| FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES |
AFFILIATE NAME: ROTARY DISTRICT 6970. AFFILIATE ADDRESS: P.O. BOX 47195 JACKSONVILLE, FL 32247. PURPOSE OF PAYMENT: SEMIANNUAL DUES. AMOUNT OF PAYMENT: 2,362. |
| FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES |
AFFILIATE NAME: ROTARY INTERNATIONAL. AFFILIATE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. PURPOSE OF PAYMENT: SEMIANNUAL DUES. AMOUNT OF PAYMENT: 3,776. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 6,138. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: POLIO ERADICATION+. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 11/11/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: POLIO ERADICATION+. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 12/03/15. AMOUNT GIVEN: 1,500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: POLIO ERADICATION+. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 09/30/15. AMOUNT GIVEN: 1,190. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: POLIO ERADICATION+. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 01/06/16. AMOUNT GIVEN: 579. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: POLIO ERADICATION+. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 03/30/16. AMOUNT GIVEN: 409. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: POLIO ERADICATION+. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 06/15/16. AMOUNT GIVEN: 290. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SUSTAINING CONTRIBUTION. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 01/06/16. AMOUNT GIVEN: 2,550. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SUSTAINING CONTRIBUTION. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 03/02/16. AMOUNT GIVEN: 2,550. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SUSTAINING CONTRIBUTION. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 04/13/16. AMOUNT GIVEN: 200. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SUSTAINING CONTRIBUTION. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: ONE ROTARY CENTER EVANSTON, IL 60201-3698. DATE OF GIFT: 06/08/16. AMOUNT GIVEN: 300. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: INTERNATIONAL COMMUNITY SERVICES. GRANTEE NAME: DISTRICT 6970 . GRANTEE ADDRESS: P.O. BOX 47195 JACKSONVILLE, FL 32247. DATE OF GIFT: 03/06/16. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: INTERNATIONAL COMMUNITY SERVICES. GRANTEE NAME: DISTRICT 6970 . GRANTEE ADDRESS: P.O. BOX 47195 JACKSONVILLE, FL 32247. DATE OF GIFT: 05/16/16. AMOUNT GIVEN: 380. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: INTERNATIONAL COMMUNITY SERVICES. GRANTEE NAME: DISTRICT 6970 . GRANTEE ADDRESS: P.O. BOX 47195 JACKSONVILLE, FL 32247. DATE OF GIFT: 02/26/16. AMOUNT GIVEN: 500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: YOUTH LEADERSHIP TRAINING. GRANTEE NAME: DISTRICT 6970 RYLA. GRANTEE ADDRESS: 220 CR 210 W, SUITE 108 ST. JOHNS, FL 32259. DATE OF GIFT: 05/26/16. AMOUNT GIVEN: 1,580. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: YOUTH LEADERSHIP TRAINING. GRANTEE NAME: DISTRICT 6970 RYLA. GRANTEE ADDRESS: 220 CR 210 W, SUITE 108 ST. JOHNS, FL 32259. DATE OF GIFT: 06/15/16. AMOUNT GIVEN: 395. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: AT RISK YOUTH. GRANTEE NAME: COMMUNITIES IN SCHOOLS. GRANTEE ADDRESS: P.O. BOX 490 PALATKA, FL 32177. DATE OF GIFT: 03/06/16. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: AT RISK YOUTH. GRANTEE NAME: COMMUNITIES IN SCHOOLS. GRANTEE ADDRESS: P.O. BOX 490 PALATKA, FL 32177. DATE OF GIFT: 04/06/16. AMOUNT GIVEN: 300. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: INTERNATIONAL COMMUNITY SERVICES. GRANTEE NAME: CHRISTIANVILLE. GRANTEE ADDRESS: P.O. BOX 1056 PALATKA, FL 32177. DATE OF GIFT: 03/16/16. AMOUNT GIVEN: 100. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: COMMUNITY SERVICES. GRANTEE NAME: BREAD OF LIFE. GRANTEE ADDRESS: 320 NORTH 5TH STREET PALATKA, FL 32177. DATE OF GIFT: 03/16/16. AMOUNT GIVEN: 25. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: COMMUNITY SERVICES. GRANTEE NAME: LEE CONLEE HOUSE. GRANTEE ADDRESS: P.O. BOX 2558 PALATKA, FL 32177. DATE OF GIFT: 02/22/16. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: SJRSC FOUNDATION. GRANTEE ADDRESS: 5001 ST.JOHNS AVENUE PALATKA, FL 32177. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: COMMUNITY SERVICES. GRANTEE NAME: PUTNAM COUNTY DISTRICT SCHOOL BOARD. GRANTEE ADDRESS: 200 SOUTH 7TH STREET PALATKA, FL 32177. DATE OF GIFT: 02/04/16. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ALIYAH CAMPBELL. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: JACOB KILGORE. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: GLENDA LYNN. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: KALIN REYNOLDS. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: BRITTANY KELLY. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: CALLIE BRAUMAN. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: AMY JONES. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: COURTNEY STROGER. DATE OF GIFT: 07/15/15. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: VOCATIONAL. GRANTEE NAME: MIKE MEREDITH. DATE OF GIFT: 12/30/15. AMOUNT GIVEN: 50. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: VOCATIONAL. GRANTEE NAME: BLANCHE JANISZEWSKI. DATE OF GIFT: 12/30/15. AMOUNT GIVEN: 50. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: VOCATIONAL. GRANTEE NAME: JERRY RASH. DATE OF GIFT: 12/30/15. AMOUNT GIVEN: 50. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: COMMUNITY SERVICES. GRANTEE NAME: SALLY JAN SMITH. DATE OF GIFT: 04/06/16. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: COMMUNITY SERVICES. GRANTEE NAME: ALL ABOUT POOL SUPPLIES. GRANTEE ADDRESS: 909 S. FOREST CREEK DR ST. AUGUSTINE, FL 32080. DATE OF GIFT: 11/04/15. AMOUNT GIVEN: 2,500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID |
ACTIVITY CLASSIFICATION: COMMUNITY SERVICES. GRANTEE NAME: PROJECT LIFESAVER INC. GRANTEE ADDRESS: 815 BATTLEFIELD BLVD SOUTH CHESAPEAKE, VA 23322. DATE OF GIFT: 03/10/16. AMOUNT GIVEN: 10,000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 36,248. |
| FORM 990-EZ, PART I, LINE 14 |
DESCRIPTION: DEPRECIATION. AMOUNT: 292. DESCRIPTION: OTHER EXPENSES. AMOUNT: 2,100. TOTAL TO FORM 990-EZ, LINE 14: 2,392. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES |
DESCRIPTION: FELLOWSHIP PROGRAMS EXPENSE. AMOUNT: 20,981. DESCRIPTION: SUPPLIES. AMOUNT: 5,620. DESCRIPTION: FOOD & SUPPLIES, COMMUNITY PROJECTS. AMOUNT: 8,126. DESCRIPTION: DISTRICT CONF/ASSEMBLY/MEETINGS. AMOUNT: 5,334. DESCRIPTION: AWARDS. AMOUNT: 752. DESCRIPTION: NEW MEMBER MATERIALS. AMOUNT: 552. DESCRIPTION: SHOES/SOCKS PURCHASED FOR NEEDY KIDS. AMOUNT: 456. DESCRIPTION: CHARTER CLUB SUPPLIES DONATION. AMOUNT: 923. DESCRIPTION: BANNER/SIGNS. AMOUNT: 543. DESCRIPTION: DEPRECIATION. AMOUNT: 223. TOTAL TO FORM 990-EZ, LINE 16: 43,510. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS |
DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 223. END OF YEAR AMOUNT: 2,208. |