TY 2017 Form 990EZ

Form990EZ

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)

Do not enter social security numbers on this form as it may be made public.

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-1150

2019

Open to Public
Inspection

Check if applicable:

Address change

Name change

Initial return

Final return/terminated

Amended return

Application pending

C Name of organization
Cumming Civitan Club Inc

Number and street (or P. O. box, if mail is not delivered to street address)PO Box 2171
Room/suite

City or town, state or province, country, and ZIP or foreign postal code Cumming, GA30028

D Employer identification number

58-1765257

E Telephone number

(770) 887-5100

F Group Exemption
Number bullet

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? Exempt purpose - Cumming Civitan Club, Inc., is a local Club of Civitan International - The worldwide mission Civitan International is to build good citizenship by providing a volunteer organization of clubs dedicated to serving individual and community needs, with an emphasis on helping people with developmental disabilities.
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 Significant activities during the year ended September 30, 2018:Scholarships totaling $4,000 to assist two local citizens to attend the University of Georgia.Contribution of $10,000 to Creative Enterprises, Inc., a 501 (c) (3) which assist adults with disabilities.Contribution of $4,000 to The Tree Project.Contribution of $3,000 to Family Promise, a 501 (c) (3) which assist families experiencing homeless.Contribution of $2,775 to Camp Big Heart, a 501 (c) (3) which provides recreational activities to children and adults with mild to moderate developmental disabilities.Contribution of $1,250 to United Way of Forsyth County - a 501 (c) (3). (Grants $ 25,025) If this amount includes foreign grants, check here ...			28a
29 (Grants $ ) If this amount includes foreign grants, check here ...			29a
30 (Grants $ ) If this amount includes foreign grants, check here ...			30a
31 Other program services (describe in Schedule O) ................ (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a)..........	32	25,025

(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
Ruth Ingram Treasurer	12.00	0
Kelli Warren President	20.00	0
Diane Gilbert President Elect	8.00	0
Rachel McClure Past President	2.00	0
Jeni Smith Vice President	1.00	0
Dianne Hansard Secretary	2.00	0
Darlene Delaney Director	1.00	0
Joy Riddle Director	1.00	0
Linda Walraven Director	1.00	0

Yes

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 .......................

Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..

49a

Did the organization make any transfers to an exempt non-charitable related organization?......

49a

If "Yes," was the related organization a section 527 organization?................

49b

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

Total number of other employees paid over $100,000 ............. bullet

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

Return Reference	Explanation
Grants and Similar Amounts Paid In Excess of $5,000.1	\| Donee's Name: Creative Enterprises Forsyth County \| Donee's Address: 410 Pilgrim Mill Road Cumming ga 30040 \| Relationship of Donee: THIRD PARTY \| Cash Amount Given: $10000
Other Expenses.1012	Insurance $93
Other Expenses.1	projects $8324
Other Expenses.2	Meeting expenses $4990
Other Expenses.3	Civitan dues $4369
Other Expenses.4	SUPPLIES $1115
Other Expenses.5	web page $359
Other Expenses.6	Memberships $110
Other Expenses.7	Post Office Box $60
Other Expenses.8	CORPORATE REGISTRATION $55

Return Reference

Explanation

Grants and Similar Amounts Paid In Excess of $5,000.1

| Donee's Name: Creative Enterprises Forsyth County | Donee's Address: 410 Pilgrim Mill Road Cumming ga 30040 | Relationship of Donee: THIRD PARTY | Cash Amount Given: $10000

Other Expenses.1012

Insurance $93

Other Expenses.1

projects $8324

Other Expenses.2

Meeting expenses $4990

Other Expenses.3

Civitan dues $4369

Other Expenses.4

SUPPLIES $1115

Other Expenses.5

web page $359

Other Expenses.6

Memberships $110

Other Expenses.7

Post Office Box $60

Other Expenses.8

CORPORATE REGISTRATION $55

1	Contributions, gifts, grants, and similar amounts received ....................	1	6,043
2	Program service revenue including government fees and contracts ................	2
3	Membership dues and assessments .............................	3	8,988
4	Investment income ....................................	4
5a	Gross amount from sale of assets other than inventory .......	5a
b	Less: cost or other basis and sales expenses ............	5b	0
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ......	5c
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 $ of contributions from fundraising events reported on line 1) (attach Schedule G if the			sum of such gross income and contributions exceeds $15,000) ..	6b	39,312
c	Less: direct expenses from gaming and fundraising events ...	6c	19,021
d	Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c)	6d	20,291
7a	Gross sales of inventory, less returns and allowances ......	7a
b	Less: cost of goods sold .............	7b	0
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .........	7c
8	Other revenue (describe in Schedule O) ....................	8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 ..............	9	35,322

10	Grants and similar amounts paid (list in Schedule O) ................	10	25,025
11	Benefits paid to or for members ......................	11
12	Salaries, other compensation, and employee benefits ................	12
13	Professional fees and other payments to independent contractors ............	13	1,200
14	Occupancy, rent, utilities, and maintenance ...................	14
15	Printing, publications, postage, and shipping ...................	15
16	Other expenses (describe in Schedule O) ...................	16	19,475
17	Total expenses. Add lines 10 through 16 .................	17	45,700

Sign Here

	Signature of officer	Date

	Type or print name and title

Software ID:	17005038
Software Version:	2017v2.2

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

18	Excess or (deficit) for the year (Subtract line 17 from line 9) ............	18	-10,378
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	24,975
20	Other changes in net assets or fund balances (explain in Schedule O) ...........	20
21	Net assets or fund balances at end of year. Combine lines 18 through 20 ..........	21	14,597

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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