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 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST INCOME. AMOUNT: 226. DESCRIPTION: DIVIDEND INCOME. AMOUNT: 526. DESCRIPTION: GAIN ON SOLD ASSETS. AMOUNT: 1,282. TOTAL INCLUDED ON FORM 990-EZ, LINE 4: 2,034. TOTAL TO FORM 990-EZ, LINE 14: 7,172. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: LODGE SENIOR SCHOLARSHIP. GRANTEE NAME: R.BELL. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBERSHIP AWARDS. GRANTEE NAME: R.HELWIG. AMOUNT GIVEN: 550. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBERSHIP AWARDS. GRANTEE NAME: E.JOHNSON. AMOUNT GIVEN: 50. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: ALZHEIMERS ASSOCIATION OF CT. AMOUNT GIVEN: 550. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: COOLEY'S ANEMIA. AMOUNT GIVEN: 100. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: AUTISM. AMOUNT GIVEN: 100. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: MAKE A WISH FOUNDATION. AMOUNT GIVEN: 200. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: EPILEPSY FOUNDATION. AMOUNT GIVEN: 1,120. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: CH 3 KIDS CAMP DISCOVERY. AMOUNT GIVEN: 1,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEMBER DONATIONS. GRANTEE NAME: AMERICAN DIABETES ASSOCIATION. AMOUNT GIVEN: 200. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 4,870. |
| FORM 990-EZ, PART I, LINE 14 | DESCRIPTION: DEPRECIATION. AMOUNT: 1,172. DESCRIPTION: OTHER EXPENSES. AMOUNT: 6,000. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: MEETINGS & CONFERENCES. AMOUNT: 6,397. DESCRIPTION: MEMBER ACTIVITIES. AMOUNT: 2,687. DESCRIPTION: INSURANCE. AMOUNT: 2,483. DESCRIPTION: SUPPLIES. AMOUNT: 1,003. DESCRIPTION: PER CAPITA DUES. AMOUNT: 5,627. DESCRIPTION: BANK CHARGES. AMOUNT: 9. DESCRIPTION: OFFICE EXPENSE. AMOUNT: 815. DESCRIPTION: PROMOTION. AMOUNT: 755. TOTAL TO FORM 990-EZ, LINE 16: 19,776. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: SECURITY DEPOSITS. BEG. OF YEAR AMOUNT: 4,200. END OF YEAR AMOUNT: 4,200. DESCRIPTION: ORGANIZATIONAL COSTS. BEG. OF YEAR AMOUNT: 270. END OF YEAR AMOUNT: 270. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 1,505. END OF YEAR AMOUNT: 471. |
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