Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 41,334 | 6,780 | 48,114 |
| 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 | ||||||
| 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 | 0 | 0 | 0 | 41,334 | 6,780 | 48,114 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | 48,114 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 0 | 0 | 41,334 | 6,780 | 48,114 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | 0 | 0 | 99 | 0 | 99 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 0 | 0 | 0 | 99 | 0 | 99 |
| 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.) .. | 0 | 0 | 0 | 22,446 | 0 | 22,446 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 0 | 0 | 0 | 63,879 | 6,780 | 70,659 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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 | ||||
| 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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Part I, line 10 | | Activity:, Grantee Name:, Grantee Address:, Amount:, Relationship:| Scholarships for High School Seniors, GA Southern University, "Georgia Southern University Cashiers Office PO Box 8155 Statesboro GA 30460", $2000.00, None| High School Scholarships, University North Georgia, "University of North Georgia Financial Aid Office 82 College Circle Dahlonega, GA 30597", $2000.00, None| High School Scholarships, University of Virginia, "University of Virginia Student Financial Services 1001 North Emmet St P.O. Box 400204 Charlottesville, VA 222904-4204", $2000.00, None| High School Scholarship, University of Georgia, "The Office of Student Financial Aid University of Georgia 220 Holmes/Hunter Academic Building Athens, Georgia 30602", $2000.00, None| Hugh Brian Youth Scholarship3 students Dunwoody, Chamblee and North Springs High Schools, HOBY, "Ms. Renee Ratcliff 325 Grovehurst Court Newnan GA 30263", $1050.00, None| High School Scholarship, Tallulah Falls School, "P. O. Box 10 Tallulah Falls, GA 30573", $400.00, None| Non Traditional Students, Georgia State University, "Perimeter Campus Dunwoody Georgia 30338", $1000.00, None| Arts Music Education Programs, Austin Elementary, "5435 Roberts Drive Dunwoody, GA 30338", $250.00, None| Arts Music Education programs, Chesnut Elementary School, "4576 N Peachtree Rd Dunwoody GA 30338", $250.00, None| Arts Music and Education Conservation Programs, Coralwood School, "2477 Coralwood Decatur, GA 30033", $250.00, None| Arts Music Education and Conservation Programs, Dunwoody Elementary School, "1923 Womack Road Dunwoody, GA 30338", $250.00, None| Music Arts Education and Conservation Programs, Dunwoody High School, "5035 Vermack Rd Dunwoody GA 30338", $250.00, None| Music Arts Education and conservation Home Life Programs, Hightower Elementary School, "4236 Tilly Mill Road Doraville GA 30360", $2000.00, None| Music Arts Education and Conservation Programs, Kingsley School, "2051 Brendon Drive Dunwoody GA 30338", $250.00, None| Music Arts Education and Conservation Programs, Peachtree Charter Middle School, "4664 N Peachtree Rd. Dunwoody GA 30338", $250.00, None| Music Arts Education and Conservation Programs, Vanderlyn Elementary School, "1877 Vanderlyn Drive Dunwoody GA 30338", $250.00, None| Arts Music Education and Conservation Programs, Woodland Elementary School, "1130 Spalding Drive Atlanta GA 30350", $250.00, None| donation for Arts programs, Stage Door Players, "5339 Chamblee Dunwoody Rd Dunwoody GA 30338", $600.00, None| Arts Education Conservation programs, Dunwoody Nature Center, "5345 Roberts Dr Dunwoody, GA 30338", $1300.00, None| Arts programs, Moving in the Spirit Dance, "PO Box 17626 Atlanta Ga 30316", $150.00, None| Arts Education Programs, spruill Center for the Arts, "5339 Chamblee Dunwoody Rd Dunwoody GA 30338", $2500.00, None| Conservation Programs, Audubon Society, "4055 Roswell Rd, Atlanta, GA 30342", $100.00, None| Arts Music Education Home Life and Conservation Programs, Interfaith Outreach Home, "P.O.Box 48075 Doraville, GA 30062", $1500.00, None| Arts Music Education programs, Dekalb County Libraries, "395 Mount Vernon Rd Sandy Springs GA 30350", $400.00, None| Home Life Program, Adult Day of Dunwoody, "1 Dunwoody Park 123, Dunwoody, GA 30338", $100.00, None| Home Life Program, Alzheimer's Association, "1925 Century Boulevard Northeast Atlanta, Ga 30345", $200.00, None| Home Life programs, American Diabetes- Camp scholarshi, "17 Executive Park Dr N. E. Ste. 115, Atlanta, GA 30329", $200.00, None| Camp Scholarships, Camp Sunshine, "1850 Clairmaont Road Decatur, Gta 30033", $1800.00, None| Home Life Program, Lekotek of Georgia, Inc, "1955 Cliff Valley Way, Ste. 102, Atlanta, GA 30329", $300.00, None| Home Life Program, Link Counseling Center, "348 Mt. Vernon Highway, N E. Atlanta, GA 30328-4139", $200.00, None| Home Life Program, Lutheran Towers - Items for gift b, "727 Juniper St NE #512, Atlanta, GA 30308", $150.00, None| Home Life Program, Malachi's Storehouse, "4755 N Peachtree Rd, Atlanta, GA 30338", $200.00, None| Home Life Program, Mountain View Nursing Home, "3675 Kensington Rd., Decatur, GA 30032", $200.00, None| Home Life program, National Osteoporosis Foundation, "251 18th Street S, Suite 630 Arlington, VA 22202", $200.00, None| Home Life Program, Northside Hospital Auxiliary, "1000Johnson-Ferry Rd NE Atlanta, GA 30342", $200.00, None| Home Life Program, Ronald McDonald House, "795 Gatewood Rd NE Atlanta GA 30329", $2000.00, None| Home Life Program, Special Olympics, "4000 DeKalb Technology Parkway Atlanta, GA 30340", $800.00, None| Home Life Program, St. Jude's Children's Hospital, "200262 Danny Thomas Place Memphis, TN 38105", $200.00, None| Home Life Program, St. Luke's Presbyterian Church - F, "1978 Mt. Vernon Road, Dunwoody, Ga 30338", $1000.00, None| Internation Outreach, AMIS, Inc. - Atlanta Ministry with, "3434 Roswell Road, N. W. Atlanta, GA 30305", $100.00, None| Internation Outreach, Beads for Life, "2336 Canyon Blvd. Ste. 202 Boulder, CO 80302", $100.00, None| International Outreach, Bright Point for Children, "2872 Johnson Ferry Road, Suite 250 Marietta, GA 30062", $2000.00, None| International Outreach, CARE International, "151 Ellis Street NE, Atlanta, GA 30303", $100.00, None| International Outreach, CURE International, "P.O. Box 207, New cumberland PA 17070", $100.00, None| International Outreach, Doctors without Borders, "333 7th Avenue, 2nd Floor New York, Ny 10001", $100.00, None| International Outreach, Friends of Refugees, "3895 Church St., Calrkston, GA 30021", $1300.00, None| International Outreach, International Rescue Committee, "2305 Parklake Drive, N. E. #100 Atlanta, GA 30345", $300.00, None| International Outreach, InMed Partnership for Children, "20110 Ashbrook Place, Suite 260 Ashburn, VA 20147", $100.00, None| International Outreach, Operation Smile, "6435 Tidewater Drive Norfolk GA", $1100.00, None| International Outreach, Save the Children, "54 Wilton Road, Westport, CT 06880", $200.00, None| International Outreach, Shot @ Life, "1750 Pennsylvania Ave, Washington DC 20006", $200.00, None| |
| Part I, line 16 | | Other Expenses:, Amount:| magazine subscriptions, $24.00| Luncheon Guest and Decorations, $200.00| Registration fees for convention and institute, $955.00| Speaker Gifts, $266.00| Post Office Box Rental, $140.00| District Meeting Expenses, $975.00| Refunds, $50.00| Memberships in Conservation Organizations, $1200.00| Conservation - National Parks Memberships, $185.00| Tallulah Falls Schools - donations for students and facilities, $5000.00| Awards and gifts, $130.00| Corporate Renewal - Georgia, $30.00| Student Art and Poetry Awards, $200.00| Memorials for members deceased during 2018, $1200.00| Disaster Relief projects, $1000.00| Women's History and Resource Center, $300.00| |
| Software ID: | |
| Software Version: |