Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE | DESCRIPTION: INTEREST. AMOUNT: 47. DESCRIPTION: CLUB FELLOWSHIP. AMOUNT: 363. TOTAL TO FORM 990-EZ, LINE 8: 410. |
| FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES | AFFILIATE NAME: ROTARY INTERNATIONAL. AFFILIATE ADDRESS: PO BOX 71394 CHICAGO, IL 60694-1394. PURPOSE OF PAYMENT: DUES. AMOUNT OF PAYMENT: 4,889. |
| FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES | AFFILIATE NAME: ROTARY DISTRICT 6690. AFFILIATE ADDRESS: PO BOX 387 HILLARD, OH 43026. PURPOSE OF PAYMENT: DUES. AMOUNT OF PAYMENT: 1,830. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 6,719. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: D4D DONATION. GRANTEE NAME: CHILLICOTHE JAYCEES SPECIAL SANTA. GRANTEE ADDRESS: PO BOX 6186 CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/07/18. AMOUNT GIVEN: 304. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DRAFTS FOR DOLLARS (D4D). GRANTEE NAME: THE BUCK FIFTY. GRANTEE ADDRESS: PO BOX 764 CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/25/19. AMOUNT GIVEN: 800. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: GRANT FOR BUDGET. GRANTEE NAME: FIRST CAPITAL ROTARY FOUNDATION. GRANTEE ADDRESS: PO BOX 188 CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: FOUNDATION FOR CLUB. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/06/18. AMOUNT GIVEN: 15,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: POLIO PLUS. GRANTEE NAME: ROTARY FOUNDATION. GRANTEE ADDRESS: 14280 COLLECTIONS CENTER DR CHICAGO, IL 60693. GRANTEE RELATIONSHIP: FOUNDATION FOR ROTARY INTERNATIONAL. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/06/18. AMOUNT GIVEN: 500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: LIGHT THE PARK DONATION. GRANTEE NAME: FIRST CAPITAL DISTRICT. GRANTEE ADDRESS: 115 W MAIN ST CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/06/18. AMOUNT GIVEN: 300. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: SPONSORSHIP. GRANTEE NAME: THE BUCK FIFTY. GRANTEE ADDRESS: PO BOX 764 CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 01/19/19. AMOUNT GIVEN: 4,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: D4D DONATION. GRANTEE NAME: THE BUCK FIFTY. GRANTEE ADDRESS: PO BOX 764 CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: DOOR PRIZE. DATE OF GIFT: 02/26/19. AMOUNT GIVEN: 120. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: BLANKETS FOR HOMELESS STUDENTS. GRANTEE NAME: PICKAWAY ROSS JVS. GRANTEE ADDRESS: 895 CROUSE CHAPEL RD CHILLICOTHE, OH 45601. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: BLANKETS. DATE OF GIFT: 12/05/18. AMOUNT GIVEN: 970. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: BLANKETS. GRANTEE NAME: MY VERY OWN BLANKET. GRANTEE ADDRESS: 407 W MAIN ST WESTERVILLE, OH 43081. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/07/19. AMOUNT GIVEN: 100. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 22,094. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: CLUB MEETING & CONFERENCE EXPENSES. AMOUNT: 9,636. DESCRIPTION: MISCELLANEOUS. AMOUNT: 134. DESCRIPTION: CLUB SERVICE PROJECTS. AMOUNT: 798. DESCRIPTION: DUES - MISCELLANEOUS. AMOUNT: 200. TOTAL TO FORM 990-EZ, LINE 16: 10,768. |
| Software ID: | |
| Software Version: |