
 
 
 

3
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
1,478
3,265
 
4,743


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2015
Additional Data


Software ID:  
Software Version:  
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 990-EZ 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
2015
Open to Public
Inspection
Name of the organization
PASSAIC COUNTY 200 CLUB
C/O MOUNTAIN DEVELOPMENT CORP
Employer identification number

22-3342763
Return Reference Explanation
FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME DESCRIPTION: MERRYLL LYNCH. AMOUNT: 13,046. DESCRIPTION: MERRYLL LYNCH. AMOUNT: 3. DESCRIPTION: COLUMBIA BANK. AMOUNT: 11,122. TOTAL INCLUDED ON FORM 990-EZ, LINE 4: 24,171.
FORM 990-EZ, PART I, LINE 7 - SALES OF INVENTORY INCOME: GROSS RECEIPTS: 70. RETURNS AND ALLOWANCES: 0. LESS COST OF GOODS SOLD: 42. GROSS PROFIT: 28. COST OF GOODS SOLD: INVENTORY AT BEGINNING OF YEAR: 708. MERCHANDISE PURCHASED: 0. COST OF LABOR: 0. MATERIALS AND SUPPLIES: 0. OTHER COSTS: 0. INVENTORY AT END OF YEAR: 666. COST OF GOODS SOLD: 42.
FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE DESCRIPTION: PRIOR PERIOD VOID CHECKS. AMOUNT: 491.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: JAMES BABCOCK. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/05/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: BETHANY DEBLOCK. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/05/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: JON BLEICHNER. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 05/18/15. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: CHRISTIAN BROGAN. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 05/18/15. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: BRIA MARIE ELLIS. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 05/18/15. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: MEGAN NICKEL. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 05/15/15. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: KEVIN KLOSZ. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 05/18/15. AMOUNT GIVEN: 1,500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: RYAN IRELAND. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/05/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: OLIVIA BOLCAR. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/05/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: ALLISON SPERANZA. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/02/15. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: CHARLES KNEPPER. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/05/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: DONATION. GRANTEE NAME: PASSAIC COUNTY PIPES & DRUMS. GRANTEE ADDRESS: 9 DWYER ROAD WAYNE, NJ 07470. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 02/17/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: DONATION. GRANTEE NAME: NORTH JERSEY CHAMBER OF COMMERCE. GRANTEE ADDRESS: 205 ROUTE 46 WEST SUITE 7 TOTOWA, NJ 07512. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 09/21/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: TIMOTHY O'SHEA. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 11/05/15. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: DONATION. GRANTEE NAME: POLICE UNITY TOUR. GRANTEE ADDRESS: P.O. BOX 528 FLORHAM PARK, NJ 07932. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 02/17/15. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: JOSEPH DUNCAN. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: MEGAN ROTHLAUF. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: GIANNA COLELLA. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: MATTHEW REDA. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: KELLY ANN COYLE. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIP. GRANTEE NAME: ENRICO VENDITTE, JR.. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 500. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 14,500.
FORM 990-EZ, PART I, LINE 14 DESCRIPTION: DEPRECIATION. AMOUNT: 1,376.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: AWARDS & PLAQUES. AMOUNT: 1,826. DESCRIPTION: DUES & SUBSCRIPTIONS. AMOUNT: 150. DESCRIPTION: ADDITIONAL EVENTS. AMOUNT: 1,925. DESCRIPTION: INSURANCE. AMOUNT: 3,315. DESCRIPTION: WEBSITE. AMOUNT: 1,167. DESCRIPTION: POSTAGE. AMOUNT: 378. DESCRIPTION: CLUB SUNSHINE COMMITTEE. AMOUNT: 167. DESCRIPTION: INVESTMENT FEES. AMOUNT: 110. DESCRIPTION: SUPPLIES. AMOUNT: 345. DESCRIPTION: TELEPHONE. AMOUNT: 1,223. DESCRIPTION: PAYROLL TAXES. AMOUNT: 2,070. DESCRIPTION: PAYROLL FEES. AMOUNT: 492. DESCRIPTION: BANK CHARGES. AMOUNT: 255. TOTAL TO FORM 990-EZ, LINE 16: 13,423.
FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS DESCRIPTION: CHANGE IN FMV OF INVESTMENTS. AMOUNT: -14,483. DESCRIPTION: DEPRECIATION (BOOK TO TAX). AMOUNT: -3,162. TOTAL TO FORM 990-EZ, LINE 20: -17,645.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS DESCRIPTION: 200 CLUB BASEBALL CAPS. BEG. OF YEAR AMOUNT: 708. END OF YEAR AMOUNT: 666. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 4,559. END OF YEAR AMOUNT: 0.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: PAYROLL TAXES PAYABLE. BEG. OF YEAR AMOUNT: 259. END OF YEAR AMOUNT: 230.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  

TY 2015 TransferPrsnlBnftContractsDecl
Name:
PASSAIC COUNTY 200 CLUB
 
C/O MOUNTAIN DEVELOPMENT CORP
EIN:
22-3342763
Declaration:
THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.