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. AMOUNT: 17. |
| FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE | DESCRIPTION: MISCELLANEOUS. AMOUNT: 119. |
| FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES | AFFILIATE NAME: CIVITAN INTERNATIONAL. PURPOSE OF PAYMENT: DUES. AMOUNT OF PAYMENT: 5,470. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: BOY SCOUTS. AMOUNT GIVEN: 615. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: SO ARK DEVELEPMENTAL CENTER. AMOUNT GIVEN: 9,709. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: OPERATION CHRISTMAS CHILD. AMOUNT GIVEN: 500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: SIGHT-BOWLATHON. AMOUNT GIVEN: 500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CIVIC SUPPORT. GRANTEE NAME: EMERGENCY WORKERS APPRECIATION LUNCHEON. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: SPECIAL OLYMPICS. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: SALVATION ARMY FOOD BASKETS. AMOUNT GIVEN: 1,739. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: CIVITAN INTERNATIONAL JR CIVITAN SNO DO. AMOUNT GIVEN: 250. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: CHARITABLE. GRANTEE NAME: HANNAH MEDICAL CENTER. AMOUNT GIVEN: 250. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 14,813. |
| FORM 990-EZ, PART I, LINE 14 | DESCRIPTION: DEPRECIATION. AMOUNT: 111. DESCRIPTION: OTHER EXPENSES. AMOUNT: 2,590. TOTAL TO FORM 990-EZ, LINE 14: 2,701. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: MISCELLANEOUS. AMOUNT: 40. DESCRIPTION: MATERIALS & SUPPLIES. AMOUNT: 95. DESCRIPTION: INSURANCE. AMOUNT: 532. DESCRIPTION: AWARDS. AMOUNT: 13. DESCRIPTION: MEALS. AMOUNT: 5,816. DESCRIPTION: TRAINING. AMOUNT: 388. TOTAL TO FORM 990-EZ, LINE 16: 6,884. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: TV/VCR. BEG. OF YEAR AMOUNT: 271. END OF YEAR AMOUNT: 271. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 249. END OF YEAR AMOUNT: 138. |
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